Psychological Issues & Depression after a Spinal Cord Injury

A quick Summary from Hamilton spinal cord injury lawyers

There’s no doubt that a Spinal Cord Injury (SCI) is a catastrophic injury with potential devastating psychological impact on the individual affected. “What did I do to deserve this?” is a common question both thought and expressed by spinal cord injury survivors shortly after their accidents.  Severe emotional negative reactions like this  following SCI are common which can threaten both psycho-social integration and security, requiring attention to the long-term psychological adjustment of individuals following SCI.

And why shouldn’t you? You have just experienced a life-changing event that impacts every single aspect of your life. You can no longer physically move (at-will) the way you used to. You no longer have the same degree of coordination. You no longer have control over your bodily functions the way you used to. You have lost your earning power. Friends and family may react to you differently than they did before your accident. You must use adaptive equipment, which is often very expensive. You are thrown into a bureaucracy of paperwork, bills, insurance, and fighting insurance denials. Plans that were made now have to be rescheduled or cancelled completely. You may no longer feel attractive. You may feel that others no longer view you as being attractive. You can no longer participate in activities you used to enjoy.  You may now stuck in a hospital or rehabilitation centre for an extended period of time, sometimes with doctors who may not fully empathize with your situation.

The point is that experiencing a SCI poses a huge challenge and requires adaptation and strong resilience to cope  – so you can develop strengths and discover new ways of doing things, not only physically, socially and vocationally, but also emotionally and psychologically.  In order to cope, often times spinal cord injury victims require lifelong funding for psychological therapy which will be part of the compensation sought after by your Hamilton Spinal Cord Injury Lawyer, along with a team of occupational therapists and life care planners that will work with your lawyer though the course of your case.

Psychological Trauma after a Spinal Cord Injury

Most traumatic spinal cord injuries (SCIs) occur due to potentially life-threatening events, including car accidents, bicycle accidents, motorcycle accidents, acts of violence (e.g. gunshot), slip and falls, trip and falls and diving into shallow water.  Given the traumatic nature of a spinal cord injury, including the actual event that caused your paralysis, and sometimes witnessing another person’s death or injury, can increase your symptoms of acute and post-traumatic stress  – symptoms which are are certainly not unusual consequence. In fact, the DSM-V identifies individuals with Spinal Cord Injuries as being at high risk for post-traumatic stress disorder (PTSD) if you have been exposed to a traumatic event that involves the perceived or actual threat of death or serious bodily injury to yourself or to others.

Psychological Grief and loss after a Spinal Cord Injury

For many Spinal Cord Injury victims, grief is a major issue. Many victims should obtain grief counseling, as soon as possible. Psychological rehabilitation should start with peer support and psychological counselling. Grief counseling is a concept made famous by Dr. Elisabeth Kübler-Ross. The five stages of grief are denial, anger, bargaining, depression, and acceptance. The stages last for different periods of time. They are not linear. This means you don’t go through each stage in order. You don’t automatically go from stage one to stage two to stage three. You may go from stage one to stage two and then back to stage one again. But you can’t get to a stage unless you have gone through the stage(s) before it. Everybody is different. Everyone heals emotionally at their own pace. There is no “set” time to get over grief – and unlike depression, the grieving process is one that will diminish over time.

Depression After a Spinal Cord Injuries

Depression is a significant problem among adults with the onset SCI and is associated with poorer outcomes and lower quality of life.   It’s been shown that that SCI  victims in the rehabilitation phase have an increased risk of depression – in upwards of 30%. In addition, the potential depressive risk may be approximately 27% when SCI patients return to their normal life.  There’s no doubt that an SCI CI could have a negative influence on mental health – since people with SCI also have increased risk of significantly lowered quality of life.  In addition, injury-related variables such as the presence of chronic pain (eg. neuropathic pain) and chronic fatigue are consistently associated with depression, as well as paralysis, loss of sensation below your level of the lesion, reduced mobility and functional independence. Additionally, people with SCI can be prone to complications such as pneumonia, septicemia, urinary tract infections and cardiac problems which may increase the clinical severity of your depressive conditions.

