What exactly is PTSD and how does car accidents lead to PTSD?
Post-traumatic stress disorder (PTSD) is an anxiety disorder stemming from a traumatic incident, such as a car accident, which causes symptoms that impact daily life.
Physical injuries are often the focus of recovery efforts in the aftermath of car accidents, while the mental impact is largely ignored. PTSD is commonly associated with military combat veterans. Most people aren’t aware that the emotional trauma from car accidents can lead to post-traumatic stress disorder. In fact, car accidents are the leading cause of PTSD in the general population.
This debilitating mental injury often goes untreated because many car accident victims are unaware that they have post-traumatic stress disorder. One study showed that nearly half of all car accident victims experience PTSD. In the United States, 4.4 million people sustain injuries in car accidents serious enough to warrant hospitalization. This means as many as two million Americans experience PTSD from car accidents.
More effort should be made to treat the psychological impacts of car accidents.
SYMPTOMS OF PTSD AFTER A MOTOR VEHICLE ACCIDENT
PTSD is indicated when symptoms that fit into the four categories listed below last longer than a month and interfere with daily functioning.
1. Intrusive Thoughts
Intrusive thoughts include involuntary memories and reliving of the accident. This can occur in one or more forms:
Flashbacks, often so vivid it may feel as though victims are re-experiencing the accident
Nightmares about the accident
Involuntary thoughts and memories of the accident
2. Avoidance of Reminders
Anxiety and horror surrounding the accident often leads to a compulsion to avoid the people, places, and situations associated with it. Common examples include:
Unwillingness to drive or ride in vehicles
Avoidance of the location of the accident or photos taken at or near the location
Withdrawal from people who trigger memories of the accident, including first responders and others who were present
Refusal to talk or think about the accident
3. Changes in Thinking Patterns and Mood
PTSD can cause personality changes, changes in thought patterns, and changes in cognitive abilities. Several examples are listed below, but this is not an exhaustive list:
Inability to remember the accident
Self-loathing
Paranoia
Negative views of the world
Inability to trust others
Misplaced guilt about the accident
Loss of interest in work, school, or other activities
Loss of ability to experience happy emotions
Strong feelings of guilt, shame, and ongoing fear
4. Changes in Arousal and Reactivity
PTSD sufferers often experience changes in energy levels, waking and sleeping patterns, and in how they react to situations that did not affect them before. Examples of these changes include:
Tendency to startle easily, jumpiness
Panic attacks
Angry outbursts
Paranoia
Recklessness
Self-destructive behavior
Difficulty concentrating
Insomnia or other sleep disorders
SIGNS OF PTSD IN CHILDREN AFTER A CAR CRASH
PTSD can be difficult to recognize in children because it often presents differently. Children have not yet developed coping skills necessary to process trauma and may be unable to understand or verbalize their thoughts and emotions. Children who exhibit any of the following symptoms should be evaluated by a professional who has experience with pediatric PTSD:
Changes in affection shown to others
Loss of interest in usual activities
Detachment or isolation
Excessive clinginess
Aggressive or violent behavior
Changes in responsiveness to others
Thumb-sucking
Bathroom accidents
Desire to sleep with parents again
Inability to speak
Regression (a return to activities previously outgrown)
Flashbacks
Involuntary memories
Repeatedly reliving the trauma through talk, play, or drawing
Traumatic re-enactment
Fear of sleep
Nightmares
Bedwetting
Insomnia (trouble going to sleep or staying asleep)
Sleep disturbances
Stomachaches
Headaches
Loss of appetite
Physical symptoms
Changes in affection shown to others
Loss of interest in usual activities
Detachment or isolation
Excessive clinginess
Aggressive or violent behavior
Changes in responsiveness to others
Thumb-sucking
Bathroom accidents
Desire to sleep with parents again
Inability to speak
Regression (a return to activities previously outgrown)
Flashbacks
Involuntary memories
Repeatedly reliving the trauma through talk, play, or drawing
Traumatic re-enactment
Fear of sleep
Nightmares
Bedwetting
Insomnia (trouble going to sleep or staying asleep)
Sleep disturbances
Stomachaches
Headaches
Loss of appetite
Physical symptoms
Changes in affection shown to others
Loss of interest in usual activities
Detachment or isolation
Excessive clinginess
Aggressive or violent behavior
RISK FACTORS OF DEVELOPING PTSD AFTER A CAR ACCIDENT
There’s no way to predict who will develop PTSD after a car accident, but researchers have identified factors that influence risk.
Risk Factors
1. Gender. Numerous studies show women are more likely to develop PTSD from car accidents than men. Researchers attribute this to the different manner in which women respond to trauma and the higher prevalence of previous traumas in women.
2. Genetics. Predisposition to post-traumatic stress disorder has been found to have a similar genetic component as mental health disorders like depression. Researchers estimate genetics can increase the risk for PTSD by five to twenty percent.
3. Personal and family history. Previous life events, mental health status, and family dynamics play a role in the human response to trauma. These risk factors include:
Previous traumatic events
History of long-term chronic trauma, such as child or spousal abuse
History of mental illness or substance abuse
Family members with mental illness or substance abuse
Lack of family support
4. Characteristics of the car accident. Experiencing an accident that is especially severe or where a fatality or serious injury occurred increases the risk of PTSD. The risk is especially high with the perception of the accident being life-threatening and the idea that “it could have been me.”
5. The effects of the car accident. Injuries from car accidents can cause permanent disability, chronic pain, temporary or permanent job loss, severe financial difficulties, and the death of loved ones who were also involved, increasing the trauma associated with the accident.
