Immediately after her involvement in the massive Feb. 25 pileup on the interstate in Etna, Peggy Leonard of Hampden snapped a photo of her car sandwiched between two tractor-trailer trucks that quickly became one of the iconic images for the accident.

Like so many involved in what is thought to be the largest chain-reaction accident in the state, Leonard was among the many who walked away with only minor injuries. A week later, she considers herself very, very fortunate.

At least 17 people were taken to Bangor hospitals and others sought treatment on their own.

Officials said it was a miracle there were no fatalities among the scores of drivers and passengers involved.

Bones mend, bruises fade and cuts heal, but mental health workers said the non-physical traumatic symptoms associated with an accident of such scale can take much longer to dissipate.

“Flashbacks to the accident, trouble sleeping and nightmares are typical reactions to such trauma,” Dr. Anthony Ng, chief medical officer at Acadia Hospital in Bangor, said this week. “It’s okay to have those reactions, but they should only last a limited time. If they start really bothering you or affecting your life, that is the time to worry about them.”

In extreme cases, Ng said, people involved in major vehicle accidents begin to have problems getting back in, driving or riding in a car.

“They get to a point they can no longer drive to work or school or go about their daily life because the symptoms have begun to so impact them,” he said.

Children are not immune to similar symptoms after a traumatic event, according to Ng, but may display them differently than adults.

“Kids who have been in accidents may express their thoughts differently,” he said. “They are not like adults.”

The trauma can manifest in bad dreams but also can be accompanied by changes in eating or sleep patterns, general irritability, personality changes and resistance to leaving home or going to school.

“Talk to them,” Ng said. “You can also ask kids to draw things to show how they are feeling.”

Involvement in accidents such as the Interstate 95 pileup also can dredge up memories of previous traumatic events, Ng said.

“People could have recurrences of old symptoms,” he said. “Maybe they were in an accident before and were feeling better and then this happened. It did not have to be a traffic accident, just something bad had happened in the past and the accident brought those memories back.”

Taken to the extreme, those symptoms over time can manifest into a form of post-traumatic stress disorder, or PTSD, Ng said.

“In some cases people can become more withdrawn, quieter and internalize their anxiety,” he said. “Those groups are more likely to develop a some type of PTSD.”

Talking with friends, co-workers, spiritual leaders and family about the accident can help those involved deal with any traumatic feelings, Ng said.

There is also professional help available for those who need it.

At Restorative Health, which offers mental health services in Bangor, individuals can simply call to set up an appointment, according to Doug Townsend, administrator for adult outpatient services and licensed counselor.

“It can be hard to ask for help sometimes,” Townsend said. “It is essential folks get beyond that and take that step and contact us.”

Asking for help is far more productive than attempting to deal with trauma-induced anxiety alone, Ng said.

“Seeking help is very much OK,” he said. “Attempting to self-medicate with drugs or alcohol is not.”

Ng emphasized that experiencing strong feelings after a dramatic event such as the crash is perfectly normal, and said those emotions should settle down after a few weeks.

“The important thing to remember is many symptoms like the nightmares will happen early on and then will go away,” Ng said. “Most people who go through something [similar to the I-95 crash] will never develop PTSD.”

For her part, Leonard said she is not experiencing any lasting mental health issues after her close call during the pileup, adding she remembers every detail.

“I’m not having any trouble sleeping,” she said. “It was absolutely a traumatic experience, but in a strange sense the whole thing was a very calm situation, given the circumstances.”

Leonard’s car ended up wedged between two 18-wheeler trucks. One of the truck drivers helped her exit her vehicle.

“I think one key thing for me dealing with it is everybody lived,” she said.

Leonard has driven past the scene only once since the accident.

“I did get a bit emotional,” she said. “There was still debris on the side of the road, [and] there were tears running down my face.”