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Summary: Yes, a road rage incident can cause PTSD, when it results in significant distress triggered by a real fear for physical, emotional, and/or psychological health and wellbeing.

Key Points:

  • Post-traumatic stress disorder (PTSD) can develop in response to any traumatic event.
  • PTSD can develop soon after the initial traumatic incident or develop months or years after the initial traumatic incident.
  • A road rage incident – due to the heightened emotions and elevated danger – easily meets criteria for a traumatic event that can lead to PTSD.

Road Rage: Anger and Fear in a Dangerous Situation

When we’re driving an automobile, we often forget the dangers that are close at hand. Think about it for a moment. We’re inside a heavy machine – maybe 2,000 pounds for a small car and over 5,000 pounds for an SUV – hurtling down the road at speeds that on the high side are two to three times as fast as a human can being can run. But that’s not all. We’re on roadways in close proximity to other thousand plus pound machines traveling at similar speeds, often passing within feet – or even inches – of vehicles passing in the opposite direction.

That’s why, with the exception of a minor, low-speed fender-bender or bumper tap in a line of traffic or parking lot, automobile accidents and near misses can be incredibly traumatic. In an instant, we go from the safety of our climate controlled cockpit, listening to music, a podcast, or simply enjoying the drive, to a serious crash that can cause injury or death, or a close call that floods your body with adrenaline and stress hormones that can result in a wide range of downstream psychological, emotional, or physical responses.

That’s why road rage can cause PTSD: fear for physical safety triggers a fight or flight response that may fade after the incident but may also recur in the presence of reminders of the incident. That’s basically the definition of a flashback, a primary PTSD symptom: a re-experiencing or re-living of the initial traumatic incident. Here’s something anyone new to learning about trauma should know:

During a flashback, your body and brain believe the initial incident is happening again. They respond as if no time has passed, can’t tell the difference between then and now, and make you feel like you’re there, back in that moment, and the negative emotions can feel just as strong as they did when the trauma occurred.

Let’s take a closer look at PTSD and learn more about why and how a road age incident can cause PTSD.

Important Facts About PTSD, Causes of PTSD, and How Traumatic Experiences Affect People

First, to ensure we’re all on the same page, here’s a definition of PTSD from the Merck Manuals, an excellent resource for evidence based information on mental health disorders:

“Posttraumatic stress disorder (PTSD) is a disabling disorder that develops after exposure to a traumatic event. It is characterized by intrusive thoughts, nightmares, and flashbacks, avoidance of reminders of the trauma, negative cognitions and mood, hypervigilance, and sleep disturbance.”

And, to add another layer of knowledge and understanding, here’s what we mean by trauma in its psychological/emotional context, as defined by the American Psychological Association (APA):

“Any disturbing experience that results in significant fear, helplessness, dissociation, confusion, or other disruptive feelings intense enough to have a long-lasting negative effect on a person’s attitudes, behavior, and other aspects of functioning.”

The APA goes on to define categories of trauma and traumatic events.

Trauma caused by human actions:

  • Rape
  • War
  • Terrorism
  • Physical and emotional abuse
  • Community violence
  • Industrial accidents
  • Serious disease, illness, or injury

Trauma caused by nature:

  • Earthquakes
  • Floods
  • Wildfires
  • Hurricanes
  • Tsunamis
  • Tornadoes
  • Volcanoes

Here’s an aspect of the APA definition of trauma that’s germane to our discussion of whether a road rage incident can cause PTSD:

“A traumatic event often challenges an individual’s view of the world as a just, safe, and predictable place.”

When we think of these aspects of what defines drama together, we can see that a road rage incident clearly meets criteria that define a traumatic event in two important ways:

  1. A road rage incident is a disturbing experience that can cause significant fear, helplessness, confusion.
  2. A road rage incident can challenge the view that the world is safe, just, and predictable.

That makes sense. A person drives along, minding their own business, and suddenly another driver shatters that peace and creates a dangerous situation, i.e. distracted driving, which in turn causes fear, i.e. what is this person going to do/are they going to run me off the road, and that fear engenders confusion and helplessness – and sends the body into fight or flight mode by flooding the body with stress hormones.

Now let’s look at the symptoms of PTSD a road rage incident might cause.

PTSD Symptoms: Fear-Based, Avoidant Behavior Disrupts Life

Experts on PTSD from the U.S. Department of Veterans Affairs (USVA) National Center for PTSD identifies four primary types of symptoms associated with PTSD. Being the focus, victim, or target of a road rage incident has the potential to cause any or all of the symptoms in the following categories.

Road Rage Incidents and PTSD: Possible Symptoms

1. Reliving the event, called flashbacks or re-experiencing.

    • An environmental cue – sight, sound, texture, taste, smell – might trigger memories of the road rage incident.
    • When the environmental cue – called a trigger – occurs, a person may feel like they’re reliving the event, with all the negative aspects present or heightened. This is called a flashback.

