1 Your guide to anxiety treatment after a motor vehicle accident
2 November 2003 ISBN Published by the Motor Accidents Authority of NSW Level 22, 580 George Street, Sydney 2000 Phone: Fax: TTY: Website:
3 Contents What is anxiety?... 2 What causes anxiety?... 2 What are some of the common symptoms of anxiety?... 3 What can I do to help manage my anxiety?... 3 When should I seek medical advice?... 4 What are anxiety disorders?... 4 What to do if you think you may have an anxiety disorder... 6 How are anxiety disorders treated?... 6 Assessment... 6 Types of treatment... 7 Cognitive behaviour therapy... 8 Counselling... 8 Medication... 9 Hypnotherapy... 9 Debriefing... 9 What to do if you think someone you know may have an anxiety disorder Where else can I get help?
4 What is anxiety? Anxiety is a normal response people have when faced with something that could be dangerous. When a person becomes anxious they usually feel upset, uncomfortable and tense. These feelings may come straight away, or after a period of shock and numbness. Sometimes these feelings are delayed. How people react to similar situations varies from person to person. What causes anxiety? Anxiety can be caused by many things including: Being afraid of certain things like flying Worrying about the future, like exams Past experiences like being involved in a motor vehicle accident. It is normal to experience some anxiety and distress after a motor vehicle accident. 2
5 What are some of the common symptoms of anxiety? People who have been involved in a motor vehicle accident may not experience any anxiety symptoms. Some people may experience only one or two, others more. Common symptoms of anxiety include worrying, being very active, feeling irritable, unable to relax or sleep properly, having no energy, finding it difficult to concentrate, feeling upset, angry, confused, tired, helpless or out-of-control, not wanting to be sociable, having unwanted thoughts or problems with personal relationships. These symptoms can also be caused by many other conditions. Check with your doctor if you are worried about your general health. For most people the anxiety symptoms will not last. What can I do to help manage my anxiety? Give yourself time. Any difficult period in your life needs time to heal. Be patient with yourself and what you are feeling. Anxiety is normal for both men and women. Talk to someone about the accident. It may be a friend, family member or someone you feel comfortable with. Just talking about your experiences, getting information about anxiety and meeting any practical needs is often all that is required to help you manage your anxiety. 3
6 Look after yourself. When people feel anxious they often neglect themselves. Eat balanced meals and try to get plenty of sleep. Do some exercise, like going for a walk. Avoid increasing the amount of alcohol you drink and avoid drugs that have not been prescribed by your doctor. Take some time for yourself and do a hobby or other enjoyable activity. When should I seek medical advice? You should seek medical advice if your symptoms: Are worrying you Are preventing you from doing your normal activities Have lasted longer than three months after the accident Are causing your friends and/or relatives to be worried about you. What are anxiety disorders? Anxiety disorders occur when symptoms do not get better over time and are severe enough to stop some people doing what they normally do. Acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) are two examples of anxiety disorders. 4
7 Most people who are involved in or witness a motor vehicle accident will not develop ASD or PTSD or experience anxiety symptoms beyond three months. Those who do develop an anxiety disorder may experience extreme anxiety and disturbing irrational thoughts and fears. Their home life, job and social activities suffer and their life seems to be overpowered by the experience of the accident. Emotions and behaviours become more intense and some people may also: Have flashbacks to the accident Dream about the accident Become distressed when exposed to reminders of the accident Feel like they are continually in a daze Be out of touch with the world or feel that their life does not seem real Avoid thoughts, feelings or conversations associated with the accident even when they may be beneficial Feel guilty about the accident. Recovery from anxiety disorders is possible with appropriate treatment and support. 5
8 What to do if you think you may have an anxiety disorder It is common for people who have an anxiety disorder to be reluctant to seek help because they do not want to admit their feelings to others. They can be embarrassed by their feelings and may think they will be judged as not having anything wrong with them. Seeking and accepting help can make a lot of difference. Many health practitioners such as a general practitioner, psychologist, social worker, counsellor or psychiatrist can assist with the treatment of anxiety disorders. How are anxiety disorders treated? Assessment Your health practitioner will usually do an assessment if you have anxiety disorder symptoms. Part of the assessment may include filling in a form about the accident and how it made you feel. The information you provide will assist your health practitioner work out the best treatment for you. Having to remember the accident during the assessment can make you feel a little more anxious. Let your health practitioner know if the assessment is causing you additional distress. 6
