A car accident can be a terrifying and painful experience that may result in emotional and mental trauma. Car accident trauma can be temporary and benign, or it may evolve into something more complicated. Post-traumatic stress disorder (PTSD) after a car accident is all too common, occurring in up to 42% of those who experience a motor vehicle accident. This makes PTSD after car accidents a major source of PTSD in the population. Getting prompt intervention for emotional distress following a car accident can reduce the risk of developing PTSD and prevent the long-term consequences of that disorder. Your car accident doctor plays a key role in identifying risk factors and referring you to the right providers.
Acute Stress Disorder
Acute stress disorder (ASD) is a response to a major traumatic event, such as a car accident, that leads to disordered emotional and physical responses. Those responses are the same as with PTSD, only they occur earlier and are expected to go away. While it is normal to have anxiety and stress immediately after a car accident, ASD begins after the third day and may last up to one month following a car accident. If the symptoms persist, it is then considered PTSD. Identifying ASD early can mean getting interventions that may prevent the development of PTSD entirely.
Post-Traumatic Stress Disorder
Any kind of trauma that causes one to fear for their life and safety is interpreted by the brain as a threat to one’s existence. This elicits a response called “flight or fight.” In medical terms, this is the response of the sympathetic nervous system, which our bodies rely on to keep us safe in crises. It increases blood pressure and heart rate so that blood gets to muscles that we use to run away from danger, it slows digestion so that we don’t waste valuable energy while fighting off an enemy, and it writes down a memory of the event in our brains so that we don’t forget the danger and how we had to respond to survive. It is this last part that can lead to trauma-related disorders, as the brain recalls the danger we faced during an event and begins to associate that threat with anything even remotely similar. Our brains may recall sights and sounds that remind us of the event, even when it has nothing to do with it, and enacts the same flight or fight response that occurred during the car accident. In some cases, it may even create a response that exceeds that of the initial reaction to the accident, and that can have long-lasting consequences on our mental health and day-to-day functioning.
Most of us are familiar with the concept of PTSD in military veterans and that loud noises or the sight of certain things might trigger a response. Those who develop PTSD after a car accident face the same problem; only for them, their triggers might be things they have to do each and every day, like driving to work or the store. They may find themselves dealing with significant problems just trying to accomplish basic tasks that remind them of the car accident, like getting medical care or filling out insurance forms. When those signs and symptoms of a dysfunctional stress response persist for more than one month, the individual meets the criteria for PTSD.
Signs and Symptoms of ASD and PTSD
Signs and symptoms of ASD and PTSD can be divided into four categories; intrusive thoughts and feelings, avoidance behaviors, negative alterations in mood and cognition, and increased reactivity. Intrusive thoughts and feelings can include thoughts about the car accident that you cannot control, nightmares, flashbacks, significant distress when recounting the accident, and signs of excess sympathetic activity (flight or fight). People may work hard to avoid any reminders of the car accident or anything associated with it. This may include people, places, objects, sounds (such as songs on the radio that was playing during the wreck), sights (such as movies with car accident scenes or similar cars), situations, conversations, and more. These are avoidance behaviors.
Negative alterations in mood and cognition can also occur and should have only started after the car accident. These are generally represented by altered thought processes and emotional responses surrounding the event and one’s self. The individual may have persistent feelings of guilt and shame and may feel they deserved any injuries or harm they experienced. They may have difficulty communicating and relating to others or taking pleasure in any activities (anhedonia). There may be an inability to recall the car accident or the events surrounding it.
People may experience increased reactivity and atypical behaviors with PTSD and ASD. This may manifest as irritability, exaggerated or irrational anger, hypervigilance, excessive startle response, emotional outbursts, as well as difficulty sleeping and thinking clearly. These are due to the physical release of certain neurochemicals that mediate the flight or fight response and keep your body alert to any dangers. While beneficial in times of immediate threat, these things can become damaging to one’s life in the long term. It is this harmful impact that leads to negative effects in the life of the person with PTSD or ASD and is required for the diagnosis to be made.
Risk Factors for Developing PTSD after a Car Accident
Whether or not someone will develop ASD or PTSD is hard to predict, but there are some factors that make it more likely. While some of those can be readily recognized, others may be more subtle, like genetic predisposition. To determine if you may be at risk, the following questions represent factors in the development of PTSD:
Was there significant bodily or emotional harm done?
