Shock, stress and feeling safe again after a serious car crash
What a trauma psychologist wants you to know about the first days and weeks
You may have left the ER with a plan to treat your injuries. Even so, your body may feel as if the crash is still going on. Or you may feel oddly calm. As a trauma psychologist, I wouldn’t judge either reaction. [1, 2]
After the same kind of event, people can feel scared, angry, relieved, numb or fairly okay. Those feelings can shift from one day to the next. None of them shows whether the crash was serious enough to count. [1, 2]
A better question to ask yourself is this: What would help me feel safer and get through today? Begin with real safety and medical care. After that, give your mind and body space to calm down. You don’t have to work through the whole crash at one time. [3, 4]
How shock can show up
People use the word ‘shock’ for the dazed, unreal or flooded feeling that can follow a scary event. In this everyday sense, shock is not a diagnosis. Stress reactions can show up right away. They can also become clearer once you’re home and the urgent tasks slow down. [1, 2]
- Your body: Your heart may pound. Shaking, an upset stomach or feeling worn out can follow. Eating or sleeping may be hard. Some people jump at the sound of brakes or a horn. [1]
- Your focus: You may replay a moment of the crash or lose your train of thought. Decisions can feel much harder than usual. Some people keep scanning the road for danger. [1, 2]
- Your feelings: Fear, anger, sadness, guilt or relief may come up. You may also feel very little at all. Feeling numb can be confusing when others expect you to cry. [1]
- Your actions: You may want people around, or you may need quiet. Some people steer clear of a certain road or keep checking on loved ones. Others put off a phone call about the crash. [1, 2]
These are examples of what can happen. You don’t have to match the list. A reaction can make sense and still feel bad. For most people, early reactions fade with time and support. Some people need more help. Pay attention to how you’re doing, but don’t diagnose yourself from one symptom. [1, 2]
Start by making right now as safe as possible
Feeling safe starts with everyday basics. Go over the medical instructions for each person who was hurt. Learn which new symptoms mean you need urgent care. Check that you have medicines, food, a place to sleep and a way to call for help. If you’re too hurt or too flooded to handle these needs, ask someone you trust or the hospital care team. Hands on help and contact with others are at the center of early care after trauma. [3, 4]
Ask yourself three questions. Am I physically safe where I am? What do I need over the next 24 hours? Who can help with one piece of that? [3, 4]
The answer could be a ride to a follow up visit or someone to stay with you tonight. It could be a call to replace a medicine, or a quiet spot away from repeated questions. Small choices can give you back a sense of control. [3, 4]
Maybe you still face a real threat, such as unsafe housing or someone who is threatening you. Handle that danger first. No calming exercise can make an unsafe place safe. Get local emergency help when you need it.
When your body hits the alarm, find where you are now
A sudden noise, an intersection or even a phone call can set your body off as if the danger were back. Try the short exercise below only if it feels helpful. It helps you notice where you are right now. It isn’t a test of your recovery. [5]
- Set your feet on the floor, or notice some other comfortable spot where your body is supported. Change this to fit any injury.
- Slowly look around you. Name three things you see and notice two sounds. Then touch something solid, like the chair you’re sitting on.
- Tell yourself: ‘The crash happened. I am here now, at [place]. Today is [date].’ Use words that feel true for you.
- If it feels okay, let your breath settle into an easy rhythm. There’s no need to force a deep breath. Then turn back to a person or a simple task in front of you.
For some people, paying attention to breathing or body sensations is upsetting. Stop the exercise if it makes you feel worse. Focus on the things around you instead. You could move to another space if it’s safe, or talk with someone you trust. A health professional can help you find a different method. [5]
You decide how much to share
Getting support doesn’t require telling the full story of the crash to everyone who asks. You might want to talk. Maybe you’d like company with no talking, or you’d rather wait. You can say, ‘I’m not ready to go over it. Could you bring dinner or drive me to my appointment?’ Help with daily tasks is support too. [3, 4]
Guidance on early trauma care stresses listening and letting people choose, with no pressure to tell the story. [3, 4]
You may need to give facts to a clinician, an insurer or someone else. Write down what you know and what you can’t remember. It’s fine to say, ‘I’m not sure.’ Don’t guess to fill in a blank. Tell a medical professional if you hit your head, passed out or have gaps in your memory. Those details may affect how they check you for injuries. [6, 7]
Build a gentle daily routine
A steady routine can cut down on the choices you face. Try to eat and sleep on a regular schedule. Take medicines as directed. Spend a doable amount of time with people who support you. Pick one reachable goal for the day, like booking one appointment or sorting one stack of papers. Follow any activity limits your care team has set. [2]
You may have calls and records about the crash to deal with. Think about setting aside one short block of time for them, with a set point to stop. Watching crash video over and over may leave you more upset. Reading comments or retelling the story can do the same. If so, step back from them for now. [1, 2]
Ask someone else to sort through less urgent messages. Don’t use alcohol or drugs to dull your feelings. They can cause new problems and make recovery harder. [1, 2]
A routine can’t promise to keep distress away later on. It does protect your rest, your treatment and your everyday life while you learn what you need.
For friends and family helping someone after the crash
Ask what would help right now. It might be quiet, company, a ride, food or help with a phone call. Listen without pushing for details. Don’t tell the person how to feel or how fast to heal. A phrase like ‘at least you’re alive’ can shut down a talk about pain or loss. [3, 4]
Offer one specific task and then do it. Needs can change, so check in again later. [3, 4]
A person who seems calm may still have needs. Someone who is upset now may not stay that way. Let them make their own choices when you can. Ask before you share their story or photos with anyone.
When to get medical or mental health care
Stress, pain, side effects from medicine and concussion can all change your sleep, focus, mood and memory. A person can have a physical injury and trauma related distress at once. When symptoms are new or getting worse, tell a health professional. Don’t decide on your own that it’s ‘just stress.’ [6, 7]
If you may have hurt your head, get emergency care for danger signs. These include a headache that gets worse and won’t go away, repeated vomiting or weakness. Seizures, slurred speech, unusual confusion and trouble waking up are danger signs too. For other urgent signs, follow your own discharge instructions. [6]
Fear, memories, lost sleep, anger or numbness may be getting worse. If so, reach out to a primary care provider or a mental health professional. Do the same if they aren’t improving or they get in the way of work, relationships, treatment or basic care. If you’re struggling now, you don’t have to wait a certain number of weeks. Treatment that works is available. [1, 2]
If you’re thinking about suicide or might hurt yourself, call or text 988 in the United States. Call 911 if there is immediate danger. [1, 2]
Four questions for a daily check in
- What does my body need today? Is it treatment, food, rest or a symptom checked?
- What one concrete thing would make tomorrow easier?
- Who could help with that? What exactly would I ask them to do?
- What can I put off until tomorrow?
You don’t have to feel a certain way to earn care. Notice what’s going on and handle the needs in front of you. Let people you trust lend a hand. Bring it to a professional if distress is taking over your days or your symptoms worry you. [1, 2]
Sources and further reading
- 1VA: Common reactions after trauma
- 2NIMH: Coping with traumatic events
- 3WHO: Psychological first aid
- 4VA: Early support after trauma
- 5VA: Coping with stress reactions
- 6CDC: Concussion symptoms and danger signs
- 7VA: Brain injury and trauma symptoms
This general guide for U.S. readers reflects a trauma psychologist’s point of view. It can’t diagnose any injury or mental health condition. Follow your own medical instructions, and get care that fits you for any symptoms or safety worries.
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