In my mid-20s, I was hit by a car while walking to school. The driver, who was elderly, thought the median was an extra turn lane, and in the process, hit three pedestrians, including me. One moment I was a stressed-out graduate student worrying about finishing her experiments; the next moment, I looked over to see the light brown hood of a car coming straight toward me, followed by oblivion. When I woke up, I was lying on the pavement, covered in blood and in more pain than I’ve ever been in, childbirth included.
In the weeks and months following the accident, I started experiencing frequent nightmares where I’d get hit by a car, over and over again. I also started having panic attacks every time I saw a car coming toward me, whether I was sitting in a car or standing on the footpath. Driving became impossible.
In the aftermath of the accident, I had developed post-traumatic stress disorder, or PTSD, which is characterised by nightmares or flashbacks of the traumatic event, avoidance of situations that evoke memories of the traumatic event, and hyper-vigilance, which can include panic attacks or the constant feeling of being on edge.
Although PTSD is often thought of in the context of war veterans, it can happen to civilians, too, with car accidents being one of the most common causes. Given how painful, terrifying, and unpredictable a car accident can be, developing PTSD is all-too-common. However, “it is highly treatable,” said Jessica Rohr, a psychologist at Houston Methodist Hospital.
Signs that you have developed PTSD
If you’ve been in a car accident, having a certain amount of fear in the days and weeks following the accident is to be expected. “This is really normal,” Rohr said. It’s when this fear goes on for too long and starts having a long-term negative impact that it becomes PTSD.
Some signs of PTSD include being in a constant state of hyper-vigilance, having intrusive thoughts about the accident (in the form of unwanted memories or nightmares), and avoiding situations that remind you of the trauma, such as driving or getting into a car.
If you were just in a car accident, one of the most important things you can do in the days and weeks that follow is to take your recovery seriously, even if you weren’t actually injured during the accident. This can include temporarily dialling back some of your regular obligations for several weeks, in order to prioritise rest. “Act like you are in recovery, because you are,” Rohr said.
It’s also a really good idea to reach out to your support network or friends or family. “The number one factor for resilience from a trauma is social support,” Rohr said. That can include having friends and family members help you in various ways, by bringing you meals, taking you to doctor’s appointments, or just spending time together. “You don’t always have to talk about what happened in order for it to be helpful,” Rohr said.
Avoidance just makes it worse
After a traumatic accident, the temptation is to cope with the fears by simply avoiding the triggers that are so terrifying. However, as Ron Acierno, a psychologist at UTHealth Houston who specialises in treating PTSD, cautions, avoidance is the worst thing you can do after a car accident. “That’s how people end up not driving for 10 years,” Acierno said. That’s because, as Rohr said, “Fear feeds on avoidance.”
Instead, the best treatment for PTSD stemming from a car accident tends to be what is called graded exposure therapy, in which a person is exposed to their triggers in a safe, structured, and systematic manner to reduce their fear response. “No amount of therapy without that exposure is going to help you,” Acierno said.
For a victim of a car accident, this might start with spending 15 minutes sitting in a parked car, until their fear response reduces to a level that is manageable, after which they might turn the car on, and drive slowly around the block. The point isn’t to avoid fear altogether, but rather to confront it in a controlled way. “Put yourself in a situation where you’re anxious but it’s not overwhelming,” Acierno said.
How to help children with their fears
For children who have been in an accident and are struggling with the after-effects, parents need to remember that “one of the symptoms of PTSD is the perceived loss of control,” Acierno said. If a child is dealing with PTSD from a car accident, “you have to be really respectful of the fact that the kid is not able to turn the wheel or press the brakes,” Acierno said. “You need to make the situation as calm and safe as possible.”
For kids, it can help if this exposure to cars is tied into something they enjoy, such as taking a short drive to get ice cream together. (This is also a strategy that can also work for adults.)
How therapy can help
If you were in a recent car accident, and you find that your fears are getting in the way of living a full life, it’s important to get help sooner rather than later. Generally speaking, treatment for PTSD can be done over the course of four to five months by attending weekly sessions. If there are complicating factors, such as past traumas or a lack of support at home, therapy might take longer, but it won’t last forever.
In my case, recovering from PTSD took years, as I didn’t have the support or resources I needed. Recovery ended up being a constant swinging pendulum, as I swung back and forth between the overwhelming fear of cars and the intense desire to live a normal life again. In the beginning, riding in the car as a passenger was all I could handle, and my walks around the neighbourhood included a lot of extra time and care when it came to crossing the street or an intersection.
However, as I continued getting out there, trying to find a way to do what I wanted to do without being overwhelmed by fear, things started getting better. The fear became more manageable, and I gradually found myself able to do more and more, until driving became the normal, everyday hassle it had always been before.
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