The Difference Between Acute and Chronic Trauma

Trauma is defined as an emotional response to a terrible event. This emotional response may include denial, shock, anger, and fear. Acute and chronic trauma can be differentiated based on the type of event experienced.

This article explores acute trauma, chronic trauma, and the similarities and differences between the two.

Woman sitting on ground leaning against couch looking upset and staring into distance

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The Trauma Spectrum

People's response to trauma exists on a spectrum. Not everyone who experiences the same traumatic event will have the same response. Some people may go on to be diagnosed with post-traumatic stress disorder (PTSD), while others may be affected but for shorter periods of time or at a clinically undiagnosable level.

Acute and chronic trauma are categorized according to the type of event a person experienced. For example, an isolated incident such as a car accident is considered acute trauma, but continuing events such as domestic abuse can be considered chronic trauma.

Acute Trauma

Acute trauma refers to trauma brought on by a single, isolated event. There has been less research on single-incident trauma than chronic trauma, despite evidence that single-incident trauma still leads to significant, complex symptoms and even PTSD in some cases.

Studies on mass shootings, a type of acute trauma, have identified risk factors for adverse psychological effects. These risk factors include being female, having close proximity to the event, experiencing greater psychological symptoms before the incident, and lacking psychological and social support resources.

Causes

Examples of acute traumatic events include:

  • Physical assault
  • Sexual assault or rape
  • Natural disasters (including hurricane, flood, wildfire, or earthquake)
  • Mass shootings
  • Terrorist attacks
  • Car crashes
  • Major injuries

Chronic Trauma

Chronic trauma refers to repeated, prolonged traumatic events. There is a large body of research on chronic trauma and its adverse health effects.

Studies show that children exposed to chronic trauma have a higher risk of mental health disorders, poor academic achievement, and becoming a juvenile offender. Mothers exposed to chronic war-related trauma have changes in their brain associated with showing empathy, possibly having implications for generational trauma.

Causes

Examples of chronically traumatic situations include:

  • Domestic abuse
  • Witnessing abuse of a parent or household member
  • War or combat
  • Community violence
  • Chronic illness, including frequent invasive medical procedures
  • Neglect, starvation, or deprivation
  • Homelessness

Symptoms of Trauma

Response to trauma is extremely varied among individuals. Most people exposed to trauma, acute or chronic, do not go on to be diagnosed with a mental health condition like PTSD.

However, they may have an understandable emotional or physical response to the traumatic event(s), leading to a variety of symptoms. These symptoms may be experienced immediately after the traumatic event, or the response may be delayed by a period of weeks or months.

Emotional Symptoms

Emotional symptoms of acute or chronic trauma can include:

  • Shock
  • Denial
  • Sadness
  • Anxiety and fear
  • Depression
  • Anger
  • Avoidance of emotions
  • Agitation
  • Numbness or dissociation
  • Difficulty concentrating
  • Intrusive memories or flashbacks
  • Difficulty regulating emotions
  • Loss of hope
  • Feeling of foreshortened future

Physical Symptoms

Physical symptoms of acute and chronic trauma can include:

  • Headaches
  • Nausea
  • Exhaustion
  • Jumpiness or being easily startled
  • Sweating
  • Difficulty sleeping, including nightmares
  • Frequent crying
  • Gastrointestinal issues and stomach pain
  • Shortness of breath
  • Racing heart rate

Trauma Symptoms in Children and Teens

It's important to be aware that young people may respond differently to trauma than adults. Some symptoms of trauma in children and teens to be aware of include:

  • Tantrums
  • Clinging to parents and/or caregivers
  • Acting out parts of the traumatic event during playtime
  • Return to thumb-sucking or bed-wetting
  • Nightmares and sleep issues
  • Developing unusual fears
  • Issues in school
  • Losing interest in previously enjoyed activities
  • Use of illicit drugs or alcohol

PTSD vs. Trauma

Only 3% of adults experience PTSD at any one time. It is difficult to predict who will develop PTSD and who will not. The number of repeated traumatic events a person experiences contributes to PTSD.

Treatment

The initial response to trauma should be finding a safe environment where the person's essential physical and emotional needs can be met. This might include relocating to a domestic violence shelter, moving into subsidized housing, or obtaining a restraining order.

Once the person's basic needs are met and they are safe, they might benefit from treatment with a trained mental health professional who takes a trauma-informed approach.

Methods of therapy treatment include:

Eye movement desensitization and reprocessing (EMDR), brief eclectic psychotherapy, and narrative therapy have less evidence to support them but are also used.

Medication may be prescribed on an individual basis, particularly if there are any co-occurring mental health conditions.

There are also some recommended lifestyle changes to help cope with trauma. Some methods to help cope in the aftermath of acute or chronic trauma include:

  • Avoiding alcohol or substances
  • Maintaining your regular routine as much as possible
  • Keeping a normal bedtime and sleep routine
  • Eating nutritious meals on a regular schedule
  • Spending time with supportive loved ones
  • Journaling or writing

When to Talk to a Therapist

According to the American Psychological Association, if your symptoms are prolonged, interfering with your daily life, or if you are having difficulty moving on with your life, then it may be time to talk to a psychologist or mental health professional. They can help you process your trauma and learn new ways of coping and managing your emotions.

Summary

Trauma is an emotional response to a horrible event. It may lead to anger, denial, numbness, fear, and even physical symptoms. Acute trauma refers to trauma brought on by a single incident, whereas chronic trauma refers to trauma brought on by multiple or prolonged incidents. The response to these incidents is highly individual. Symptoms may occur immediately or after a delay, and treatment will differ based on a person's individual needs and response.

A Word From Verywell

People are incredibly resilient, and the majority of people who experience acute or chronic trauma do not go on to develop PTSD. Still, even limited symptoms can be incredibly distressing and interfere with your daily life.

No matter your level of symptoms, or the type of traumatic event you endured, your experience is valid. Talk to your healthcare provider, mental health professional, or a supportive loved one about finding a safe living environment, if needed, and seek appropriate treatment through therapy or other methods.

Frequently Asked Questions

  • How does trauma affect the brain?

    Trauma's effects on the brain are complex and not fully understood. However, it is known that various biological changes can occur after a traumatic event, which affect the body's stress response and are associated with PTSD and other mental health conditions. Changes can be to limbic system functioning (behavioral and emotional responses), dysregulation of neurotransmitters that affect arousal, and hypothalamic–pituitary–adrenal axis (HPA) changes impacting cortisol (stress hormone).

  • What is complex trauma?

    Complex trauma is exposure to multiple traumatic events, often of an invasive and interpersonal nature, such as abuse or profound neglect during childhood. This trauma can lead to wide-ranging and long-term effects.

  • What’s the difference between acute, chronic, and complex trauma?

    Acute trauma is a single traumatic event, such as a car crash. Chronic trauma is prolonged or repeated traumatic incidents, such as combat or domestic abuse. Complex trauma is a combination of both acute and chronic trauma, often occurring in childhood, that disrupts many aspects of development and one's sense of self.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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