Depressive features often experienced are such things as anhedonia, depressed mood, weight changes, sleep and psychomotor disturbances, concentration difficulties, intrusive thoughts, and fatigue. Depressed SCI victims will often demonstrate flattened affect, tearfulness, or irritability and may have difficulty with attention, recall, and calculation. Fear, hypervigilance, autonomic overactivity, concentration difficulties, intrusive worrisome thoughts, and avoidant behavior are seen with anxiety disorders.

Factors which Influence Psychological Suffering in Spinal Cord Injury Victims

Overall, when an individual experiences a spinal cord injury, there are many factors that may contribute to psychological suffering. These factors include feelings such as:

  • Loss of independence
  • Helplessness
  • Panic
  • Sadness or depression
  • Fatigue
  • Loneliness
  • Isolation
  • Resentment
  • Grief
  • Uncertainty of the future
  • Lack of control over one’s body
  • Self-esteem and body image issues
  • New health issues

An individual’s personality and age are significant factors in the psychological suffering a spinal cord injury victim may experience. Studies have indicated that younger individuals have a higher chance of accepting their condition, and are generally more flexible in adapting to the new lifestyle changes that come with loss of mobility.

External factors such as socio-economic status, financial stress, and occupational status are also significant determinants of one’s psychological suffering. Individuals who are in recovery from a spinal cord injury may find that they are accumulating a significant amount of debt and financial stress without the opportunity to return to work. This leaves strong feelings of uncertainty and doubt in the future, which can add its own psychological strain to the individual’s life.

Chronic Pain After a Spinal Cord Injury

It is common for individuals with spinal cord injury to experience chronic pain after the injury. Up to 70% of spinal cord injury victims report experiencing some type of pain after their injury. This pain can be so severe that it limits their ability to function, maintain relationships, or work. Chronic pain is defined as an ongoing and consistent pain or burning sensation that lasts for over 12 weeks.

This type of pain may manifest either as neuropathic pain at the area of the injury or below it, similar to a phantom limb. It may also manifest as pain in the muscles and limbs that are now being used to compensate for the lack of mobility. For example, it is common for spinal cord victims to experience pain in their arms from using their wheelchair. Another way that chronic pain may manifest is through visceral pain relating to digestive stress such as constipation.

Chronic pain is often associated with depression and emotional distress. Depression can cause the body’s biological pain receptors to become intercepted and trigger these physical responses. Suffering through chronic pain can cause significant psychological suffering to the injured on top of the suffering they have already endured, creating a vicious circle of suffering for the victim.

Emotional Recovery After a Spinal Cord Injury

Recovering from a spinal cord injury requires a significant amount of physical therapy and activity. However, there is also a significant emotional component to this process. Every individual is different and will therefore respond to different treatment and recovery methods.

Spinal cord injury victims may exhibit symptoms of withdrawal and isolation as they undergo the initial grieving process and come to terms with their permanent condition. If these symptoms do not disappear during the recovery process the individual may require extra psychotherapy or medication.

Unfortunately, suicide rates are significantly high among individuals with spinal cord injuries. Suicide is five times more common in spinal cord injury victims than the general population. Occurrences are higher in males and those who exhibit risk factors, including substance abuse, major depression, other mental illness, self-neglect, and chronic pain.

An individual with a spinal cord injury may be at risk for suicide within five to six years after the injury. Any indications of suicide should always be taken seriously and proper safety measures taken immediately to ensure the individual’s health and well-being.

Psychological and emotional recovery  is unfortunately expensive and for many spinal cord injury victims, the requirement is  and should be life-long. It’s important that you retain a spinal cord injury lawyer that is experienced and works with other professionals that are also experienced in  identifying, quantifying and valuating your needs presently, and into the future.  remember – in addition to the physical and  psychological trauma that a spinal cord injury victims suffers, the economic burden throughout his or her life can be staggering.  Our spinal cord injury lawyers are experts in recovering compensation for spinal cord injury  victims, and will ensure that all of your needs and costs are properly documented, costed out and recovered.

