Following an accident or traumatic event, physical injuries are easy to see. Paralysis, severe burns, blindness, traumatic brain injuries, fractures, and amputations are especially visible to others. But the psychological toll that trauma takes after a catastrophic injury is more difficult to recognize and quantify.
The effects of catastrophic injuries on mental health can cause just as much damage as physical wounds and often require more time to heal. Psychological distress slows a patient’s physical recovery and makes it difficult for victims to function in their daily lives, on the job, in personal relationships, and in activities they once enjoyed.
What Is Psychological Distress?
Psychological distress is defined as any condition that negatively influences a person’s ability to participate in their day-to-day life. It’s positively correlated with traumatic experiences such as motor vehicle crashes, falls, sports injuries, assaults, and other events causing a person to fear for their life or safety. When injuries result in both physical and psychological harm, the cost of care and rehabilitation is twice as high as for patients without mental health concerns.
Risk Factors
One study showed that catastrophic, life-changing injuries lead to increased psychological distress. Patients with traumatic brain injuries, spinal cord injuries, and whiplash-associated disorders demonstrate significantly higher levels of distress than the general population and higher levels than patients with minor injuries. Chronic pain and fatigue are contributing factors, leading to a decrease in patients’ quality of life.
Individuals already stressed before a traumatic event are at higher risk for distress afterward as well. Financial hardships caused by the accident further complicate mental health issues, leading to frustration, anger, and depression in survivors. Unfortunately, long periods of undiagnosed and untreated psychological distress can lead to chronic absenteeism, increase the odds of developing a mental disorder, and up the risk of self-harm and suicide.
Signs
Survivors wrestling with symptoms of psychological distress may experience ongoing memories of the event, including flashbacks. Troubling or disturbing thoughts and other signs of anxiety and depression could indicate a patient needs to seek treatment from a mental health professional.
Common Conditions Associated With Catastrophic Injuries
The most common mental health diagnoses given to patients following a catastrophic injury include post-traumatic stress disorder, anxiety, and depression.
Post-Traumatic Stress Disorder (PTSD)
It’s estimated that 20 to 40% of motor vehicle accident survivors go on to develop PTSD, a mental health condition characterized by flashbacks, nightmares, and uncontrollable thoughts about the traumatic accident or event. Symptoms of PTSD usually begin within a few months and increase in severity as time goes on to include:
Intrusive Memories
Those diagnosed with PTSD have unwanted memories of the experience, reliving the traumatic event as if it were happening over and over again. They may have recurring nightmares and show signs of severe emotional distress or even have physical reactions to loud noises, certain smells, small spaces, or other things that remind them of their trauma.
Avoidance
Some patients completely avoid thinking or talking about the traumatic event. Instead, they go out of their way to avoid locations, activities, and people who remind them of what happened.
Mood Changes
Individuals with PTSD often have negative thoughts about themselves, others, and the world around them. They feel hopeless and have trouble maintaining close relationships with other people as they detach themselves from family and friends. They tend to lose interest in activities they once enjoyed and find they are unable to experience positive emotions. Instead, PTSD patients may describe feeling completely numb.
Emotional Response
Many survivors are easily startled or frightened by loud noises and feel the need to constantly be on guard. Some engage in self-destructive and risk-taking behavior, such as speeding or abusing drugs and alcohol. They also experience trouble concentrating and insomnia and can appear irritable, angry, and aggressive.
Anxiety Disorders
Up to 47% of victims catastrophically injured in a motor vehicle crash are later diagnosed and treated for an anxiety disorder. Uncertainty regarding the future, a lack of control over their lives, and economic strain can cause debilitating symptoms of anxiety that include heart palpitations, panic attacks, insomnia, and phobias. Persistent anxiety interferes with a patient’s daily life by paralyzing them with fear. They may avoid certain activities to prevent negative feelings from resurfacing.
Generalized Anxiety Disorder (GAD)
GAD causes persistent feelings of dread, with symptoms lasting for months to years:
- restlessness
- fatigue and insomnia
- difficulty concentrating
- irritability
- headaches, muscle aches, stomach aches, and other unexplained pain
- uncontrolled worry
Panic Disorder
Patients diagnosed with panic disorders experience frequent and unexpected periods of intense fear, discomfort, and loss of control known as panic attacks, even when no clear danger is present. Panic attacks are marked by a pounding or racing heartbeat, sweating, shaking, chest pain, and feelings of impending doom and chaos.
Phobia-Related Disorders
Exposure to stressful or negative life experiences, such as catastrophic injury, is a risk factor for developing phobia-related disorders. A phobia is an intense fear of a particular object or situation that is not proportional to any danger that might be present. Refusing to drive or even sit in a vehicle following a car accident is one example. Patients with irrational or excessive worry over encountering the feared situation avoid it at all costs and experience intense feelings of anxiousness when confronted with it.
Depression
Depression is a mood disorder affecting how a person feels, thinks, and behaves. Catastrophic injuries that cause a loss of independence or changes to life circumstances trigger symptoms of depression in many patients. Nearly 30% of spinal cord injury patients develop some form of depression, with younger individuals at highest risk. Depressed patients experience ongoing feelings of sadness, diminished interest in life activities, and difficulty concentrating. Depression leads to a cycle of suffering and mental anguish that increases physical pain and slows the healing process. Symptoms include:
- Feelings of overwhelming grief, emptiness, or hopelessness
- Tearfulness
- Outbursts of anger, irritability, and frustration
- Lost interest in hobbies and sex
- Insomnia
- Fatigue or a lack of energy
- Unexpected weight loss or gain
- Anxiety, agitation, and restlessness
- Delayed physical reaction times
- Feelings of worthlessness, guilt, and shame
Treatment Options
The impacts of trauma from a catastrophic injury on an individual’s mental health can’t be overstated. Patients experiencing symptoms of psychological distress should seek medical attention immediately. Doing so can speed the recovery process for physical injuries and prevent further emotional trauma to the patient.
