How To Determine If Someone's Got Post-Traumatic Stress Disorder After A Car Accident?

Car accidents — or, more accurately, road traffic accidents — come in all sorts of shapes and sizes, causing anything from "phew, that was a near miss, I'm glad we're all OK even if the car has to be fixed" situations, to extensive casualties. More than 50 million people from all across the globe find themselves in traumatic car accidents every year, research indicates. 

Not everyone who survives a traumatic car accident develops post-traumatic stress disorder, but road traffic accidents can, of course, lead to PTSD. One meta-analysis (that's a study that reviews other studies) found that the overall rate of PTSD following road raffic accidents is just over 22 percent, making this kind of trauma a very significant risk factor for the trauma-related anxiety disorder. 

Anyone who has been in a traumatic vehicle or road accident would do well to keep an eye on their symptoms. If they didn't seek counseling anyway after the accident — something more people should really consider if they have the resources — they should strongly consider talking to their doctor if they have the tell-tale signs of post-traumatic stress disorder. 

So, how do you determine if you have PTSD after a car accident? While not everyone can accurately self-identify PTSD, you certainly play an important role. The diagnostic criteria are the same across all types of trauma, so let's take a look. 

1. You have been exposed to trauma

To be diagnosed with PTSD, you have to have been exposed to a trauma. The DSM-5 — the diagnostic and statistical manual of mental disorders, used to diagnose PTSD and many other disorders — defines this as "exposure to actual or threatened death, serious injury, or sexual trauma". 

That means that you can be diagnosed with post-traumatic stress disorder, if you meet the other diagnostic criteria, if you were yourself in a vehicle at the time of an accident, if you were a pedestrian involved in a road traffic accident, or if you directly witnessed a serious road traffic accident without yourself being in the accident. This is true regardless of whether you or another party were seriously injured, or if anyone died, though more severe accidents are predictive of PTSD. 

If you were injured or someone in your family was, the recovery process, financial worries, loss of income, and potential resulting disability can all, in themselves, add another layer of trauma to the accident. 

If you were in a more serious road traffic accident, you can already check this part, by definition. 

2. You keep 'reliving' the accident

To be diagnosed with PTSD, you'll have at least one "reexperiencing" symptom. Different people experience these in different ways. 

You may suffer from intrusive and involuntary memories of the event. You may relive the accident in your nightmares, or have other horrifying dreams that are in some way related.

You may have flashbacks, moments preceded by a trigger where you suddenly feel like you are, in one way or another, at the scene of the accident again. These may be cued by smells, sounds, songs, or anything else. 

Anything that reminds you of the accident, from, say, insurance documents to cars in general or being near the scene, may cause you significant distress. These reminders can cause you physical symptoms as well, from palpitations to excessive sweating or nausea. 

If you have any of these symptoms, you can give yourself another checkmark here. 

3. You try to avoid reminders of the accident

This one can come in the form of avoiding internal reminders of the accident — thoughts, feelings, and memories. You may do this by keeping ridiculously busy, telling yourself not to think about it, avoiding talking about it, or even in unhealthier ways like abusing alcohol to numb intrusive thoughts about the accident. 

It may also come in the form of avoiding external reminders — stuff outside your own mind. In the case of road traffic accidents, that could include refusing to drive again, staying away from the scene of the accident, avoiding the people who were there with you when it happened, being unable to listen to the song that played when the accident occurred, or being unable to wear the clothes you had on when the accident happened, for instance. 

Some people will have both, but you must have one to be diagnosed with PTSD. If you do, that's another checkmark. 

4. Your thoughts and mood have been impacted by the accident

This can manifest itself in a broad range of ways, and to be diagnosed with PTSD, you have to recognize at least two:

• You're actually unable to remember important aspects of the accident, a phenomenon known as dissociative amnesia. 
• You have unrealistic, exaggerated, negative thoughts about yourself or the rest of the world — like "nobody can be trusted", or "bad things will happen again". 
• You feel guilty and blame yourself for the accident, even if it wasn't your fault. 
• You chronically feel afraid, horrified, angry, ashamed, or guilty. 
• You have lost interest in attending activities that used to be important to you. 
• You feel detached, alienated, isolated, alone. 
• You seem to be unable to experience positive emotions. 

Got two or more? That's another tick. 

5. You're hyperaware

These hyperarousal symptoms can manifest as being much less able to sleep, constantly being on the lookout for danger, finding it hard to concentrate, and being quick to startle — any trigger that is somehow connected to the accident can set you off. You may also experience angry outbursts and feel irritable a lot of the time, and even engage in reckless or self-destructive behaviors. 

If you recognize two or more in yourself, you may have PTSD.

6. Other bits

To be diagnosed with PTSD, you have to meet the diagnostic criteria for at least one month — but not necessarily immediately after the accident. The symptoms will have a significant negative impact on your daily life, and shouldn't better be explained by some other condition. 

A final word