On-going symptoms

It is common for strong emotional reactions and physical symptoms, as described earlier in this guide, to begin to subside gradually and go away.  Your reactions and symptoms are likely to subside even though you are still grieving and very sad about what has happened. However, you may also find that some of your reactions and symptoms don't go away entirely, or come back sometimes, or even get worse.

If strong emotional reactions and/or physical symptoms do not start to subside within the first few months following a traumatic bereavement, reactions and symptoms may be described by medical personnel as a condition or several conditions.

One condition is Post-Traumatic Stress Disorder. People said to be suffering from Post-Traumatic Stress Disorder may suffer a range of on-going reactions and symptoms, including, for example, suffering flashbacks of what happened, having extreme emotional outbursts or feelings, or being very fearful and avoiding certain situations. Significant minorities of people bereaved by road crashes (up to nearly half in some studies) have been found to suffer from Post-Traumatic Stress Disorder [1].

Other conditions include depressive disorders and anxiety disorders. For example, people said to be suffering from depression may suffer in a variety of ways, such as struggling to feel happy or motivated or struggling to perceive a meaningful or happy future. 

Getting help

If you are suffering on-going emotions and symptoms, it is important to continue to seek support from family or friends. However, if available, you should also consider seeking treatment. It is not a sign of weakness to do this. You have suffered a terrible event and are correctly putting your welfare first so you can have a happy future.

The recommended help for people who have suffered a sudden bereavement and have ongoing trauma symptoms usually includes, centrally, confidential one-on-one sessions, with a psychological therapist who has training and experience in helping suddenly bereaved people to recover, through talking.

This approach is backed by government advice. For example, England’s National Institute for Health and Clinical Excellence guideline 26 

Talk-based therapy is recommended for children as well as adults. 

However, it can be hard for many people to access this specialist help. Many bereaved road crash victims have told Brake that they didn't know how to access this kind of help, or it wasn't available to them free or at low cost, or that there was a long waiting list. In the poorest countries, this kind of help may not be available. 

If you think this kind of help may be available where you live, but you don't know how to access it, talk to people around you who might know, such as a doctor or faith leader. Showing them this page may help them understand your needs. 

If you try counselling, and you don't find your counsellor helpful, it can be worth trying a different counsellor who better meets your needs. 

There may also be charities who can help you. For example, in the UK, Brake runs a helpline for bereaved and seriously injured road crash victims, and there are other charities around the UK providing various kinds of face to face support and counselling for people with a range of different needs, for example charities that specifically support bereaved children. 

Faith leaders can also be helpful at this time. 

Drug treatments

Drug treatments such as anti-depressants are not recommended as a first-stage treatment. They are not a good alternative to expert, talk-based therapy. 

Drugs may mask rather than cure symptoms, may impede your ability to function normally, may have a range of side effects, and may be addictive and difficult to give up.

Some people bereaved by road crashes find some drugs useful to them, for example drugs that help them to sleep if they are struggling with insomina. You are recommended to consider carefully and discuss risks of any drugs you are offered and the duration over which you may take them. 

Moving towards happiness 

Many suddenly bereaved people who are starting to feel generally more positive about life and are recovering from their shock symptoms find that bad days and sad thoughts still occur. This is a normal part of grieving.

For some people this happens particularly at times such as anniversaries. Sometimes something small such as a smell, sound, comment, or photograph can trigger sad emotions.

When something good happens it is sad the event cannot be shared with the person who died.

But it should gradually become easier to have happy thoughts about someone who has died and the joy they brought to the world. It should become easier for you to enjoy life and the experiences it brings.

For many people, being happy again is a wonderful way to respect someone who has died and the joys of life. It is not disloyal to someone who has died to feel happiness again.

 @Copyright Brake 2017

[1] Heron-Delaney M, Kenardy J, Charlton E, et al. A systematic review of predictors of posttraumatic stress disorder (PTSD) for adult road traffic crash survivors. Injury, 2013, 44(11):1413–1422