You’re rear-ended on Tropicana at dusk. The impact snaps your wrist against the steering wheel; airbags bloom, glass settles, sirens fade. The ER splints you, the orthopedist sets a plan, your attorney gets the file moving. Family says, “You’re lucky—this could’ve been worse.”
Six weeks later your cast is off, but you aren’t okay. Headlights in your rearview make your heart thud. You avoid left turns. Sleep is shallow and fractured; mornings arrive with a clenched jaw. Coworkers ask if you’re distracted. You start skipping outings because crowds feel like a threat. No one mentioned psychiatry. No one asked how the nights are going.
On paper, you’re “recovered.” In real life, the injury never ended.
What you’re feeling isn’t rare...it’s the rule after trauma.
In a prospective cohort of 1,084 injured patients followed at 4 major trauma hospitals, 31% met criteria for a psychiatric disorder at 12 months; 22% had a new disorder they’d never experienced before (common new diagnoses: major depression 9%, generalized anxiety 9%, PTSD 6%, agoraphobia 6%). (PubMed)
Mild TBI made several disorders ~2× more likely (e.g., PTSD OR 1.92, panic disorder OR 2.01, social phobia OR 2.07, agoraphobia OR 1.94). Crucially, functional impairment tracked most closely with psychiatric illness—i.e., life actually works worse when these conditions are present. (PubMed)
Put plainly: psychological fallout is common, diagnosable, and tied to real-world disability, not just “stress.” (PubMed)
Even when symptoms are severe enough to warrant treatment, most injured people never receive mental health care in the first year. despite effective treatments existing. In a prospective study of 677 trauma-center patients (with 6- and 12-month follow-ups), the single strongest predictor of getting care was physician referral. Without it, uptake was poor; with it, the odds of using mental health services were nearly eightfold higher. (PubMed)
Translation: the difference between living with it and getting better is often whether someone opens the door to psychiatric care. (PubMed)
No referral. No evaluation. Life quietly shrinks.
Sleep fragments into short, anxious cycles; daytime fatigue worsens concentration...exactly the kind of functional impairment that accompanies post-injury psychiatric illness. (PubMed)
Avoidance spreads: first night driving, then highways, then social plans; the world narrows around the fear.
Mood dips; irritability strains relationships; work performance falters. None of this shows on an X-ray, all of it matters.
Medically and legally, the injury remains invisible because it’s undocumented.
The cost isn’t just emotional. It’s missed treatment, prolonged disability, and sometimes, if there’s a legal case, that's unrecognized harm.
Now rerun the same story with one difference: someone closes the loop. Your surgeon, PCP, therapist, or attorney initiates a psychiatric referral with a board-certified MD who understands the implications of personal injury and the Las Vegas landscape.
You’re evaluated at Axis Psychiatry using structured, diagnostic methods; symptoms are named (e.g., PTSD, adjustment disorder, depression) and dated to the incident. (PubMed)
A plan starts: trauma-focused therapy, sleep strategies, and medication when indicated—and the trajectory bends toward recovery. The AJP cohort underscores why this matters: identification and treatment of psychiatric disorders are “important for optimal adaptation after traumatic injury.” (PubMed)
Crucially, you now have objective medical documentation, not just “I feel off,” but charted symptoms, severity, and functional limitations over time (the exact currency courts and insurers understand). (PubMed)
Statistically, this shift is decisive: with a referral, patients become nearly eight times more likely to actually receive care. That’s not a nudge; that’s a door swinging open. (PubMed)
Without treatment
Hyperarousal and avoidance harden into habits; the “small” crash begins to dictate routes, jobs, relationships.
Sleep and mood erode, compounding functional impairment—the variable most closely linked to post-injury psychiatric illness in the AJP cohort. (PubMed)
In litigation, distress is easy to minimize because it isn’t clinically established, measured, or tied to causation.
