Being accident-prone might be a symptom of other health problems

Did you scald your hand with coffee this morning? Cut yourself shaving? Twist your ankle on a curb? Just another bad day, right? But what about rear-ending that car last week or slicing your finger while making dinner the other night?

A rash of mishaps may spell more than bad luck. Like a fever warning of an infection, being accident-prone can be a symptom of deeper issues, according to health writer and accident expert Samantha Dunn, author of the new book, "Not by Accident: Reconstructing a Careless Life" (Henry Holt, 2002).

Her theory is echoed by experts who say that mental states such as stress, depression and anxiety can make us more vulnerable to accidents. The result can be as minor as spilled coffee or as major as a spill down the stairs. For Dunn, the result was nearly fatal.

Her memoir, coming to paperback in March, offers lessons for anyone who has ever been accused of having two left feet.

Dunn, who lives in Malibu, Calif., but spent part of her childhood in Arlington, had always laughed off her pattern of sprains, cuts and broken bones until five years ago after her left leg was almost severed when she inadvertently startled her horse and was trampled.

During 18 months of recovery, she began to examine her painful history of accidents, which had escalated: She had recently fallen down a flight of stairs and had broken her tailbone in another horseback-riding accident. She also delved into the research and became an expert in the science of clumsiness.

She concluded that stress and depression were at the root of her lifelong predisposition to calamity, and that guilt over her unraveling marriage had intensified its severity.

"There are periods in a person's life when they go through incredible rashes of accidents," Dunn said. "I'm not saying it's a psychological syndrome, but a confluence of what's going on in their life."

A warning flag

Anything that divides our attention can lead to clumsiness, according to mental-health experts.

"Certain emotional states can in and of themselves be a distraction so you're not focused on what you should be — so you cut your finger while slicing bread or you slip while walking down stairs," said John Carr, professor emeritus of psychiatry at the University of Washington.

Research is sparse because accidents by their nature are unpredictable and generally caused by multiple factors. But car-crash research and clinical observations suggest stress, depression, anxiety and sleep deprivation can contribute — likely because of the mental distraction, slowed reaction time and clouded judgment that characterize these states, notes Carr.

For instance, a study of couples with marital troubles found people had a higher incidence of traffic accidents and violations in the year surrounding a divorce.

Dr. Matthew Handley, a family physician at Group Health, said that when he sees a patient coming in repeatedly with a series of injuries, it serves as a warning flag. Often, he said, it's a clue to alcohol abuse or other high-risk behaviors. Or he may find that the patient has lost a job or is having difficulty in a relationship and may need counseling to help manage stress.

The connection may also work the other way around, suggests UW clinical psychologist Craig Sawchuk. "Bad things happen and for some people they can happen more frequently than for others. It can take a toll and cause stress and anxiety and feelings of depression," he said. This could lead to a cycle of stress contributing to accidents, which in turn fuel even more stress.

'Always been a klutz'

People who are involved in a string of mishaps often make two disempowering assumptions, Dunn said. They either attribute it to some greater power — "God is trying to tell me something" — or dismiss it as some personality flaw — "Oh, I've always been a klutz."

"Accident-proneness can be a harmful concept; if you buy into that you give up on trying to prevent injuries," said Harborview's Dr. Frederick Rivara. As founding director of the hospital's Injury Prevention and Research Center, Rivara wants people to know that most injuries can be prevented.

And we're not just talking about sparing your banged-up shin from another bruise. Unintentional injuries are the No. 1 cause of death among people age 1 to 34 in Washington and the No. 5 cause of death among all ages combined, according to Centers for Disease Control and Prevention statistics.

By far, the biggest cause of injury deaths is traffic accidents, a realm in which Rivara notes distracted people need to be particularly careful as they can endanger others as well as themselves.

Clues to illness, hazards

All preventable injuries are not just a matter of mental state; clumsiness can also be a clue to illness or environmental hazards, experts say.

A sudden spate of injuries could be a symptom of something physiological such as disrupted balance from an ear infection, the first sign of vision difficulties, or, in the most extreme cases, multiple sclerosis or a brain tumor. In children, it can also be a clue to attention deficit hyperactivity disorder (ADHD).

Accidents may also be a product of an unsafe environment. If you or your child are having an inordinate amount of accidents, you need to look at whether you are putting yourselves in risky situations. Is your child riding a scooter before she's developmentally ready? Could your floor simply be too slippery?

Looking for triggers

But if you get a clean bill of health and you seem to get into accidents in multiple environments, what can you do about it?

Carr suggests looking back and asking yourself where your mind was right before the accident. For instance, if you periodically spill hot soup, drop a cake or hit your head on a cupboard, explore what precipitated the mishaps. Were the kids screaming? Were you worrying about paying the bills? Or were you simply zoned out?

"If you analyze the situation, you will have tremendous insight into the source of your distraction," Carr said. "People are vulnerable to accidents when they're not aware of what's putting them at risk."

Focus on the 'now'

With today's constant distractions, such as concerns over national security, worsening traffic and job instability, and multi-tasking becoming the accepted mode of coping with time pressures, many of us are "quite literally outside of our minds, thinking of something else," Dunn added.

She says she bucked her pattern of accidents by embracing the Zen Buddhist notion of mindfulness, the practice of moment-to-moment awareness.

"Everyone doesn't need to become Buddhist, but we all do need to become more present in our lives," she said. "The thought I try to have in my head is: What am I doing right now? In the grocery store, I'll say it to myself out loud to keep myself focused on the task at hand."

Sawchuk supports moment-to-moment awareness as a way to not only avoid mishaps but also to cope with depression, stress and anxiety. People with anxiety tend to fret about the future and those with depression ruminate on the past, he said, so he trains patients to devote their focus to the here and now.

For instance, when driving, stop your mind from wandering by focusing on the concrete things that are going on around you. Be aware of your hands on the steering wheel, the car in front of you, how the air feels, what you are hearing, and eliminate distractions such as the radio, he said.

Dunn says her accident served as wake-up call: As she had been carelessly looking away from her horse, so had she been looking away from her life. Today, not only are her broken bones healed, she has also mended the broken parts of her life. Now she's walking — and is back on her horse — and says the label "accident-prone" no longer applies.

Julia Sommerfeld: 206-464-2708 or jsommerfeld@seattletimes.com.