Q: My daughter was recently involved in a serious car accident where one of her friends was badly injured.  We’ve always been a close-knit family, but she’s been more withdrawn, moody, and refuses to talk with us about her feelings since the accident.  What can I do to help her get back to her old self?

A: Thank you for your question. I’m glad that you’re reaching out to help support your daughter during this difficult time in her life, as parental support and guidance are critical for her healing process.  

From what you’re describing, it sounds as if your daughter may have been traumatized by the car accident.  A traumatic experience is an event in life that causes a threat to one’s safety, and possibly places that person’s life, or the lives of others, at risk. As a result, a person will experience high levels of distress emotionally, psychologically, and physically that can temporarily disrupt their ability to function in daily life. Adolescents will often be concerned about the strong emotions they’re experiencing, but due to the developmental stage they are in, they will manage their distress differently than a child or adult. 

After experiencing a traumatic event, one’s body will shift into a state of heightened arousal.  It’s as if the body turns on a series of internal alarms.  When the alarms go off, one is able to access a lot of energy in a short amount of time to enhance one’s chance of survival.  In most instances, this heightened state of arousal will last for a short period of time, or until the threat subsides. One is usually very tired afterward, as this state of arousal uses quite a bit of energy.  

During the normal healing and recovery process, the body is coming down from the heightened state of arousal as the internal alarms turn off, the high energy level subsides and the body returns to a normal state of balance.  This re-setting of the body usually occurs within about one month after the event. 

Adolescence is a time when young people are in the process of navigating their sense of independence.  However, after a traumatic experience, they will tend to vacillate between independence and insecurity, which can be somewhat perplexing for both them and their parents.  

As a parent, it’s important to know the common reactions to trauma in adolescents in order to best support them.  Although every young person is different, the following reactions are what you may see with your daughter:

• Increased alertness and responses to stimuli
• Avoidance of thinking or talking about the event, or the inability to stop thinking and talking about it
• Recurrent, distressing flashbacks, thoughts, or memories about the event
• Strong emotions such as sadness, anger, anxiety, and guilt
• Overreacting to small things
• Changes in mood
• Physical complaints of headache or stomach aches 
• Trouble sleeping or having nightmares
• Isolating and withdrawing from family and friends
• Depression and feelings of hopelessness
• Difficulty with short term memory, focusing, and concentration
• Feeling overwhelmed
• Increased need for independence, yet feelings of insecurity
• A drop in grades and overall school performance

It can be difficult to see your teen struggling, especially if they choose not to talk with you about it.  There are a number of reasons this may be happening. They may still be in shock and trying to deal with the reality of what happened, in addition to being confused about their thoughts and feelings. Again, it’s important to remember that they don’t always know how to identify their feelings, which in turn makes it difficult for them to express their feelings. Adolescents may feel they need to be strong for others or don’t want to upset their parents or family members. Often they may choose to spend time with their peers as it can serve as a distraction from uncomfortable emotions.  

There are a variety of ways that parents can help their adolescent deal with the distress of a traumatic experience.  First of all, it’s important to provide an environment that is consistent and stable.  It may be necessary to limit the amount of activities they are involved in to help reduce their level of anxiety.  Being clear with your teen about the rules and boundaries you have for them will help to establish consistency and routine. Another way to reduce their anxiety is to ensure a predictable environment. This can be done by having clear expectations of them, informing them ahead of time of any upcoming changes in schedules, and making sure they know how to contact you should they need to. 

 After experiencing a traumatic event, it is vital for the healing process to ensure a sense of safety.  This can be done by providing a predictable environment, limiting confusion, and providing opportunities for your teen to share their thoughts and feelings with you without judgment. Keep in mind that there will be things that remind your teen of the trauma they are experiencing (places, people, sounds, etc.).  It will be helpful to develop a plan with them for how they can deal with these reminders. 

If the behaviors or symptoms you’re seeing with your daughter begin to become unmanageable, or are interfering with her daily functioning, it may be helpful to seek professional mental health services.  Fortunately, there are a number of treatment interventions that are specifically designed to help those who are struggling with trauma.  

Gladys Smith