Depression and Spinal Cord Injury: Symptoms and Treatment
If you or someone you love has experienced a spinal cord injury (SCI), you can expect the mental journey ahead to be as taxing as the physical journey. Mental and physical health are closely linked, and it’s essential to remember that a holistic view of wellbeing is key for rehabilitation and survival.
Individuals living with an SCI face a high risk of clinical depression. The WHO reports that 20 to 30 percent of spinal-cord-injured individuals show significant signs of depression, a rate four times higher than the general population. A 1998 study also shows that suicide rates are also three to five times the rate of the general population.
Injuring one’s spinal cord is a life-changing, complex event. The loss of independence and mobility coupled with stress and pain often results in anxiety and, in some cases, clinical depression. Adults living with SCI also face socio-economic uncertainty with a 60 percent global unemployment rate, according to the WHO.
The first few months following an SCI injury may be the hardest, but take hope. Depression is treatable and time-limited, and you are not alone—friends, caregivers and fellow spinal-cord-injured individuals are available to help guide you out of depression.
Symptoms of Depression in Spinal Cord Injury
Although nearly all spinal-cord-injured individuals experience some form of grief or sadness, there are a few symptoms that distinguish depression from day-to-day emotions:
· Loss of interest or enjoyment in activities
· Problems thinking or concentrating
· Changes in sleep patterns
· Loss of appetite and/or weight loss
· Diminished energy and/or libido
· Feelings of hopelessness, worthlessness or self-blame
· Thoughts of suicide or death
The Northwest Regional SCI system offers a quick depression self-test that you can take online to assess your risk of depression. If you are considering ending your life, call the national suicide prevention hotline anytime at 1-800-273-TALK (8255) to speak to a counselor.
Treatment of Depression in Spinal Cord Injury
Although depression is mental, it is still medical, and should be treated as a related condition to the SCI. Untreated, depression can impair rehabilitation and functionality.
Experts have found the following options successful in treating post-SCI depression. If you believe you may have depression, contact your primary care physician or mental health practitioner as a first step to determine which treatment or combination of treatments may be right for you, including:
· Individual therapy
· Group therapy
· Anti-depressant medication
· Exercise (stretching, physical therapy, resistance exercises)
Advice for Caregivers
If you are a family member or caregiver of someone living with an SCI and are concerned by signs of depression, speak to them lovingly but pragmatically about their mental health and about seeking treatment with your help. For some, the option of attending therapy with a friend or family member is preferable to individual therapy.
As a caregiver, you are also at a higher risk of depression due to the added stresses of caregiving. If the symptoms above sound like something you have experienced, take steps to seek treatment.
World Health Organization. http://www.who.int/mediacentre/news/releases/2013/spinal-cord-injury-20131202/en/
Archives of Physical Medicine and Rehabilitation. http://www.ncbi.nlm.nih.gov/pubmed/9821893
Northwest Regional Spinal Cord Injury System http://sci.washington.edu/info/pamphlets/depression_brochure.pdf
Spinal Cord Injury Rehabilitation Evidence http://www.scireproject.com/