9 Types of treatment The treatments described in this booklet will not be suitable for everyone with an anxiety disorder. Your health practitioner will work out what is best for you. Your health practitioner should explain the treatment they will use and get your approval before they start. This is called getting your informed consent. Everything about your treatment, including all you say, is strictly confidential. You will need to give your consent before any information about your treatment can be passed on. The treatments listed below have been taken from the MAA s publication Guidelines for the management of anxiety following motor vehicle accidents. The list starts with the treatments that have been shown to have the best results. 7
10 Cognitive behaviour therapy The best treatment to try first is usually cognitive behaviour therapy. A range of different treatments come under the heading of cognitive behaviour therapy, including: Training you to challenge the way you think about the accident, for example, not blaming yourself for the accident happening Under supervision of the therapist describing the accident or writing a detailed account of it which you then read to the therapist as well as to yourself Developing ways to manage your anxiety, for example, by relaxation, breathing training and learning coping skills. Counselling Although less effective than behavioural therapies, counselling provides a supportive, relaxing environment to talk about the accident and your feelings with a trained health professional. People sometimes feel more comfortable talking to someone who is not a friend or family member. Counselling sessions are useful for giving information about anxiety disorder symptoms and support to decrease symptoms. They do not include any training or tasks that may be demanding or distressing. 8
11 Medication Medication is one of a range of treatments for an anxiety disorder. If you have been prescribed medication to help manage your anxiety, ask your medical practitioner to explain how it will help you and if there are any side effects. Hypnotherapy Hypnotherapy may assist in the treatment of PTSD if combined with cognitive behaviour therapy. Hypnotherapy by itself is not considered an effective treatment for anxiety following a motor vehicle accident. Debriefing This is talking through your experience of the accident with a person trained to do debriefing. It is usually done in one session and within 72 hours of the accident. You may have heard a lot in the media about debriefing after a motor vehicle accident and that it seemed like a good thing to do. However, it has been shown not to be useful in reducing anxiety disorders. 9
12 What to do if you think someone you know may have an anxiety disorder Remember they cannot just choose to be less anxious. Saying things like don t worry so much will not help. Remind the person it is normal to feel anxious after an accident and that anxiety can go away over time. Encourage them to talk about the accident and their feelings and accept how they feel. Do not pressure them to talk if they are not ready. Although the person needs your support, try not to take over. It is important they feel they have control over what they are doing. As they adjust to the experience of the accident they will have good and bad days. You may need to remember this. If you think their anxiety is becoming a problem, encourage them to accept that they are not well and have the right to seek help, just as they would for a broken bone. 10
13 Where else can I get help? Further information on anxiety is available from: Mental Health Association of NSW Information Service Phone: or Web: Health NSW Common Health Topics Web: NSW Anxiety Disorders Alliance Phone: or Anxiety Disorders Association of America Web: National Center for PTSD Web: For information or help making a compulsory third party personal injury claim, contact the: Motor Accidents Authority Claims Advisory Service Phone: (cost of a local call) Web: 11
14 Other publications This guide is for people involved in motor vehicle accidents and for their friends and family. The MAA has also published a technical guide for health professionals involved in the treatment of anxiety disorders. Copies of Guidelines for the management of anxiety following motor vehicle accidents can be downloaded from the MAA web site: or phone to order a copy. 12
16 Published by the Motor Accidents Authority of NSW Level 22, 580 George Street, Sydney 2000 Phone: Fax: TTY: Website:
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