PTSD and Car
Accidents
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.
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
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
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
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:
Sleep disturbances
- Fear of sleep
- Nightmares
- Bedwetting
- Insomnia (trouble going to sleep or staying asleep)
Physical symptoms
- Stomachaches
- Headaches
- Loss of appetite
Changes in responsiveness to others
- Changes in affection shown to others
- Loss of interest in usual activities
- Detachment or isolation
- Excessive clinginess
- Aggressive or violent behavior
Regression (a return to activities previously outgrown)
- Thumb-sucking
- Bathroom accidents
- Desire to sleep with parents again
- Inability to speak
Traumatic re-enactment
- Flashbacks
- Involuntary memories
- Repeatedly reliving the trauma through talk, play, or drawing
Sleep disturbances
- Fear of sleep
- Nightmares
- Bedwetting
- Insomnia (trouble going to sleep or staying asleep)
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
- 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.
- 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.
- 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
- 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.”
- 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:
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.
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.
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.
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:
- Read a description of the crash aloud.
- Talk about the accident experience, including your emotions and actions.
- Visit the crash site.
- Sit in the driver’s seat and visualize yourself driving.
- Take a short drive around the block or an abandoned parking lot. Have another driver or a driving instructor present.
- Gradually progress to busier areas with the other driver still present.
- Drive past the crash site, with the other driver present.
- Drive in a safe area without the other driver,
- 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.
Finding Help After a Car Accident Resulting in PTSD
If you’re experiencing a crisis caused by the emotional aftermath of a car accident, there is help available, whether you need a therapist, advice, support, or intervention.
- For local assistance, dial 211. This is your local resource line, where you can ask the operator for a list of available resources in your area.
- Call or text SAMHSA’s 24-hour helpline. This helpline provides support and referrals to local treatment facilities, support groups, and helpful organizations.
- Their phone number is 1 (800) 662-HELP (4357)
- Text at 435748 (HELP4U)
- If you’re experiencing suicidal thoughts or feelings, please call the national suicide prevention hotline at 1-800-273-8255. As of July 16, 2022, you’ll be able to access this lifeline by dialing 988.
- The National Center for PTSD offers a helpline at 1 (800) 273-8255.
- To find a Therapist or Licensed Professional Counselor, search using the American Psychological Association’s psychologist locator or National Board for Certified Counselors finder.
Potential Compensation
Post-traumatic stress disorder is a medical condition that involves mental anguish and requires professional treatment for the best possible outcome. You may be entitled to compensation to cover the cost of therapy and the pain and suffering PTSD has caused. A car accident attorney can investigate your accident and help you recover these damages so that you can seek the treatment you need for as long as it’s needed to get back to your life how it was before the trauma occurred.