Driving or riding again after a serious car crash
A trauma therapist and a rehabilitation clinician explain how to ease back into safe travel
Treatment may require a ride before you feel ready to be in a car. A road you know well may suddenly feel dangerous. A trauma therapist would tell you that fear can ease when you take on safe travel in small, doable steps. A rehabilitation clinician would first ask whether it’s medically safe for you to drive right now. Both views count. Nobody should be pressured to ‘just get back behind the wheel.’ [1, 2, 3]
Make sure your body is ready before you test your nerve
Did you have a concussion, dizziness or changes in your vision? Ask your treating clinician when you can drive. Ask the same if you have a broken bone, pain that makes it hard to turn or any limit on movement. [1, 2]
Go over your medicines with a clinician or pharmacist. Opioid pain medicine, muscle relaxants, sleep aids and some other drugs can slow your attention or coordination. Sometimes the effect lasts into the next day. Feeling calm is no proof that your reaction time is back to normal. [1, 2]
If you can’t drive yet, plan how you’ll get to treatment, work and caregiving duties. Ask about rides from family, help from a clinic social worker, insurance benefits or local transportation services. Riding as a passenger is a fine way to keep your appointments while you heal. [3]
Pin down which part of travel feels hard
Fear may latch on to the driver’s seat or a passenger seat. It may center on a certain intersection, highways, dusk, rain or the sound of brakes. Write a short list. Don’t write off every worry as irrational. Some roads and conditions really are unsafe. You’re looking for safe situations that fear has made hard to face. [3, 4]
Pay attention to what happens right before you cancel a trip. Are you afraid of another crash? Is it a flare of pain, a dizzy spell or worry that you’ll panic at the wheel? The answer shapes your plan. Medical symptoms call for a medical check. If trauma reminders keep coming up, a therapist can help you work on them. [1, 4]
Climb a ladder of small, safe steps
When travel is medically cleared, start with a step that’s hard but doable. You could sit in a parked car or take a short ride with a driver you trust. Or you could drive a short, familiar route in daylight. Repeat that step until it feels easier or more predictable. [3, 4]
Then add one change, like a longer trip. The order of steps is personal to you. A trauma therapist can help you lay it out. [3, 4]
- Pick a time when you’re rested and don’t have to hurry out the door.
- Share the goal with a support person, such as ‘A ten minute ride around the block, then home.’
- Follow the usual rules of the road. Do not do grounding exercises that pull your eyes or attention away from the road.
- Afterward, write down what you learned as well as how scared you felt. A line like ‘I noticed the alarm, stayed aware of where I was and arrived safely’ is good information to have.
If pain, tiredness or fear gets to be too much, make the step smaller. Shrinking a step is an adjustment. It isn’t a sign your recovery failed. Exposure practice means facing a feared situation on purpose. Do not use it to test a condition that is really unsafe or to get around medical limits. [1, 4]
If fear hits in the middle of a trip
Behind the wheel, you may feel you can’t keep your attention on traffic. Put your focus on reaching a safe spot to stop. Pull over when it’s safe. Then take stock of where you are and decide if you can keep going. If you can’t drive safely, call someone for another ride. Don’t push yourself to keep driving just to prove something. [3]
As a passenger, tell the driver what would help. That might be a break, a slower route or a clear heads up before turns. [3]
Confidence can grow before fear is gone
You don’t need to be free of fear before every trip. The aim is to make safe travel possible while fear has less and less control. Avoiding reminders can bring quick relief. If avoiding becomes your only response to reminders, though, it can spread. Gradual practice in safe situations, with support, is part of trauma treatment that works. [4, 5]
Find a therapist trained in trauma if fear keeps you from trips you need to make. Do the same if panic makes driving unsafe or your world keeps shrinking. Tell the therapist about your physical injuries, medicines and any limits on driving. A plan that brings all of this together is safer and works better than treating the fear on its own. [1, 5]
Plan your next trip
Pick one trip you need to take. Make sure you’re medically ready and set up a safe way to get there. Then choose one small part of it to practice. Doing that much is enough for today.
Sources and further reading
- 1CDC: Returning to activities after concussion
- 2FDA: Medicines and driving
- 3VA: Coping with stress reactions
- 4VA: Avoidance
- 5VA: Prolonged exposure therapy
This article shares general U.S. information drawn from trauma therapy and rehabilitation. Reading it does not clear you to drive. Follow your treating clinician’s limits and local law. If your symptoms could affect safe driving, get care for your own situation.
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