Q: My daughter was involved in a serious car accident, and although her injuries were not severe, she has recurring nightmares and is scared to drive. Is this post-traumatic stress disorder? If it is, can you explain and tell us types of treatments needed?
A: It is quite possible that she is suffering from post-traumatic stress disorder. You do not necessarily have to be seriously injured. It is the possibility of serious injury or death occurring to you, or even witnessing this happening to someone else, that can cause this illness.
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People suffering from this disorder may repeatedly experience the ordeal in the form of flashbacks, which are vivid visual memories and nightmares. These can occur at any time out of the blue, or may be associated with events that remind the person of the traumatic situation. In your daughter’s case, this might be driving past the scene of the accident or even just getting in a car.
Symptoms usually begin within three months of the traumatic experience.
Researchers have studied the brains of affected individuals with scans and have found changes in the hippocampal region of the brain, which is the area responsible for emotions and short-term memory. A sudden pouring of stress-related hormones into the blood stream at the time of the incident may also be a factor in causing the disorder.
Some therapists believe that problems can occur even years after experiencing such things as childhood abuse, but I do not believe that these should be put in the same category as what your daughter experienced, and the treatment is not the same.
Medical treatment may involve the use of an antidepressant medication such as Zoloft or Luvox, especially if sleep is affected. Behavioural therapy performed
by a psychologist or psychiatrist may also be helpful.
Quite often a combination of medication and psychotherapy is recommended.
With treatment, most people recover within six months. Some studies have shown that if people are given an opportunity to talk about their experiences as soon as possible after the catastrophic event, the severity of stress may be reduced. There was a study of 1,200 children who lived through a hurricane. They were followed up for two years afterward, and the ones that received immediate counselling did much better than those who did not.
If nothing is done at the time and the trauma occurred a long time ago, some psychiatrists believe it is better to leave well enough alone. Stirring up the old memories may just make things worse for the individual.
Clare Rowson is a medical doctor with a practice near Belleville, Ont. Her columns are intended for general information only. Individuals are encouraged to also seek the advice of their own doctor regarding medical questions and treatments.
