Acute Stress Disorder

 

Acute stress disorder is a psychological response to a deeply traumatic event. It usually occurs soon following the event, and can last anywhere between several days and for up to four weeks.

 

Causes

As its name suggest, acute stress disorder is the result of a traumatizing situation, where the patient has experienced extreme stress, alarm, pain and/or serious injury.

 

Disease pathway

During the period in which the patient is affected by acute stress disorder, they will experience a series of spontaneous, intrusive recollections, wherein they will relive the traumatic event.

 

Symptoms and diagnosis

The symptoms of acute stress disorder arise from the body’s response to a feeling of intense helplessness. Generally, the condition is diagnosed if an individual presents with three or more of the following symptoms:

·         Aloofness, or emotional detachment;

·         Decreased responsiveness to surroundings;

·         Avoidance of objects, people, etc., that evoke memories of the event;

·         Feelings that they, or others, are not real; and

·         Memory loss (amnesia), particularly of the event.

 

Treatment

Most patients will recover from acute stress disorder without the need for medical intervention.

A number of factors are of considerable benefit to patients’ recovery from acute stress disorder, including:

·         Removal from the traumatic situation;

·         Appropriate expressions or demonstrations of empathy and understanding from others; and

·         The opportunity to relay the traumatic events, and their subsequent reaction.

 

 

 

Efficacy of Alternative and Other Treatments According to GRADE* Ranking:

Pine Bark Extract [1, 23, 24, 25]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: no recommendation (There is insufficient evidence to support claims that Pine Bark extract helps to treat stress)

Grade of Evidence: very low quality of evidence

Cannabis (Marijuana, weed, hemp) [1, 14, 15, 16, 17, 18, 19, 20, 21, 22]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: Weakly in favor (Evidence shows that smoking or ingesting cannabis may help in relieving symptoms of stress, although some studies have yielded mixed results)

Grade of Evidence: low quality of evidence

Kava (Piper Methysticum) [1, 10, 11, 12, 13]:

WARNING: In rare cases, kava may lead to liver failure and other life threatening problems. The FDA warns that those who have had liver problems, or are on medicacations which may affect the liver, patients should check with their doctors before taking Kava. Other side effects include headache, upset stomach, drowsiness, weight loss, bloody urine, and muscle weakness.

Recommendation: No recommendation (Early studies indicate that Kava may be helpful in reducing the symptoms of stress. However, subsequent studies have yielded contradictory results. More research is needed.)

Grade of Evidence: Very low quality of evidence

Ginseng [1, 6, 7, 8, 9]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: no recommendation  (There is insufficient evidence to support claims that ginseng helps to treat stress)

Grade of Evidence: low quality of evidence

Flower Remedies [1, 4, 5]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: no recommendation  (There is insufficient evidence to support claims that flower remedies help to treat stress)

Grade of Evidence: very low quality of evidence

Chamomile (Matricaria Chamomilla) [1, 2, 3]:

Please note, this management does NOT treat the condition itself. It is proposed only as a weak supportive symptomatic support, and even then, has insufficient evidence to back up this claim at present.

Recommendation: weakly against (Available evidence does not support claims that Chamomile helps treat stress disorder. In addition, allergic reactions and side effects like cramps, itching, rashes and difficulty breathing can be relatively common)

Grade of Evidence: low quality of evidence

Reiki:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: no recommendation (There is insufficient evidence to show that Reiki helps with stress disorder)

Grade of Evidence: very low quality of evidence

Reflexology:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: no recommendation (available evidence does not support claims that reflexology can help treat acute stress disorder)

Grade of Evidence: low quality of evidence

Polarity Therapy:

Please note, this management does NOT treat the condition itself. It may mildly  help with the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: no recommendation (There is insufficient evidence to show that Polarity Therapy helps with stress disorder)

Grade of Evidence: very low quality of evidence

Massage:

Recommendation: strongly in favor (clinical evidence suggests that Massage may be effective in helping to treat stress disorder)

Grade of Evidence: moderate quality of evidence

Magnetic Therapy:

