HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

Suggest Treatment For Post-traumatic Stress Disorder After An Accident

default
Posted on Tue, 9 Feb 2016
Question: hi, my daughter was rear ended in a car accident back in October 2015, she suffered a concussion and whip lash. she has been doing PT for her back and neck since. Had an MRI done on her and that showed nothing. However, her penmanship has changed along with some of her personality, she has been a straight A student all through High School and all 3 years in college - she will be taking her last semester of college after winter break. She received incompletes for all of her fall 2015 classes but because she has been a straight A student and a great kid all 21 years of her life, her professors were willing to let her complete her work over this winter break. Back in early 2015 her primary suggested Zoloft for her to help with some anxiety she had been having. However, the day after her accident she took herself OFF zoloft and did not consult her physician nor let me (her mom) know. I only found out after the pharmacy at her college was calling the home phone for her to pick up her prescription a couple of times within a 2 week span back in end of November. I spoke with the XXXXXXX of Students at her College as my concerns grew worse to find out if she had even been attending classes after being home for 3 weeks after her accident. She had not hardly if at all been going to classes. Since she has been home for winter break, she seems to have off and on days but my BIG concern now is I notice her right hand thumb and pointer fingers twitching almost in a circular motion. We tried to have a psychiatric eval done on her at emergency room but she refused to sign anything to stay overnight. She is a criminal justice and psychology major - so she knew enough that if she signed the paperwork she may never find a job in the field of criminal justice/psychology. She has not seen too much of her friends this winter break. She tells me that she is taking care of herself and trying to get her school work done. She seems to have picked up her studying more within the last week and actually see her doing her papers online. Dr's at the hospital after trying to get her evaluated stated that she should see a psychologist on a regular basis and enroll her in a post concussion clinic. She has an appointment March 21st - but I have had her primary call and say that she needs to be seen sooner - so she is at top of wait list to see a neurologist. Is there anything else that I should be doing. She is adamant that there is nothing wrong with her and that she does not need to be on medication. FYI - her cousin committed suicide 7 years ago. Mom needing some guidance......Thank you!
doctor
Answered by Dr. Alexander H. Sheppe (6 minutes later)
Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks very much for your premium question.

First, let me say that you are indeed right to be worried about this situation. Even with a negative MRI, what you are describing are very concerning symptoms. Traumas like this are called TBIs (traumatic brain injuries) and can be quite serious.

You describe two symptoms of complications of TBI. One is depression and withdrawal, which your daughter exhibits, especially with regard to the decline in her school attendance. Another problem is this twitching of her fingers. She may be having seizures.

She needs an urgent psychiatric evaluation for depression (she would beenfit from an antidepressant), and an urgent neurological evaluation for TBI and possibly seizures. The sooner you make an appointment, the better. You are doing all you can to help your daughter. Continue to show her support during this difficult time.

In the future, for continuity of care, I encourage you to contact me at my private link below. After you ask a direct question it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by : Dr. Prasad
doctor
default
Follow up: Dr. Alexander H. Sheppe (38 minutes later)
Thank you for your advice and I think I have tried to do everything I can for her so far. I need to call her out on her finger movements I think? I have tried to keep an even keel at home with her as to not upset her as she seems to get upset if I call her out on anything. She drove thru toll booths 3 times with no payment, I paid 2 of them for her, she has parked her car on campus right in front of her dorm and received 3 tickets for it. XXXXXXX told her not to worry about those, she said she would talk to security on campus and have those taken care of. she has taken out 3 credit cards of which I made her pay - she seems to finally this week taking responsibility for paying what she owes including the one toll XXXXXXX I told her I would not pay for. How do I get a 21 year old to realize that she needs more help than she thinks she needs? Social worker isn't going to be able to help her.
doctor
Answered by Dr. Alexander H. Sheppe (23 hours later)
Brief Answer:
Followup

Detailed Answer:
It is clear you love your daughter very much. You want to do everything you can to make her feel and be okay. You ask how to make her realize that she needs more help than she thinks she needs.

