Your 17-year-old daughter was recently involved in an automobile accident in which her best friend was killed instantly. Although your daughter was not seriously injured, over the past month, you have noticed that she has become increasingly withdrawn and anxious. She often expresses fear about driving and has recurrent nightmares about the night of the car accident.

Although you suspect that your daughter is feeling distressed, you aren't sure how to intervene. How do you know if your child is depressed or experiencing a more serious problem? What can you do to help her feel like herself again?

It's important to recognize that she may be experiencing an emotional reaction to the accident, and to understand that people who experience a traumatic event can be affected by an anxiety disorder called posttraumatic stress disorder.

What Is Posttraumatic Stress Disorder?
Posttraumatic stress disorder (PTSD) is an emotional condition that often occurs after direct or indirect exposure to a terrifying event in which physical harm was threatened, witnessed, or actually experienced. Traumatic events that can cause PTSD include violent assaults such as rape, physical or sexual abuse, school or neighborhood shootings, natural or manmade disasters, or car accidents. People who have been involved in military combat can also experience PTSD; this form of PTSD is sometimes called "shell shock." Mental health professionals also now recognize that the diagnosis of a life-threatening medical illness can also trigger PTSD in some individuals.

Most people with PTSD try to avoid any reminders or thoughts of the trauma. Despite this avoidance, people with PTSD often re-experience the ordeal in the form of intense "flashbacks," memories, nightmares, or frightening thoughts, especially when they are re-exposed to events or objects that remind them of the trauma, according to the National Institute of Mental Health (NIMH). Survivor guilt (feelings of guilt that result from having survived an event in which friends or family died) is also often a significant component of PTSD.

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