psychiatrist to deal with the stress

A Car Wreck


Dylan, a 15-year-old high school student, was referred to a psychiatrist to deal with the stress from being involved in a serious automobile accident, Dylan was riding in the front passenger seat when, as the car was pulling out of a driveway, it was struck by an oncoming SUV that was speeding through a yellow light.

The car he was in was hit squarely on the driver’s side, which caused the car to roll over once and come to rest right-side up. The collision of metal on metal made an extremely loud noise. The driver of the car, a high school classmate, was knocked unconscious for a short period and was bleeding from a gash in his forehead.

Upon seeing his injured friend, Dylan became afraid that his friend might be dead. His friend in the back seat of the car was frantically trying to unlatch her seat belt. Dylan’s door was jammed, and Dylan feared that their car might catch fire while he was stuck in it. After a few minutes, the driver, Dylan, and the other passenger were able to exit through the passenger doors and move away from the car.

They realized that the driver of the SUV was unharmed and had already called the police. An ambulance was on its way. All three were transported to a local emergency room, where they were attended to and released to their parents’ care after a few hours.

Dylan had not had a good night’s sleep since the accident. He often awoke in the middle of the night with his heart racing, visualizing oncoming headlights. He was having trouble concentrating and was unable to effectively complete his homework.

His parents, who had begun to drive him to and from school, noticed that he was anxious every time they pulled out of a driveway or crossed an intersection. Although he had recently received his driving permit, he refused to practice driving with his father. He was also unusually short-tempered with his parents, his younger sisters, and his friends. He had recently gone to see a movie but had walked out of the theater before the movie started; he complained that the sound system was too loud.

His concerned parents tried to talk to him about his stress, but he would irritably cut them off. After doing poorly on an important exam, however, he accepted the encouragement of a favorite teacher to go to a psychiatrist.

When seen, Dylan described additional difficulties. He hated that he was “jumpy” around loud noises, and he could not shake the image of his injured and unresponsive friend. He had waves of anger toward the driver of the SUV. He reported feeling embarrassed and disappointed in himself for being reluctant to practice driving.

He stated that about 5 years earlier, he had witnessed the near-drowning of one of his younger sisters. Also, he mentioned that this past month was the first anniversary of his grandfather’s death.