Signs you may need emotional help after a serious car crash
How a trauma psychologist thinks about assessment and treatment choices
After a crash, lots of people feel afraid, sleep badly, have upsetting memories or snap at others. For many of them, these reactions fade. Some people need a professional’s support, either soon or further down the road. [1, 2]
You don’t have to figure out whether what happened to you “counts” as trauma before you book a visit. A trauma psychologist would ask how your symptoms are affecting your life. They would also ask what else might be feeding them, such as an injury or a medicine. [1, 2]
Let your daily life be the guide
Think about getting help if you can’t sleep or take care of yourself. Panic that keeps coming back is another reason. So is skipping travel or treatment you need. Pulling away from people counts too, as do days ruled by memories, anger or guilt. Reach out sooner if your symptoms are getting worse. There’s no set waiting period once your safety or your ability to get through the day is affected. [1, 2]
A primary care clinician can look for medical causes. They can also refer you to a psychologist, psychiatrist, licensed clinical social worker or another qualified mental health professional. In that first talk, bring up any possible concussion, serious pain or change in your medicines. [1, 3]
What an assessment usually looks like
Expect questions about the crash and your symptoms. A clinician will also ask about your sleep, mood, safety and anything you now avoid. Past experiences and how you’re coping day to day come up as well. You may fill out short questionnaires. A screening score is not a diagnosis. [3, 4]
A fuller assessment helps tell trauma related distress apart from depression, panic, substance problems or the effects of a concussion. Sometimes it turns out to be a mix. Feel free to ask why a question is being asked and how your privacy is handled. [3, 4]
Questions about the crash itself may come up. If one feels hard, say so. It’s fine to ask why they need a detailed account. If talking is tough, bring a one page summary of your symptoms. Let them know if parts of your memory are missing. The clinician can work with whatever you do know. [3]
Terms your care team may use
Acute stress disorder is something a clinician can check for in the first month after a traumatic event. It applies when symptoms cause a great deal of distress. Posttraumatic stress disorder, or PTSD, comes up when trauma symptoms last past a month and get in the way of life. [2, 4]
A clinician makes these diagnoses. One symptom is not enough to label yourself. You may still need care for other conditions even if you don’t meet the criteria for PTSD. [2, 4]
How the main treatments compare
For PTSD, therapies that focus on the trauma have the strongest evidence behind them. Cognitive processing therapy helps you examine beliefs about the event, such as blaming yourself. Prolonged exposure helps you slowly face safe memories and situations you have been avoiding. EMDR follows a structured method to process the memory. Sessions look different in each one. Ask a trained clinician which fits your symptoms and what you prefer. [5]
Medicine may also be an option, especially for symptoms that last or another condition that needs treatment. A prescriber can walk you through the benefits, side effects and interactions. They can also tell you how long a medicine may take to start working. Mention any pain medicine you take or worries you have about driving. No one treatment is right for everyone. [5, 6]
Questions to bring to your first visit
- What are you checking for, and what else could explain these symptoms?
- Which treatments fit my goals? What would I work on between visits?
- How will we know if care is helping? When will we look at the plan again?
- What should I do if my symptoms get worse before my next appointment?
You can also ask about cost, insurance, remote visits and help in your language. Ask, too, whether the clinician has experience with car crashes or injuries. A good plan is one you understand well enough to explain back in your own words. [6]
If you might hurt yourself
If you’re thinking about suicide or might hurt yourself, call or text 988 in the United States. Call 911 if you’re in immediate danger. You can get help for emotional distress while you’re also getting medical care for your crash injuries. [1]
Start with a plain request
You don’t need polished words. A short opening like this is enough: “Since the crash, I’m having trouble sleeping and can’t ride in a car. I want an assessment and a plan.” Nobody needs a diagnosis to ask for care.
Sources and further reading
- 1NIMH: Coping with traumatic events
- 2VA: Common reactions after trauma
- 3VA: How PTSD is assessed
- 4VA: Acute stress disorder
- 5VA: PTSD treatment basics
- 6VA: Signs of good care
This is general education for U.S. readers from a trauma psychologist’s point of view. Your own diagnosis and treatment plan must come from a clinician. Crisis and emergency resources are different outside the United States.
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