A traffic accident can change a person's entire life from one moment to the next, and experts say the physical injury often takes less time to heal than the psychological after-effects.
"Every person reacts differently to shock," says Erneli Martens, a priest working for the emergency rescue services in the northern German port city of Hamburg.
Clear indications that a person is in shock like screaming is seldom the case, she says. "Some people are quite calm and then often don't get any attention."
But First Aid workers should pay special attention to such people. "Sometimes it is sufficient just to be on standby without saying much," she advises.
Questions too can help assess how the person is feeling.
"If the person says something like: 'I don't know where I am', it is an indication of a shock condition and then the person should not be left alone. Relatives can be called to pick the person up," says Martens.
Accident victims should under no circumstances be sedated, warns Dietmar Lucas, from the Association of German Psychologists (BDP).
"This applies especially when the person is highly emotional. The adrenalin level has risen to such a point that a high dosage is necessary to calm down the person, on the other hand the medication disorientates the victim even more," says Lucas.
Psychological after-effects are often revealed days or even weeks after the accident. Rescue workers and eyewitnesses too are known to suffer from post-traumatic syndrome. Lucas points to typical symptoms such as depression, fear, sleeplessness, crying attacks, and heart and stomach ailments.
"I recently treated a woman suffering from extreme flashbacks," Lucas explains. "She was a passenger in a vehicle involved in a serious accident and repeatedly experienced the event like a football match in slow motion."
The mind looks at the situation over and over again trying to reach a conclusion. Sometimes an answer is found that might say: "I have to be more alert when children are playing next to the street."
But even when the person shares no blame for the accident, the mind remains restless because it cannot find a solution, except for one. The person adopts an avoidance strategy by refusing to drive a car again, the psychologist explains.
Accident victims should seek help from advice centres at an early stage if they find they are having problems dealing with the shock, Lucas advises.
Therapists can help the person dealing with flashback. Special courses are offered for people afraid to take the wheel again.
Wilfried Echterhoff, who heads a psychological institute in Cologne for accident victims, says a typical case would involve sessions with a psychologist who would also accompany the person on a test drive to overcome the fear of losing control.