When reminders of a car crash set off fear and panic
A trauma psychologist explains how to spot the alarm and respond safely
When a car horn blares, your heart races. At a familiar intersection, the moment of impact flashes into your mind. A call from the insurance company leaves you shaky. These reactions can be unnerving, more so when you know the crash is behind you. A trauma psychologist would start by checking what is going on right now. After that, you can help your body and your focus come back to the present. [1, 2]
Below you’ll find the common kinds of fear people feel after a crash. You’ll also find a short plan for when fear hits and ways to keep it from shrinking your life. A strong reaction to a reminder, by itself, isn’t proof that you have posttraumatic stress disorder. Any new or worrying physical symptom should still get medical attention. [2, 3, 4]
Why everyday sounds and places can feel like danger
In a crash, your brain and body may tie danger to details that were around you at the time. That could be screeching brakes, a certain road or an ambulance. It could be a smell, a time of day or the feeling of riding as a passenger. [1, 2, 5]
Later, a detail like one of those can trip an alarm even when things are different now. Some cues come from inside you, like a thought, pain or a racing heart. The reaction happens on its own. You didn’t choose to overreact. [1, 2, 5]
Ask yourself if you’re facing a reminder or a real threat right now. Squealing brakes can be a reminder. A driver drifting into your lane is a live threat. It calls for a safety move right away. Before you tell yourself all is well, stop and look for proof in the present moment. [1, 5]
Name what you're going through
- Fear from a reminder: A sudden picture may flash in your mind. You may feel tight or have an urge to get out. You know where you are, yet your body stays on guard. [1, 2]
- Panic episode: A wave of intense fear comes with physical symptoms. Your heart may pound. Shaking, dizziness, tingling, chest discomfort or trouble catching your breath can come with it. It may feel like something terrible is about to happen. Having one episode isn’t proof of panic disorder. [3]
- Flashback: It can feel like the crash is happening all over again. You may lose track of where you are now. A painful memory can be very vivid and still not be a flashback. If you’re not sure which one you had, or it keeps happening, tell a clinician. [2]
These descriptions can help you pick a response. They aren’t meant for diagnosing yourself. Pain, concussion, side effects of medicine and other health problems can cause symptoms that look like fear. Get medical advice for any symptom that is new, severe or unclear. [4]
A short plan for the moment fear hits
Practice these steps while you’re calm so they come to mind more easily later. Skip any step that makes you feel worse. [2, 6]
- Check for danger. Are you in traffic, hurt or facing a real threat? Deal with that first. If you’re driving and can’t keep your mind on the road, pull over when it’s safe. Do not close your eyes or do a focus exercise while the car is moving.
- Name the cue. You might say, ‘That horn made me think of the crash.’ Or try, ‘This phone call brought it all back.’ You don’t have to get the cue exactly right. [1, 6]
- Find the present. Look around you. Take in the room, the people, the date and one thing within reach. Point out how now differs from the crash: ‘I am in my kitchen. The road is not here.’ If you’re outside, get to a safer spot first. [2]
- Help your body calm down. Breathe at an easy pace without forcing it, or plant both feet on the floor. If paying attention to your breath makes things worse, look at what’s around you or talk with someone. [2]
When you feel more grounded, choose one thing to do next. You could finish a simple task, ask someone to sit with you or take a short break. There’s no need to make a big decision while the alarm is at its peak. [2]
If it feels like you’re back in the crash, keep your eyes open. Focus on where you are now. Move around if that’s safe. If you need help getting back to the present, call someone you trust. Let a clinician know if these episodes keep happening. [2]
A racing heart isn't always panic
Panic can bring on intense physical feelings. A recent crash can also leave injuries or medical complications. Get urgent medical care for new or unexplained chest pressure or pain. Do the same for shortness of breath, fainting or other serious symptoms. In the United States, call 911 for possible warning signs of a heart attack. A clinician can help tell panic apart from a medical cause. [3, 4, 7]
Once any urgent medical cause has been dealt with, it may help to recall that panic usually peaks and then fades. Use the short plan above. Go easy on yourself if you had to stop what you were doing. [2, 3]
Once the wave passes
Take a few minutes to recover before you drive, make a hard call or go back to a demanding task. If you were behind the wheel, keep going only once you can focus and handle the car safely. If you can’t, get another ride. Stick to any driving limits your treating clinician has given you.
