Four years ago, Amy (not her real name) was an attractive, twenty-something living in Boise, Idaho. She had been married for a few years. She and her husband Dan had recently had their first child, and he was working a well-paying job at a technology company while Amy was living her dream of being a stay-at-home mom. When the car accident happened, it was scary and stressful, but they saw it as only a minor speed bump in along the road to their dreams.
Imagine their surprise when things started to crumble not long after the accident.
At first, Amy didn’t know what was going on. She tried to act normal around Dan, but when he went to work she found she just sat on the couch. She avoided going out, especially if it meant she would have to drive herself. Being in the car gave her an unreasonable feeling of fear and anxiety.
Soon, this depression affected her relationship with her husband. Dan couldn’t understand how this vibrant, beautiful, intelligent woman had turned into a recluse who seemed to hate him and hate being a mother. Was it something he had done?
A year after the accident they finally sought professional help. A diagnosis came: Severe depression and PTSD. The cause? The car accident.
Like most of us, Amy and Dan had never heard of a car accident causing depression. “it wasn’t even severe,” they reasoned. “I wasn’t hurt very badly and I completely physically recovered after only a month or two,” Amy explains. “The idea that somehow the car accident had given me this emotional issue was crazy. It didn’t make sense. In a way, it made me feel worse, like I was permanently broken.”
Their marriage began to falter as they sought the best way to deal with this unexpected challenge. More than a year had passed, they reasoned. Shouldn’t Amy’s emotions return to balance soon? Did they need the help of more professionals? How would they pay for such help? What about medication? What about ongoing therapy? A few months later, Dan moved out, and Amy’s depression deepened as she began to lose her sense of identity.
The Hidden Cost of Depression
When many of us think of the cost of injury, we focus on the direct, obvious costs related to the physical injury. How big is the hospital bill? How much does physical therapy cost? For people like insurance adjusters and personal injury attorneys, it can be difficult to evaluate the cost of psychological damage.
Ryan Anderson, attorney at Morris Anderson Law says, “Medical costs are obvious because they are seen. What is often discounted, however, is the cost of depression following an injury. Mental health is hard to quantify, and is often overlooked by health care providers. Unfortunately, when you pursue insurance benefits or workers’ compensation benefits, you might not receive help for the depression and anxiety that can result from an injury simply because it is so often dismissed by outsiders.”
“Usually, people who are injured are out doing things in life,” says Barby Ingle, the Chairperson of the non-profit Power of Pain Foundation, a charity that works to educate and support patients with chronic pain. “Suddenly, they are no longer able to do those activities.”
When you’re in that situation, particularly if an injury affects your ability to work and provide for your family, you can begin to lose your self-esteem. “Who we are is wrapped up in what we do,” says Ingle. “You find yourself losing your sense of self.”
This can result in depression and anxiety. According to a study published in the American Journal of Psychiatry, 19 percent of patients subject to a major brain trauma meet the criteria for major depression after a month.
Another study published in the American Journal of Psychiatry found that at least one-third of all people involved in non-fatal car accidents experience persistent anxiety and depression. The study’s head author, a professor of psychiatry the University of Oxford with the study was published, points out that those with less severe injuries might actually be more prone to psychiatric complications than those who have more severe injuries. It can take between three months and 12 months for many victims to recover from these types of car accidents.
The problem can be even more pronounced the longer the injury lasts. “Usually if an injury is only one or two weeks, a patient can get sad, but as healing takes place, you start to feel better,” says Ingle. “Ongoing injuries, or injuries that result in chronic pain can result in long-term depression, since there is no getting back to what you had as ‘normal’ before the accident or injury.”
In the meantime, since depression and anxiety are not like physical injuries that visibly heal, they may not get the attention — and the compensation — that they deserve.
The Price of Care
When someone is injured on the job or injured in a car accident, the physical injuries can be tracked. Progress is seen, and physical therapy often yields observable results. Mental health is trickier. Even if a patient receives compensation for physical injuries, it can be difficult to receive that same compensation for help battling the associated depression and/or anxiety.
The incidence of depression following a work injury is especially high. According to a study published in the Journal of Occupational & Environmental Medicine in 2012, the odds of injured workers being treated for depression were 45 percent higher than those of noninjured workers. The study, which was conducted by researchers at the Centers for Disease Control and Prevention, points out that, while additional costs related to depression are present, they often aren’t covered by the workers’ compensation system, so employers or the victims themselves are responsible for the costs.
In these cases, especially if insurance doesn’t cover the necessary help, a victim might be responsible for the cost of getting the mental health treatment needed. Many victims may not be able to afford that help, and if insurance doesn’t offset some of the cost, there is a very real risk that untreated depression can lead to suicide.
The World Health Organization reports that less than 25 percent of those with depression receive adequate treatment. Other studies indicate that about two-thirds of people who complete suicide have symptoms of depression at the time of death, and that the risk of suicide is 20 times higher for those with major depression than it is for the general population.
Ingle also points out that treating the mental health of an injured patient can get expensive. “Caring for an injury from any accident can be expensive, and after awhile many patients run low on funds,” she says. “Sometimes the mental health aspect is overlooked.”
In fact, many don’t even realize that those suffering from injury-related depression are underserved because the costs aren’t usually included in figures related to occupational injury. The CDC study suggests that there is a $67 billion price tag for treating work-related injuries and illnesses, but that number doesn’t include the mental health costs.
Information about the cost of depression following car accidents is even hard to quantify, since so many accident victims don’t receive adequate treatment for their depression. Insurance companies are required to compensate for depression in a car accident or other personal injury claim, but it can be hard to accurately assess what this compensation is “worth” — especially if the depression develops a few months after the accident.
Patients injured in any sort of accident need to consider the fact that depression can be costly, especially if it limits the ability to work. Additionally, Ingle points out that it’s important to get help for depression and anxiety, since, left alone, the costs can be even higher, and cost a patient more than money.
For Amy and Dan, the cost of the depression that followed her accident was shockingly high. They experienced a period of separation, and it took Amy nearly 3 years to fully recover from her experience. Dan has moved back in, and Amy is back to the vibrant, active person she was before a relatively minor car accident almost shattered her world.
This article was written by Miranda Marquit, personal finance blogger, and Greg Hamblin, former insurance agent who just wanted to give a car insurance quote to Amy and instead discovered that car accidents do more than just raise rates.
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