Even though there have been dramatic improvements in road conditions over the last 40 years and even though there is greater education of drivers on vehicle safety, there are more than 3 million motor vehicle injuries each year in the US. Some of these injured persons evolve to have post traumatic stress disorder, an emotional disorder that can last indefinitely after experiencing a traumatic episode.
The major symptoms of post traumatic stress disorder fall into three major categories. The first is “reliving the event”, which can disrupt the persons day to day activities. Reliving the event can include the presence of flashbacks in which the event seems to happen over and over again. There are repeated memories of the event, which seem to be real as well as repeated nightmares highlighting the event. The patient with this feels many strong and uncomfortable feelings near situations that remind the patient of the previous trauma.
Second is emotional avoidance in which the patient feels detached or numb as though nothing seems to matter. The patient feels detached from people and from reality and is sometimes unable to remember important details of the trauma. He or she will show a lack of interest in his or her normal activities and will have a flat affect, showing fewer and fewer of his or her normal moods. The patient will often avoid people, places or situations that remind them of the event and will feel as though they have no real future.
Third, there are arousal problems. The individual has problems concentrating and often startles easily. The individual also has an exaggerated startle response and experiences hyper vigilance, feel more aware of one’s surroundings. There is increased irritability or the possibility of outburst of anger. There is difficulty falling asleep or staying asleep at night.
Some people feel survivor’s guilt, especially if others died or were more seriously injured in the accident. There are episodes of increased anxiety, tension, agitation, dizziness, headache, palpitations, fainting spells and other emotional outbursts.
Post traumatic stress disorder can be chronic if not treated with psychotherapy and possibly medications. In fact, years can go by with the above symptoms going unabated unless the person works through their feelings around the accident or injury in therapy. It is a good idea to catch this type of person as soon as possible so that the person can be treated before the symptoms become intractable and more difficult to treat. The longer the patient goes with the symptoms, the greater will be their impairment and the more difficult will be the job of the therapist when it comes to treating the person with post traumatic stress disorder.
It is the job of the family physician to recognize this type of person in his or her practice and to refer the patient to the proper therapist or counselor to manage the patient’s case. The family physician is in the best place to evaluate what the person was like prior to the accident and to compare that to what they’re like after the accident occurred.