Protective Factors
These factors are associated with a reduced risk for developing PTSD:
1. Support from family and friends. Friends and family alleviate the added stress created by the accident in numerous ways. They can help with daily tasks, take over childcare, provide transportation, locate services, and offer comfort. 2. Support group participation. Support groups offer a safe place to exchange stories with others who have also experienced trauma. Attending or accessing a support group may be easier than talking with friends and family and is especially beneficial to those without an established support network. 3. Learning to be okay with actions during the accident. It’s human nature to second-guess actions in emergency situations, but those who accept themselves and their actions tend to have more positive outcomes. 4. Coping strategies. Everyone has different coping mechanisms for handling crises. Those who consciously use positive coping strategies such as mindfulness activities, positive self-talk, and exercise often overcome the trauma with more success.
TREATMENT FOR PTSD FROM CAR ACCIDENTS
The strong emotions of horror, fear, and depression are normal responses to trauma. When these emotions persist over the course of a month or longer, they could indicate the development of post-traumatic stress disorder. This is especially true if these emotions affect your relationships and day-to-day life. Many trauma victims are reluctant to seek help because of the stigma associated with mental health disorders like PTSD. They falsely perceive the development of PTSD as a sign of weakness or believe they can power their way through the emotions. Seeking therapy for PTSD should be regarded similarly to seeking treatment for any other effect of the trauma, such as broken bones. Professional therapy provides the best outcomes for PTSD. When seeking treatment, it’s important to select a therapist that specializes in treating PTSD. PTSD has been widely studied, and there are a variety of effective treatment modalities that have been proven effective. Cognitive Behavioral Therapy Cognitive behavioral therapy is an all-encompassing term that focuses on addressing the behaviors, thinking patterns, and emotional responses at the root of PTSD. It can be divided into two sub-types: cognitive processing therapy and prolonged exposure therapy. Cognitive Processing Therapy Cognitive processing therapy (CPT) focuses on changing the thinking patterns that contribute to the heightened emotional responses and stress-induced behaviors that define PTSD. This therapy includes the following:
Education about PTSD
Assessment of symptoms
Discussion about avoidance and other coping mechanisms
Discussion of mortality
Learning how to challenge thoughts and reshape beliefs
The goal of CPT is to develop balanced beliefs, which translates to healthy emotions and ultimately healthy behavioral responses.
Prolonged Exposure Therapy
Prolonged exposure therapy involves a gradual re-exposure to the elements of the trauma under strict conditions to reshape emotional responses and de-program triggers. It’s important for this therapy to proceed only under the supervision of an experienced therapist, as re-exposure that’s too rapid has been shown to worsen symptoms.
Prolonged exposure therapy may start with imagined or simulated exposure that’s less threatening and gradually increase as emotional responses improve. Throughout the process, the patient practices applying techniques like muscle relaxation and mental retraining as learned in cognitive processing therapy.
EMDR Therapy
EMDR therapy is eye movement desensitization and reprocessing therapy that involves the patient focusing on an object that is moving back and forth, such as a therapist’s finger while talking briefly about the trauma. It’s thought that the bilateral eye movements while talking about the memory help the brain form new associations with the memory and reduce its emotional impact. This therapy is widely used and more comfortable for some patients.
Supportive Psychotherapy
Supportive psychotherapy focuses on general problem-solving skills and assurance of unconditional support. Patients learn to see the car accident less severely and place it in context with other life experiences. While psychotherapy has been proven to be marginally helpful for PTSD sufferers, cognitive behavioral therapy has been proven to be much more effective.
Medications Medication is often used in conjunction with other therapies to treat PTSD. Antidepressants have shown the most promise in PTSD treatment. These medications regulate brain chemicals and impact emotions, which can help improve the efficacy of cognitive behavior therapy. The need for medication may only be temporary and could be discontinued when PTSD improves.
HOW LONG CAN PTSD PERSIST AFTER A CAR ACCIDENT? There’s no known modality to determine the length of time PTSD after a car accident will persist. Many individuals never develop PTSD, and for some, PTSD clears up on its own within a few months or a year. According to the American Psychiatric Association, PTSD that lasts for a year or longer usually does not clear up on its own. PTSD can last a lifetime without treatment, and symptoms could worsen with age as various life events occur. However, it’s never too late to seek treatment, and therapies are continually improving and adapting to patients’ needs as new research emerges.
HOW TO GET BACK TO DRIVING AGAIN Driving phobia is a common reaction to a car accident. Prolonged exposure therapy is the most effective method of alleviating these fears and getting back into the driver’s seat. This type of therapy should always be supervised by a therapist who is experienced with PTSD. The specific steps to overcoming a driving phobia will vary per individual and the severity of the condition. As you complete each step and retrain your thoughts and responses, you can progress to the next step. The re-exposure process may look similar to the steps below: 1. Read a description of the crash aloud. 2. Talk about the accident experience, including your emotions and actions. 3. Visit the crash site. 4. Sit in the driver’s seat and visualize yourself driving. 5. Take a short drive around the block or an abandoned parking lot. Have another driver or a driving instructor present. 6. Gradually progress to busier areas with the other driver still present.
7. Drive past the crash site, with the other driver present
8. Drive in a safe area without the other driver
9. Keep slowly progressing until you're comfortable driving anywhere, even alone.
Be patient with yourself and the process. If you’re working with a therapist, follow your therapist’s recommendations for exposure progress. Progressing too quickly could damage any previously achieved momentum, resulting in regression or a reemergence or increase in symptoms. (Source from NST Attorneys At Law)
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