With treatment
Nighttime improves first; better sleep reduces reactivity, which makes exposure work (e.g., getting back behind the wheel) tolerable.
Targeted therapy and, when appropriate, medication reduce panic spikes and restore daily function—exactly the “optimal adaptation” trajectory emphasized by Bryant et al. (PubMed)
Documentation translates experience into admissible medical evidence: baseline vs. post-incident status, diagnosis, severity, prognosis, and reasonable treatment needs. In real cases, that’s the difference between “subjective complaint” and recognized injury. (PubMed, Digital Commons@DePaul)
Courts have learned what clinicians see daily: pain you can’t see can still disable. Legal scholarship catalogues how psychiatric expertise makes these harms legible to the fact-finder: clarifying diagnosis and causation, quantifying impact, and distinguishing genuine injury from ordinary upset. (Digital Commons@DePaul)
Two well-known doctrines illustrate the point (examples, not limits):
Eggshell plaintiff: defendants take plaintiffs as they find them. If trauma aggravates a pre-existing vulnerability (say, anxiety to panic disorder), the law doesn’t discount the worsening—it recognizes it. Psychiatric evaluation is how that aggravation is shown. (Digital Commons@DePaul)
Negligent infliction of emotional distress (NIED): when severe emotional harm occurs (including in certain bystander scenarios), courts look for objective medical evidence. Psychiatric testimony converts “invisible pain” into defensible fact. (Digital Commons@DePaul)
In short: psychiatry doesn’t inflate claims; it illuminates injuries the law already contemplates so people aren’t left uncompensated simply because their wounds don’t bruise.
At Axis Psychiatry, personal-injury psychiatry is a core competency, not an afterthought. We designed our process to close the loop quickly and thoroughly:
Fast access: five experienced providers and flexible scheduling—because delays harden symptoms and prolong suffering.
Comprehensive evaluations: incident-anchored timelines, differential diagnosis, severity and functioning assessments, and treatment plans linked to measurable outcomes. (That “functioning” piece is pivotal, echoing the AJP finding that impairment is the practical signal of illness after injury.) (PubMed)
Court-ready documentation: clear causation analysis, baseline vs. post-injury comparisons, prognosis, and reasonable care needs, which is precisely the kind of objective record Wong et al. show is more likely to be created when someone initiates referral. (PubMed)
People deserve to recover fully. That requires seeing, and treating, the injuries that never make the scan.
If you’ve been physically hurt and something still feels wrong months later, you’re not failing recovery; you may have a treatable psychiatric injury that’s common after trauma. The data says you’re not alone (31% at a year; 22% brand-new conditions). Identification and treatment change outcomes. (PubMed)
If you’re a clinician or an attorney guiding someone through recovery, the evidence is straightforward: referral is leverage for health (nearly 8× higher odds of care uptake) and a reliable bridge between lived distress and legally cognizable harm. (PubMed)
Axis Psychiatry exists to close that loop, so “recovered” means more than a mended bone.
Bryant, R. A., et al. “The Psychiatric Sequelae of Traumatic Injury.” American Journal of Psychiatry 167(3):312–320 (2010): 12-month prevalence 31%, 22% new-onset; increased odds with mild TBI; impairment associated with illness; importance of identification/treatment for optimal adaptation. (PubMed, Psychiatry Online)
Wong, E. C., et al. “Mental Health Service Utilization After Physical Trauma: The Importance of Physician Referral.” Medical Care 47(10):1077–1083 (2009): prospective n=677; nearly 8× higher odds of service use with physician referral. (PubMed)
Bromberg, W., & Brody, S. A. “Psychiatry and the Law of Personal Injury.” DePaul Law Review 21(1):28 (1971): early analysis of psychiatry’s role in clarifying, validating, and quantifying emotional harm in personal-injury litigation. (Digital Commons@DePaul)
This post is for informational purposes only and is not medical or legal advice. For individualized guidance, consult a licensed clinician or attorney.
