In 1980, the American Psychiatric Association added post-traumatic stress disorder to its manual of mental disorders. The official diagnostic criteria for PTSD say symptoms may occur following a distressing or shocking event “that is outside the range of usual human experience.” Initially, PTSD was considered a condition that affected primarily combat veterans, but over the years, psychiatrists have learned a lot about how PTSD affects civilians, including survivors of serious car crashes.
The Prevalence of PTSD in Crash Survivors
The U.S. Department of Veterans Affairs says about 9 percent of people who are involved in serious crashes that cause injuries develop PTSD. That may sound like a low number, but roughly 3.5 million people are involved in personal injury crashes every year – meaning at least 315,000 people each year are at risk for PTSD.
It’s difficult to say exactly how many people develop PTSD, because some crash survivors may not recognize that their lingering psychological problems are connected to their crash, or doctors may not know a patient’s history. For example, a person experiencing major depression may seek treatment for that disorder, but if they fail to mention their serious car crash, the treating physician might not recognize that the depression is a symptom of PTSD.
Children and teens may be at heightened risk of a missed PTSD diagnosis. When a child exhibits problems such as restlessness, irritability, and falling grades, a doctor might diagnose attention deficit disorder, rather than PTSD. And some doctors simply lack the training necessary to identify PTSD, regardless of the patient’s age.
Symptoms of PTSD
An article in American Family Physician described how PTSD affected a man who survived a serious car crash. At age 22, he crashed into a bridge abutment, and the impact trapped him in the vehicle and fractured his jaw, hip and left leg. Emergency workers had to extract him from his van.
About 12 years later, the man told his new doctor that he suffered from headaches, insomnia, dissociative states of consciousness, and that he performed rituals to avoid contamination. He told his doctor about the crash, and the doctor recognized the man was suffering from PTSD. With medication and therapy, the man was finally free of PTSD symptoms, 18 years after the crash.
PTSD doesn’t always last that long. It may be short-term, without many symptoms. But to make an official PTSD diagnosis, a doctor must determine that a patient has for at least one month shown the four primary PTSD symptoms:
- Re-experiencing (such as flashbacks or bad dreams)
- Avoidance (such as avoiding people or places that are reminders of the crash)
- Arousal and reactivity (such as being easily startled or having sleep disturbances)
- Cognition and mood (such as withdrawal from friends and family, and persistent negative thoughts about oneself).
Risk Factors for PTSD
Most survivors of serious crashes don’t develop PTSD. The degree of post-accident stress and support may play a role in who develops the condition and who doesn’t. For example, a person who comes from a close-knit family and has many friends may be at a low risk of PTSD following a crash. A crash survivor with no support network and financial problems may be more likely to suffer from PTSD.