The Effects of Post-Traumatic Stress Disorder from Car Accidents
I was diagnosed with Post-Traumatic Stress Disorder in late 2013, at the age of 17, after a fatal car accident took the life of my best friend. We were driving home from spending the day together at a park and we were just talking and laughing, no cell phones out, no radio on. There was a stop sign that I did not see, and a car hit us on the passenger side where my best friend was sitting. I don’t remember very much about the accident or that day, a classic effect of PTSD.
Post-Traumatic Stress Disorder is defined as, “the mental, emotional and physical repercussions experienced after an extremely stressful experience” (Seward, 2015). PTSD can be caused after experiences where ones sense of safety is threatened, seen commonly from survivors of sexual abuse or assault, veterans, first-responders, and victims of violent crime. There is a common misconception that the highest rate of people who have diagnosed with PTSD is war veterans when in fact, those who have been in severe car accidents who hold that unfortunate title. It has been found that nine percent of the population who gets into a car accident will develop PTSD (Maynard, Gans. 2018).
There are factors that can influence the likelihood of whether someone will get PTSD after a traumatic event including sex, as females are more likely to get PTSD than males and have it be longer lasting. If someone had experienced problems in their childhood such as sexual abuse, substance abuse, physical abuse or other trauma, their risk of developing PTSD is raised. I would say I certainly fall under that category because my mother has a severe alcohol addiction and got into many car accidents with my brother and I when were younger. I have always been sensitive towards driving and hyper-vigilant when driving with others since I was very young. My therapist told me, as is supported by current research and the DSM V, that my preexposure to car accidents and the sensitivity towards then greatly increased my risk of evening PTSD.
The symptoms of PTSD usually start within three months of the traumatic event but can be severely delayed and can begin years after an event. Some symptoms of PTSD include; chronic anxiety, flashbacks, insomnia, memory loss, emotional detachment, and clinical depression, suicidal tendencies, agoraphobia and substance abuse (Seward. 2016). In my case, I ticked all of the boxes except the substance abuse, I am very fortunate especially given my family history. In the days after the accident, I began having nightmares that would replay the accident over and over in my mind, which increased my feeling of anxiety, guilt and made me extremely sleep deprived because I refused to sleep as long as I could. In the next few months, my condition only worsened and only felt more detached, isolated and empty, even though I was surrounded by love, support, and kindness. My family recognized that I was not improving and recommended by that I go and see a therapist to get help. I flat out refused because I not only didn’t want to leave the house (I was agoraphobic for over a year), but I knew if I saw a therapist I would have to talk about the accident and I wasn’t ready. The only person I would get in a car with was my Dad and if anyone so much a changed lanes next to us as we were driving, I would have a panic attack.
About a year later, I moved away from home and tried to go to school. I ended up having to drop out because I never went to class and could not focus, study or remember what I had previously studied. This was a huge change for me, as I had always been a straight a student that had no trouble studying for hours on end. The DSM V lists, “impaired function across social, interpersonal, developmental, educational and occupational domains”, as some of the functional consequences of PTSD (DSM-V, 2013). The DSM-V also concludes that PTSD is associated with poor personal relationships, absenteeism and lower occupational and educational success. At the time, I had not gotten help for my PTSD and I did not understand why I could not function much at all which only furthered my depression and isolation.
It wasn’t until I got home from my failed attempt at school that I decided I was ready to get help and that what I was experiencing was not normal and was beyond what would be considered normal after experiencing a traumatic event. The current understanding is that there should a structured interview by a mental health professional, as well as at least one self-assessment and an unstructured professional assessment (Goodnight, Ragsdale, Rauch, Rothbaum. 2018). My own experience followed this model very closely, as in my initial appointment I was given a survey that asked me questions about my own perception of my current mental health state, and then my therapist and I sat down and talked and then she asked me some questions off what I assume was a list she had already prepared or had. The DSM V uses a set of criterion (A-H), to help mental health professionals diagnose PTSD and distinguish it from similar disorders such like Acute Stress Disorder (ASD), whose symptoms are very similar to that of PTSD, except the symptoms only last about a month. To be diagnosed with PTSD, one must have experienced a certain number of symptoms from each category. For example, with Criterion D, someone must have at least three of the symptoms or changes. There are seven listed, and I experienced six of the seven intensely. One of the main factors that separated PTSD from other disorders is the length of time it persists for. If I asked myself, I would say it took 4 years for me to begin to feel somewhat like my old self. When I asked my therapist, she agreed with my perceived time-frame. I was also told that because I had waited almost a year to seek help, that I exacerbated the issue and that had I sought help in the immediate weeks after, I likely would have improved much faster. This is supported by the textbook which states that initial treatment is referred to as critical incident stress management (CISM), the purpose of which is to “1) significantly reduce the traumatic events of the incident and 2) prevent further deep-seated PTSD occurrence” (Seward, 2015). By waiting so long to receive help, I only made the damage worse and longer lasting.
Treatment for PTSD varies person-to-person from the use of medications, behavioral therapy, group therapy or cognitive therapy. In my case, we began with EMDR, or Eye Movement Desensitization and Reprocessing. EMDR is known as one of the most effective PTSD treatments (PTSD, 2018) and uses an image that the patient finds upsetting while simultaneously focusing on the sounds of movement until the sense of distress lessens. EMDR has also been shown to be an effective tool used to combat sensorial triggers for those on the Autism Spectrum (Buuren, Sizoo, Mevissen, Jongh, 2018.). 44 Some of the mental images I used was a picture of the accident scene or of my friend that has passed away. I had avoided thinking of those pictures previously at all costs, and I found it incredibly distressing to look at them. When I thought about those images, I felt panic and I could hear my heartbeat begin to race in the ears, classic symptoms for a potential panic attack arising. Instead of panicking, I would focus on a light that would dance from left to right until I eventually felt myself to begin to relax. This was not an instant fix though and it took a lot of work to be able to see those image without being transported back to the scene of the accident.
Another therapy that is commonly used in the treatment of PTSD is the use of medication. PTSD brings on many mental health issues including depression, anxiety, and insomnia, all of which are commonly treated with medications. Commonly used medications include Prozac, Zoloft, Paxil and Effexor (WebMD.2018). My therapist and I discussed the use of medications, but given my family history, I try not to take any medication unless absolutely necessary. Instead, we used a therapy called Autogenic Training, which focuses on trying to re-establish a state of homeostasis after its interrupted by a traumatic event (Sadigh.1999). Some of the exercises used in this technique include verbal repetition of certain phrases which help direct the attention towards sensations in certain bodily extremities. In my case, I would repeat a phrase and focus on feeling my hands get heavier, or feel my arms or feet begin to warm. For me, it was very important to my scutes to give my constantly anxious brain something else to focus on when I began to get overwhelmed. Both treatments that I used have that in common, which is what made them so successful for me.
In half of those who are diagnosed with PTSD, they have a complete recovery within months, while the other half can be symptomatic for months, or even years. I fell into the latter category. Recovery from PTSD for likely be lifelong. It has been five years since the accident and I still have issues with my memory, as it is hard to remember that accident and memories before it, social anxiety, seemingly a remnant of my agoraphobia and depression. I was in a car accident last year and it was very traumatic for me, even though it was a minor accident. It took me over a month to begin to feel somewhat normal again. Advancements are being made every year in the diagnosis and treatment of PTSD, so I have high hopes that by the end of the century, it will be far easier for mental health professionals to find and help those who need it.