Later, write a short note that answers four questions. What reminded me of the crash? How did my body react? What showed me I was in the present? What helped? [6]
A few words will do. You’re looking for a pattern. There’s no need to track every heartbeat. The VA’s worksheet on trauma reminders is built on the same basic idea. It has you name the cue and how you reacted. [6]
Take back the safe parts of your life
Steering clear of a reminder can bring quick relief. If the list of things you avoid keeps growing, it can make work, treatment, relationships and travel harder. Don’t force yourself into a situation that’s unsafe or restricted for medical reasons. Notice which activities are safe but now feel scary. Pick one and take a small, doable step back toward it. [5, 8]
Say a phone call about your claim sets off the alarm. You could start by writing down two questions. Then have someone you trust sit close by during the call. If traffic noise is hard, you might spend a short time near a quiet street with someone beside you. Give yourself room to stop. [5, 8]
The purpose is to learn that you can handle a reminder and still stay in the present. If even small steps feel like too much, build a plan with a clinician trained in trauma. [5, 8]
Small steps like these are different from watching graphic crash video again and again. They’re also different from forcing yourself to retell every detail. You don’t have to prove you’re tough by flooding yourself with more than you can handle. [2, 5]
If you're with someone who is afraid
When someone is scared, talk calmly and offer simple choices. You might ask, ‘Do you want me to stay, get you some water or call someone?’ If they seem confused about where they are, help them notice their surroundings. Don’t debate whether their fear makes sense. Look for injuries or medical warning signs. If they were driving, help them stop safely and set up a ride if they need one. [2]
Later, ask what helped. Don’t promise that nothing bad will ever happen again. Try something like, ‘We can make a plan for what to do if this feeling comes back.’
Signs it's time for professional help
See a primary care provider or a mental health professional if panic, flashbacks or fear keep coming back or grow stronger. Do the same if they get in the way of sleep, health care, work, relationships or travel. Get help sooner if you’re skipping medical care you need. The same goes if you must drive but can’t do it safely. There’s no need to wait for a diagnosis or a set number of weeks before asking. [2, 9]
A clinician trained in trauma can help you pinpoint your reminders. Together you can build a gradual plan for safe situations you’ve started to avoid. When a trauma related disorder is present, trauma focused psychotherapy is among the treatments that work. Before you start with a new clinician, ask how they evaluate symptoms and which approach they use. [8, 9]
In the United States, call or text 988 if you’re thinking about suicide or might hurt yourself. For immediate danger, call 911. [9]
Questions for a reminder card
- Am I in real danger right now? If so, respond to it.
- What brought the crash to mind?
- Where am I right now? How is this different from that day?
- What’s one safe thing I can do next? Who can help me?
A reminder can feel strong and still tell you nothing about what comes next. Every time you check the present and pick a safe response, you practice a new way through the alarm. If it stays hard, help is out there. [1, 2, 8]
Sources and further reading
- 1VA: Trauma reminders
- 2VA: Coping with stress reactions
- 3NIMH: Panic symptoms
- 4VA: Brain injury and trauma symptoms
- 5VA: Avoidance
- 6VA: Trauma reminder worksheet
- 7AHA: Heart attack warning signs
- 8VA: Prolonged exposure therapy
- 9NIMH: Coping with traumatic events
This article shares general U.S. information from a trauma psychologist’s perspective. It can’t diagnose an injury or a mental health condition. Follow your medical instructions, and see a professional about any symptoms that concern you.
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