Recommendation: no recommendation (There is insufficient evidence to show that Music Therapy helps with stress disorder)

Grade of Evidence: very low quality of evidence

Hydrotherapy:

Recommendation: weakly in favor (available evidence supports claims that hydrotherapy can help to treat acute stress disorder, but more research is needed)

Grade of Evidence: low quality of evidence

Yoga:

Recommendation: strongly in favor (clinical evidence suggests that yoga may be effective in helping to treat stress disorder)

Grade of Evidence: moderate quality of evidence

Tai Chi:

Recommendation: weakly in favor (available evidence suggests that Tai Chi may be effective in treating with stress disorder)

Grade of Evidence: low quality of evidence

Shamanism:

Recommendation: no recommendation (There is insufficient evidence to show that Shamanism helps with stress disorder)

Grade of Evidence: very low quality of evidence

Qigong:

Recommendation: weakly in favor (early trials suggest that Qigong may help patients better cope with stress)

Grade of Evidence: low quality of evidence

Aromatherapy:

Recommendation: weakly in favor (early trials suggest that Aromatherapy can help patients better cope with stress)

Grade of Evidence: low quality of evidence

Creative Art Therapy (Expressive Therapy):

Recomendation: weakly in favor (Expressive Art therapy may potentially help to deal with stress, but more research needs to be done)

Grade of Evidence: low quality of evidence

Biofeedback:

Recommendation: no recommendation (There is insufficient evidence to show that biofeedback helps with stress disorder)

Grade of Evidence: very low quality of evidence

Breathing Exercises (Breathwork):

Recommendation: no recommendation (There is insufficient evidence to show that Breathwork helps with stress disorder)

Grade of Evidence: very low quality of evidence

Curanderismo:

Recommendation: no recommendation (There is insufficient evidence to show that Curanderismo helps with stress disorder)

Grade of Evidence: very low quality of evidence

Humor Therapy:

Recommendation: weakly in favor (initial findings suggest that humor therapy may help to relieve stress, but more studies are needed to clarify these effects)

Grade of Evidence: low quality of evidence

Hypnosis:

Recommendation: weakly in favor (Many reports suggest that hypnosis can help to reduce stress)

Grade of Evidence: low quality of evidence

Image Therapy:

Recommendation: weakly in favor (A review of many studies done suggest that image therapy may help in managing stress)

Grade of Evidence: low quality of evidence

* www.gradeworkinggroup.org

 

Summary References

Treatments:

1. Ades T, Alteri R, Gansler T, Yeargin P, "Complete Guide to Complimentary & Alternative Cancer Therapies", American Cancer Society, Atlanta USA, 2009

2. http://www.abchomeopathy.com/r.php/Cham

3. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-chamomile.html

4. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/flower-remedies

5. http://www.ncbi.nlm.nih.gov/pubmed/12635462

6. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-ginseng.html

7. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/ginseng

8. Invalid

9. Invalid

10. http://www.publish.csiro.au/?act=view_file&file_id=SP05005.pdf

11. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/kava

12. http://www.kavazen.com/pages/library.htm#KavaZen and Kava Safety

13. http://nccam.nih.gov/health/kava/index.htm

14. http://www.nlm.nih.gov/medlineplus/marijuana.html

15. http://nccam.nih.gov/research/extramural/awards/2004/

16. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/marijuana

17. http://www.nationalmssociety.org/about-multiple-sclerosis/what-we-know-about-ms/treatments/complementary--alternative-medicine/marijuana/index.aspx

18. http://www.ncbi.nlm.nih.gov/pubmed/16957511

19. http://www.ncbi.nlm.nih.gov/pubmed/12965981

20. http://www.ncbi.nlm.nih.gov/pubmed/17589370

21. http://mct.aacrjournals.org/content/6/11/2921.long

22. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2562334/?tool=pmcentrez 

23. http://www.clinicaltrials.gov/ct/show/NCT00214032

24. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/pine-bark-extract

25. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-pycnogenol.html