This chapter was a bitch to write.

Mandy, being rather concerned for her daughter's well-being, decided to take her daughter to the hospital to see if she had suffered any internal injuries. Unfortunately, due to the nature of hospitals, they were forced to visit the hospital seven days after Ashley's accident.

"Mrs. Teslow?" a young female doctor called out.

"Yes?" Mandy asked, standing up.

"Your daughter doesn't seem to have suffered any internal damage from the collision…" Mandy sighed in relief. "I'd like her to be sent to the fourth floor for some other examinations, though…"

"The… fourth floor?"

"Oh, the fourth floor is our psychiatry ward. Ashley showed quite a few signs of clinical depression… I wanted someone else to check up on her."

Despite Dr. Nooner's reassurances that she wasn't sure if Ashley truly was depressed, Mandy seemed very troubled by this news.

"Alright, Ashley, my name is Greg Schipper… how are you feeling today?" the doctor asked, looking at a clipboard.

"Okay, I guess… I don't really think I injured myself in that crash, so I doubt there's--"

"Oh, you're perfectly physically healthy," he reassured her. "I'm just here to ask you a few questions… okay, Ashley, I'm going to give you a series of various indicators… you tell me how much you were bothered by the signs; if you weren't bothered by them, all the way to being bothered so much you couldn't stand them in the past seven days. Understand?"

"I think so," Ashley said, nodding.

"Okay… have you been affected by any numbness or tingling on your body in the past week?"

"No…"

Ashley continued to rattle off answers. …No… didn't bother me much… couldn't stand it… bothered me a lot… slightly bothered… moderately bothered… couldn't stand the feeling… felt that way all week… sometimes, but I could stand it… no… didn't feel that either… a little… yes, a lot… no… yes, it terrified me… of course… slightly… only once… no… yes, it bothered me…

"Okay, Ashley… I'll be back in a while." He went out into the hall and found Dr. Nooner standing, awaiting the results. "You were right… she shows classic signs of PTSD…"

"PTSD?" Dr. Nooner asked. "You were supposed to give her the BDI…"

Dr. Schipper nodded, and a while later, he came back into Ashley's room. "I've got a few more questions for you, Ashley," he said. "I'm going to give you 21 different topics… I want you to tell me how you feel about them and how they affect you, okay?"

"Alright…" Ashley sighed.

"Okay… how sad have you felt lately?"

"So sad I can hardly even stand myself," Ashley replied.

Dr. Schipper nodded and made an X on the paper. "Are you at all pessimistic about your future?"

"Let's just say there's a light at the end of the tunnel. I'm just not sure if it's an oncoming train."

He marked an X in the 2 column and continued. "Do you see yourself as a failure?"

"I see a lot of failures I've made in the past, yeah."

"Do you get as much pleasure from things as you used to?"

"I don't get pleasure from anything anymore."

"Do you ever have any guilty feelings?"

"All the time."

Making another mark on the paper, he asked, "Do you have any punishment feelings?"

"No, I don't…"

"How is your self-esteem?"

"I disappoint myself."

"How often do you criticize yourself?"

"All the time…"

"Have you experienced any suicidal thoughts?"

"Rarely…" Ashley responded after a long pause.

"Do you cry often?"

"I cry over just about everything and anything."

"Do you feel restless or agitated?"

"More than I used to. It's a noticeable change, but it's not really that big…"

"Have you lost interest in activities you once enjoyed?"

"Yes, I've lost interest in many things…"

"Are you having feelings of indecisiveness?"

"It gets harder to make decisions as time goes on, yeah…"

"Do you feel worthless?"

"Compared to others, I'm not anything special…"

"Do you have much energy inside of you?"

"Not really enough energy to do much, really…"

"Has your sleeping been disrupted?"

"I barely sleep anymore."

"Have you noticed if you're more irritable than usual?"

"Slightly, yes."

"Have you experienced any changes in your appetite?"

"Some days I don't eat anything, other days I have to lock myself in my room to stop myself from raiding the kitchen."

"Are you having concentration problems?"

"I can hardly concentrate on anything… I'm always thinking of other things."

"How fatigued have you been feeling?"

"Too fatigued to do much of anything."

"Do you have any interest in sex?"

"No. None."

Making a final mark in his paper, he nodded. "Okay, Ashley. I'll be back shortly. Sorry for this wait…"

"It's okay," she said, absently, as he left the room.

"Miss Teslow," Dr. Schipper began, "I just gave your daughter two different tests. One test gauges how much she is affected by stress, and the other is a measure of how depressed she is… according to the results, Ashley shows classic signs of Post-Traumatic Stress Disorder, or PTSD…"

"But… her… her sister died recently. Wouldn't that be normal?"

"Well in most cases, Ashley's nightmares, dissociation, and insomnia would be perfectly normal in a case such as hers, however--"

"However?" Mandy asked.

"However… after I gave your daughter the BDI to test her level of depression, she scored a 46. The range of 29-63 indicates severe depression in the individual. Because of these results, it seems that her anxiety symptoms are comorbid with depression, which leads me to believe that she is indeed suffering PTSD and is not just being affected by her recent loss."

"How will she get treated for this then?"

"Well, the good news is that these two disorders seem to have been set off by similar stressors in Ashley's environment, so they're very closely related. Odds are if we can treat her for one, the other problem will be much easier for Ashley to deal with. I recommend putting her on medication and starting her on psychotherapy. I'd like to keep her here at the hospital for a few days, if at all possible…"

"So… I have depression and… post-traumatic stress disorder…" Ashley muttered. Mandy nodded.

"They're going to keep you here at the hospital for a few days, okay, hon?" Mandy asked, patting her daughter's hand.

Ashley kept staring at the same blank spot on the wall. "Uh… oh, okay… I guess that would work…" Mandy sighed in relief. She thought it would be much harder for her.

"Come here, Ashley," a nurse said from the back of the room. Ashley, with a face of confusion and fear, followed her out the door, giving her mom a final brief wave.

Normally, the BDI is taken as a survey filled out by the subject. I did it in that format so it'd be easier to write and so that it would read more fluidly.