While even minor injuries can lead to PTSD, the more severe the injury or emotional damage, the more likely one is to develop PTSD as a response.
Did you feel that you had no control over the situation?
A feeling of helplessness in a situation can often lead to emotional trauma from an accident, particularly if the person is trapped or forced to witness harm to a loved one.
Did you experience severe pain after the car accident?
Those who have higher levels of pain are more likely to experience PTSD.
Do you have a history of mental illness?
Mental illness can make coping with additional stressors more difficult, and the brain chemistry changes may make your brain more susceptible to setting down unhelpful pathways of response.
Do you have a history of existing childhood trauma?
Adverse childhood events can contribute to an elevated flight or fight response later in life that can have significant health ramifications and increases the risk of developing PTSD after a traumatic event.
Do you have adequate support in your life?
A lack of support increases the stress one feels in any situation, which can further train the brain to believe there is an ongoing threat to your existence, setting the stage for the development of PTSD.
Prevention of PTSD
Since ASD comes before PTSD, it is often during the first month after a car accident when interventions can best prevent the development of full-blown PTSD. Studies have shown that while it may be beneficial to talk to a therapist or someone else to decompress after an accident, those who receive cognitive behavioral therapy that focuses on individual coping strategies have a significant reduction in PTSD risk. Such therapy includes changing how one thinks about the car accident and the risk of harm after, what trauma responses are and what one should expect from them, how to effectively relax, and exposure to triggers while in a safe and controlled setting. Access to this care often requires a referral from a treating provider, such as your car accident doctor.
Dealing with PTSD and ASD
Understanding how and why you are feeling the way you do is the first step in coping with the responses. This is not your fault and is not a sign of any weakness or moral failure on your part. It is your brain seeking to protect you from future harm after it has learned a past experience is threatening and drawing false associations with other things. Knowing this is a matter of brain chemistry and activity can help you process what is happening and seek the right care. You may find joining a support group helpful after a car accident so that you can benefit from the experience of others and know you are not alone.
Relaxation is a key element in dealing with emotional trauma. The flight or fight response has an opposite, the rest and digest response, which is the parasympathetic nervous system response. Rest and digest can be triggered by anything that brings you peace and calm. This can be a warm bath, a walk in the park, meditation, yoga, reading a good book, art, massage, or laughter. Exercise is both an excellent parasympathetic trigger and releases endorphins, the body’s natural happiness and pain relief hormones. Seek out your support system for help with tasks so that you can focus on healing and recovery. Spend time with loved ones and friends to foster feelings of safety and peace.
Interestingly, there is research that shows that certain video games may help individuals cope with and prevent the development of PTSD symptoms. Games with a visual and spatial aspect, such as block-building games, can benefit those with PTSD. Word games also are of use in this manner, although they may be more difficult for some users.
Firstline interventions for the care of these disorders is generally psychotherapy. Therapists trained in trauma-related disorders can offer several options for care, from cognitive behavioral therapy to eye movement desensitization and reprocessing (EMDR). EMDR uses a trick of the brain to train it to recognize the traumatic event as non-threatening. The same applies to certain medications used to treat PTSD, which work by exploring the memories of the car accident while the person is in a safe environment and tricking the brain into remaking the association without the flight or fight response. Medications can also be used to treat specific symptoms of PTSD, like insomnia, nightmares, and elevated blood pressure.
Avoid the use of drugs, alcohol, or dangerous activities to distract yourself from your thoughts. Reckless behaviors can occur as part of PTSD symptoms, so be aware that you may do things you would not normally do and ask yourself if this is a choice you would have made before the car accident. If you find you are doing any of these things, reach out to a friend, family member, or trusted medical professional for help as soon as possible.
A skilled car accident doctor can help prevent the development of PTSD by identifying those most at risk and referring them to the right specialists for treatment. This may mean seeing a therapist or a psychiatrist who can teach you appropriate coping skills or other treatment options. The providers at AICA Jonesboro can help guide you through this stressful time and ensure you get the right care for all of your needs, so get in touch to schedule an appointment today.