I think one possible solution to this, paradoxically, is to stop helping her when she gets into trouble. When you bail her out of situations like running through toll booths or getting parking tickets, she does not learn that there are negative consequences to her irresponsible actions. Sometimes it takes something bad happening for people to really realize that something is wrong.

In my experience, parents want to help their children as much as they can. But sometimes you have to step back and allow them to fail to learn from their mistakes?

Does this make sense? What are your thoughts?

Dr. Sheppe
Above answer was peer-reviewed by : Dr. Prasad
doctor
default
Follow up: Dr. Alexander H. Sheppe (36 minutes later)
I totally understand that and at the time I paid them for her was to just get that off our plate at that time, as I had harder things to deal with. That is why after that I told her one more ticket and it was on her. She has since paid that ticket and has worked out things with the XXXXXXX of Students about her 3 tickets illegally parked on campus. My fear is because she has been SUCH a great student and has had SO much going for her in her future that if I let her fall into that black hole - she is never going to reach her work goals of which she so deserves. I understand I can't be her crutch and to take a hard stand and I was trying to wait to do that after she has been actually diagnosed with 'something'. I told her today, when the Mass General in XXXXXXX calls with their next available appointment calls, we are going that nothing else matters. She said OK mom but what is a neurologist going to do for me? I told her, XXXXXXX you have not been the same since your accident and I want a professional's opinion as to what is going on with you. She still doesn't see it. I have so much I can show the neurologist and things to tell the neurologist of what I have observed. Who knows a child better than their mom? I feel defeated already and have done nothing but try to get help for her. I thank you for your answers but you did not answer one of them, do I call her out on me seeing her finger movements? OR do I save that for when she finally can see the neurologist - I feel as if I don't want her to feel bombarded but someone in the 'KNOW' needs to see and diagnose what I have been seeing. Your thoughts? again, Thank you!
doctor
Answered by Dr. Alexander H. Sheppe (2 minutes later)
Brief Answer:
Followup

Detailed Answer:
I would ask your daughter about the finger movements. If she denies that it's a problem, at least you brought it to her attention. You can then bring it up to her neurologist when you do see one, and let the neurologist use this information in their decision making. I think having a dialogue with your daughter about this issue is probably the best approach. Who knows, maybe she also notices the finger movements but is too afraid to talk about them.

Dr. Sheppe
Above answer was peer-reviewed by : Dr. Prasad
doctor
default
Follow up: Dr. Alexander H. Sheppe (23 hours later)
I will do that, and I thank your for your support. I just wanted to make sure that I had support of a professional in the know... I appreciate your help and wish me luck!
doctor
Answered by Dr. Alexander H. Sheppe (4 hours later)
Brief Answer:
Followup

Detailed Answer:
You are very welcome! I am happy to be of help. I wish you the very best of luck.

Again, in the future, for continuity of care, I encourage you to contact me at my private link below. After you ask a direct question it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
Answered by
Dr.
Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2236 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Suggest Treatment For Post-traumatic Stress Disorder After An Accident

Brief Answer: Consultation Detailed Answer: Hello, and thanks very much for your premium question. First, let me say that you are indeed right to be worried about this situation. Even with a negative MRI, what you are describing are very concerning symptoms. Traumas like this are called TBIs (traumatic brain injuries) and can be quite serious. You describe two symptoms of complications of TBI. One is depression and withdrawal, which your daughter exhibits, especially with regard to the decline in her school attendance. Another problem is this twitching of her fingers. She may be having seizures. She needs an urgent psychiatric evaluation for depression (she would beenfit from an antidepressant), and an urgent neurological evaluation for TBI and possibly seizures. The sooner you make an appointment, the better. You are doing all you can to help your daughter. Continue to show her support during this difficult time. In the future, for continuity of care, I encourage you to contact me at my private link below. After you ask a direct question it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private link: tinyurl.com/DrSheppeAnswers