Understanding Stress Disorders

Symptoms, Causes and How we Can Help

Stress disorders occur when an event or series of events exceeds the coping capacities of an  individual. Stress disorders include acute stress response, adjustment disorder, post-traumatic stress disorder (PTSD) and complex trauma disorder.

Stress disorders often cause a physical state of crisis

Symptoms may develop on the following levels:

Physiological symptoms such as racing heart, sweating, hot flushes

Cognitive symptoms such as memory, concentration and attention difficulties

Changes in emotions such as anger, aggression, fear and hopelessness

Emotional symptoms such as difficulties regulating anger, frustration, tolerance or acceptance

Behavioural changes

Stress Disorders at a Glance

Acute stress response
This is a temporary disturbed reaction that follows an extraordinary crisis situation within one hour, e.g. an accident, confrontation with physical or mental violence or the unexpected loss of a loved one. A disturbed reaction can manifest itself in a kind of “anesthesia“, a constriction of consciousness, a limited attention, disorientation or the inability to process the stimuli. The symptoms usually subside after a few hours or days. If the symptoms persist, post-traumatic stress disorder (PTSD) may develop. In the case of PTSD, a psycho-therapeutic or psychiatric practice should be consulted.

Adjustment disorder
Can occur after a drastic life change or after a stressful life event, if the adjustment reaction to the new event is disturbed. Typical events can be divorce, birth of a child, marriage, job loss, retirement, achieving a long-awaited goal, loss of a loved one, escape, culture shock and emigration. Changes in experience and behaviour can therefore be traced back to these clearly defined triggers. Typical symptoms of the adjustment disorder are a subjective feeling of distress, social withdrawal and changed social behaviour, feeling of emptiness, joylessness, fear, worries, sadness, depressive mood, which can also lead to an inability to work in the short term.
Usually the adjustment to the new life situations takes place after a few weeks or months and the symptoms disappear. However, if the symptoms persist for more than half a year, the adjustment disorder can turn into a depressive episode which, depending on its severity and duration, may require treatment. Despite its short-term character, a psychotherapeutic practice can be visited in the case of an adjustment disorder in order to work on dealing with and adjusting to the new life event within the framework of short-term therapy.

Post-traumatic stress disorder (PTSD)
PTSD is always preceded by one or more events of exceptionally threatening proportions, involving a direct threat to one’s own body or life or to another person. The event is so catastrophic that it would cause deep despair in most people. Some examples of these types of events are a serious traffic accident, fire disaster, violent assault or assault, rape, hostage-taking, terrorist attack, finding a corpse. The development of PTSD does not necessarily have to occur immediately after the event, but often occurs weeks or months later; it is rather a delayed response to the stressful event. Often, the people affected re-experience the event in the form of intrusions such as flashback (sudden, real memories), which can lead to massive fear and anxiety. Other symptoms include increased alarmism, hypervigilance (increased attention), sleep disturbances, especially nightmares about the event, emotional anesthesia, inner emptiness, social withdrawal, joylessness, avoidance of certain places or situations reminiscent of the event. PTSD is treated as part of psychotherapy. There are special trauma therapies such as EMDR (Eye Movement Desensitization and Reprocessing), narrative trauma therapy or cognitive behavioral therapies that work with imaginative procedures such as imaginary re-scripting.

Complex trauma disorder
Complex post-traumatic stress disorder (complex PTSD) has not yet been included as a diagnostic category in the catalogue of classification systems for mental disorders. In future, however, it will also be possible to diagnose complex PTSD and map it appropriately. In contrast to PTSD, complex PTSD is characterised by repeated or prolonged severe trauma, for example in the form of years of physical, emotional or sexual abuse and extreme neglect in childhood, imprisonment and torture, repeated violence, war and flight. In the course of time, chronic trauma can lead to changes in the nature of the person affected, in addition to the typical symptoms of PTSD. This can manifest itself in the following symptoms: Disturbances in affect regulation, especially in dealing with anger and rage, self-damaging behaviour, suicidal behaviour, disturbances of consciousness such as dissociations, memory loss and concentration disorders, social withdrawal, isolation, problems trusting others, avoidance of relationships due to the danger of revictimization by others, development of various physical complaints, sleep disorders, predominant feelings of guilt, shame, hopelessness and despair. Complex PTSD should be treated as part of long-term psychotherapy with an experienced psychological psychotherapist, psychosomatist or psychiatrist.

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