Acute stress disorder pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2] Yashasvi Aryaputra[3]


The exact pathogenesis of acute stress disorder is not fully understood. It is thought that acute stress disorder is caused by either sympathetic nervous system, both directly and indirectly through the release of adrenaline and to a lesser extent noradrenaline from the medulla of the adrenal glands, or hypothalamic-pituitary-adrenal axis.


  • When triggered by a stimuli, the body has a natural "fight-or-flight" response
  • In response to such stimuli, the body can release either adrenaline or noradrenaline, which result in physiological responses such as increased heart rate, constricted blood vessels, and increased breathing
  • The locus ceruleus "fires" neurons in a very minimal manner when an individual is in a calm state
  • The locus ceruleus "fires" neurons at a much faster and more intense rate if a stimulus seems threatening
  • The "fight-or-flight" response we feel is a result of our sympathetic nervous system, which raises our pulse and causes anxiety
  • Another response, called the "rest-and-digest" response, is a result of the parasympathetic nervous system, which reduces heart rate, and can potentially cause loss of consciousness
  • The parasympathetic nervous system increases digestion by stimulating the digestive system and urinary system[1]


  1. Isaac, Jeff (2012). Wilderness and rescue medicine. Burlington, MA: Jones & Bartlett Learning. ISBN 978-0-7637-8920-6.