Safe driving and psychiatric illness

Summer is just about here and the streets of our city are gradually getting busier with people heading to the parks and beaches and the many attractions the beautiful region has to offer.

All this extra traffic on the road brings to mind issues of safe driving. You might ask what this has to do with mental health – and I will tell you that many psychiatric conditions can have profound effects on our ability to drive safely.

In the past I have mentioned this in relation specifically to Attention Deficit Hyperactivity Disorder (ADD/ADHD) and this is one of the most common conditions that can affect driving.

Both teenagers and adults with ADD/ADHD have a higher risk of getting into an accident when on the road. In fact, studies show that those with the disorder are in four times as many accidents and are also four times more likely to be at fault for an accident than peers without ADD/ADHD. Individuals with this condition are also much more likely to receive tickets for driving infractions.

This is not surprising given the symptoms of difficulty paying attention, impulsivity, risk-taking tendencies, immature judgment and thrill seeking that are common among individuals with this condition.

Effective treatment of ADD/ADHD can help to diminish these problems. Also, limiting the number of passengers, music and other distractions is very important for those with this condition.

ADD/ADHD is definitely not the only condition that can cause problems with driving safety. Any condition in which a person’s cognitive abilities are impaired can affect the ability to operate a vehicle safely. Some of these include mania, depression, psychotic disorders, dementia and others. As with ADD/ADHD, effective treatment of the condition can often help a lot.

Unfortunately, elderly individuals with conditions such as Alzheimer’s or other dementias may not be able to treat their disorder sufficiently to reverse cognitive impairment.

Alzheimer’s is a progressive disease that continues to worsen in time and can be very dangerous to both the individual and other drivers when driving continues too late into the disease. In these cases, it may be necessary to stop driving.

Sometimes, medications used to treat a psychiatric or other illness can cause driving impairment. Any medication that lists sedation as a possible side effect should not be used in conjunction with the operation of a vehicle. If you are not sure if your medication is going to impair your driving, speak with your health care provider. If you feel impaired you probably are and should not drive. Particular care should be exercised when medication is just started or when the dose is changed. Be cautious until you are sure how you will react. Most antidepressants do not impair driving. They may even improve driving ability since depression is associated with slowing of reaction times and cognitive impairment.

Someone who is manic should not be driving. Poor insight, are lack of inhibition and risk taking are virtually universal in this state and a manic individual is extremely unlikely to limit his or her own driving because lack of insight makes it difficult to realize one’s own impairment.

It may be necessary for a doctor or loved one to initiate a review of driving performance because the affected individual may not be fully aware of his or her limitations. This can be difficult for everyone concerned but it is an important responsibility that we all share. If someone is killed or seriously injured, that is much more difficult to deal with.

Road rage is another serious problem with a psychiatric connection that we will deal with in a future column.

 

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