Re-Adjustment and Reintegration Into Society

For many spinal cord injury victims, re-adjustment into society can become distressing and psychologically stressful to experience. These individuals are now experiencing a loss of mobility, which requires significant adjustments to how they go about performing their regular activities.

Adjusting to a new lifestyle is complicated and frustrating. Re-integrating into society is a significant component in a spinal cord injury victim’s recovery. However, it is not a simple task. While the individual is in recovery, whether in the hospital or in a rehabilitation facility, they will begin to learn how to perform daily tasks with their limited mobility before they venture back into society. This allows the injured to become accustomed to these tasks and ensure they are normalized. Once they have normalized these routines, they can begin to re-enter society comfortably, at their own pace.

In some situations, this may also include new activities and learning new skills. For example, one may opt to learn to drive a vehicle with adaptive hand controls that allow individuals in wheelchairs to operate a vehicle on their own. This takes considerable time and discipline in order to achieve some type of independence.

Additionally, there are many aspects of society that can cause stress and social anxiety to a spinal cord injury victim. Large crowds in public spaces can increase anxiety as the individual must maneuver a wheelchair or mobile-assistive device within those conditions. Sometimes factors as seemingly minuscule as waiting for an elevator at a sporting event can cause depression or stress when the elevator is full of able-bodied individuals who simply do not feel like taking the stairs. Situations such as this can be stressful and upsetting for individuals in wheelchairs or other transportation devices that have no choice but to rely on these elevators.

How to Help a Loved One Who Has Suffered a Spinal Cord Injury

As a friend or family member, watching a loved one suffer through the implications of a spinal cord injury can be heartbreaking. The most important thing for loved ones to do is provide reassurance the injured. Recovery can be incredibly time-consuming and invasive, both physically and mentally, and the victim will benefit from as much support as possible.

Ensure that the individual is always treated with respect and dignity. This is integral to their healing and recovery process. Many individuals who are now confined to a wheelchair or mobility handicap may experience sadness and loss of self-worth because they are no longer able to use their body the way they once did. It is therefore important for these individuals to understand that they are valuable members of society and that they are not treated differently than anyone else.

Ultimately, as the victim’s loved one, it is important to create a strong system of support while also allowing the individual to retain self-management and independence wherever possible. There are many resources available that can assist families and loved ones during this difficult time.

Get The Support You Need From a Hamilton Spinal Cord Injury Lawyer serving claimants all over Ontario

Spinal cord injury, for many, often results in long-term or permanent complications and has a negative impact on many victim’s lifestyles in different aspects such as their social and family relationships, education, employment, and financial status – all of which often results in psychological complications and depression.  Psychosocial problems for persons with Spinal Cord Injury are often associated with financial hardship due to unemployment and the cost of living in Ontario, followed by difficulties with transportation, home modification, education,love and marriage, social communication. Often times, victims of spinal cord injury end up dealing with psychological problems such sadness, depression, irritability/anger, suicidal thoughts, and a lack of self-confidence.

If you or a loved one has suffered a spinal cord injury it’s important that you speak to a spinal cord injury lawyer sooner rather than later – in order to ensure that the proper insurance is arranged, caregivers are hired, your home is prepared for discharge, your occupational therapists have been retained and have costed your attendant care needs and that all of your needs and requirements are met. It’s also very important that psychological therapy (presently and life-long) starts sooner rather than later to deal with these the myriad of emotional issues that will affect a victim soon after injury, and for many, the remainder of their lives.

Our spinal cord injury lawyers can determine the actual and true value of your everything you need – from needs, to wheelchairs, to modified transportation, help you find the appropriate compensation that can help ease some of your concerns and burdens, and take legal action against those responsible for causing the accident that led to your injuries.

Contact our offices at 905-333-8888 or through our online form to contact our Hamilton personal injury lawyers and set up a free consultation. We can travel to you if you are unable to visit our offices, and will always keep your information confidential and secure.

*This information has been obtained from our experience and knowledge of spinal cord injury law as well as Medical Peer Reviewed Journals and Medical Studies from SCIRE (Spinal Cord Injury Research Evidence)

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