2. Avoidance behavior.

    • A person who experiences a traumatic road rage incident may avoid anything that reminds them of the event, including:
      • Driving
      • Riding in car
    • If they’re able to drive, they may avoid anything reminiscent of the event, such as:
      • Being on the freeway
      • Traffic
      • Cars that look like the other car involved in the incident
    • They may avoid talking about the incident – or avoid thinking or talking about cars – altogether.

3. Deteriorating mental health.

    • The symptoms of PTSD can cause behavior associated with mental health problems such as anxiety and depression, including:
      • Withdrawal from family and friends
      • Low mood, persistent negative thoughts/thinking
      • Chronic tiredness
      • Low self-esteem
      • Increasing use of drugs or alcohol to reduce/cope with negative emotions

5. Feeling on edge all the time, called hypervigilance and/or hyperarousal:

    • Worried all the time
    • Constantly jumpy and anxious, as if something bad is about to happen
    • Easily startled
    • Uncharacteristic irritability, anger, angry outbursts
    • Problems falling asleep and staying asleep

A deep dive into research on PTSD symptoms shows that fear – the most likely outcome of a traumatic road rage incident – is associated most strongly with the following PTSD symptoms:

  • Flashbacks
  • Nightmares
  • Upsetting memories
  • Extreme avoidance
  • Elevated startle response

These symptoms, when left untreated, can cause significant disruption in daily life, including:

  • Problems with family, peer, and romantic/partner relationships
  • Problems navigating work, school, and social situations
  • Difficulty with memory, concentration, and decision-making
  • Risky behavior, including unsafe sex and excess use of intoxicants

Yes, it’s true: a road rage incident has all the components that can cause PTSD. If you have any of the symptoms of PTSD we mention above, they’re related to cars and driving, and you’ve been the target or victim of a recent road rage incident, then we encourage you to seek a full psychiatric evaluation. If an experienced mental health provider diagnoses PTSD, then you can seek professional support and appropriate, evidence-based care.

Treatment for PTSD: What Works?

The foundation of PTSD treatment is an approach called trauma informed care, which providers organize around three guidelines: realize the impact trauma has on a person, recognize the symptoms of trauma in a person, and actively work to avoid retraumatizing during treatment. To learn more about trauma-informed care, please read this article on our blog:

What is Trauma-Informed Care for Mental Health Disorders?

When adhering to the core guidelines and principles of trauma-informed care, evidence shows the most effective treatment for PTSD includes an integrated, holistic, person-first combination of the following treatment modalities:

  • Psychotherapy
  • Medication (if needed)
  • Education
  • Lifestyle changes
  • Complementary/Expressive Therapies

Here’s how the Veteran’s Administration introduces their resource page on PTSD treatment:

“PTSD treatment works. Those who have gone through trauma can learn to feel safe in the world and cope with stress. There are several helpful treatments, so you have options. There is no one treatment that is right for everyone. Working with your health care provider, you can decide together which is best for you based on benefits, risks, side effects and other preferences.”

This is true whether your PTSD was caused by childhood trauma, military service, or a road rage incident. The emotions, the fear, and the avoidance can be disruptive and problematic for anyone with PTSD, and when left untreated, rarely resolve on their own, but rather escalate over time and cause more disruption, functional problems, and emotional distress.

An important thing about PTSD treatment to understand is that medication is a relatively small part of the overall treatment picture. An approach that focuses on the whole person – work, school, social life, family – and helps them process their memories and emotions effectively leads to the best outcomes.

An experienced PTSD therapist helps patients with lifestyle changes and supportive modalities that promote overall wellness, including but not limited to:

  • Sleep hygiene
  • Healthy eating
  • Daily exercise and activity
  • Stress management, i.e. yoga, mindfulness

However, the core of PTSD treatment is one-on-one therapy with an experienced, skilled psychiatrist, psychotherapist, or counselor, and should involve some type of exposure therapy focused on the healthy, effective, and productive processing of traumatic memories. Evidence-based psychotherapeutic approaches and gradual exposure modalities include:

  • Cognitive behavioral therapy (CBT)
  • Cognitive processing therapy (CPT)
  • Cognitive therapy (CT)
  • Prolonged exposure therapy (PE)
  • Written exposure therapy (WET)
  • Eye Movement Desensitization and Reprocessing (EMDR)
  • Present-Centered Therapy (PCT)

Remember: treatment work. And the earlier a person with PTSD – from a road range incident or other source of trauma – gets the treatment they need, the better the outcome.

Online PTSD Resources: Find the Support You Need

If you or someone you know needs professional treatment and support for PTSD, please contact us here at Crownview Co-Occurring Institute: we can help. In addition, you can find support through the following online resources:

About Angus Whyte

Angus Whyte has an extensive background in neuroscience, behavioral health, adolescent development, and mindfulness, including lab work in behavioral neurobiology and a decade of writing articles on mental health and mental health treatment. In addition, Angus brings twenty years of experience as a yoga teacher and experiential educator to his work for Crownview. He’s an expert at synthesizing complex concepts into accessible content that helps patients, providers, and families understand the nuances of mental health treatment, with the ultimate goal of improving outcomes and quality of life for all stakeholders.