Our physical health and mental health are closely linked. When your physical health is affected by illness or injury, your mental health is more vulnerable. When you experience a spinal cord injury (SCI) resulting in paraplegia or quadriplegia, both the injury and side effects from treatment can affect the way you think and feel.
Following a SCI you might experience changes in mobility, functionality, level of independence, employment and financial situations, the way you live day-to-day, as well as how you see yourself and relate to others. You might feel hopeless about the future and not want to burden others with your feelings. These are common responses, however support, information and effective treatment can help.
Our mental health
The emotional impact of a new SCI – feeling sad, frightened, confused, worried or angry, for example - can be overwhelming. The most common mental health problems for people with a SCI are anxiety and depression, and these can occur immediately following the injury, during rehabilitation or later as a result of changes in physical condition or personal circumstances.
While most people with a SCI do not have mental health problems, they are commonly experienced and many people may not realise that they are becoming depressed. Sometimes someone with a SCI may already have had some mental health problems and having the SCI can make them worse or come back.
Most people receive a SCI from a traumatic event or injury, such as a car accident, damaging fall or act of violence, so it is understandable that many people with a SCI have disturbing and distressing memories related to their injury. These symptoms often pass, but for some people they may lead to a condition called Post-traumatic stress disorder (PTSD).
What is depression?
While everyone may feel low from time to time, depression is an illness which significantly affects the way you feel, causing a persistent lowering of mood. Depression is often accompanied by a range of other physical and psychological symptoms that can interfere with the way you function day-to-day.
Symptoms may include: persistently feeling extremely sad or tearful; disturbances to usual sleep patterns; loss of interest and motivation; feeling worthless or guilty; loss of pleasure in activities that are usually enjoyable; changes in appetite or weight; loss of sexual interest; physical aches and pains; and problems thinking or concentrating.
What is anxiety?
Sometimes feelings of anxiety are so overwhelming they can interfere with your ability to function. Symptoms can include: constant worries; obsessions or urges which you can’t control; intense excessive worry about social situations; panic attacks; or an intense, irrational fear of everyday objects and situations. Other symptoms of anxiety disorders may include a pounding heart, difficulty breathing, upset stomach, muscle tension, sweating or choking, or feeling faint or shaky. It is common for people to experience depression at the same time as increased anxiety or they may have problems with alcohol or drug abuse.
Mental health problems, like PTSD or Depression, are not an inevitable part of a SCI, but when they occur they can and should be treated promptly. Treatment for Depression, for example, can improve your capacity to manage rehabilitation. Suffering in silence doesn’t help either your physical or mental health. Treatment may include a combination of psychological or ‘talking’ therapies (for example, cognitive behaviour therapy), medication, community support programs and education and support for families. Many of these treatments have been tested to ensure that they are effective for people with a SCI and mental health problems.
Your doctor/GP can make a diagnosis and refer you to a clinical psychologist or other qualified health professional through a Medicare Mental Health Care Plan. This means that you can receive a Medicare rebate towards the cost of your treatment. Your doctor will ensure that any mental health related medication does not interact negatively with any medications - including non-prescribed ones - you are already taking.
Supporting the supporter
Family and friends of people with a SCI who have a caring role (carers), are often emotionally affected and may have to make adjustments. They are also at higher risk of depression.
Being a carer for someone with a SCI doesn’t mean taking all the responsibility on your own shoulders – there are support groups and services available to help. Carers should look for signs of stress in themselves, as when a person feels stressed intensively, or for a long time, it can start to affect their own physical and mental health. Mental health problems often create a feeling of powerlessness, and developing a plan together helps everyone regain a sense of control over the situation. The SANE Guide for Families (of people experiencing mental health problems) can help.
You can seek a break from being the main carer on a regular basis or as needed. Call 1800 059 059 for further information.
Some ideas for living well with a spinal cord injury
- Talk things over with a friend and share fears and concerns. It can be a great relief to get worries off your chest and this will help you feel supported.
- Develop a network of peers so you can keep in touch with others who are having similar experiences and to share ideas on how to manage.
- Maintain an active lifestyle and remain involved in activities and aspects of life that interest you.
- Learn and use helpful ways to cope, which may include: relaxation strategies such as meditation or listening to music, making pleasant activities part of your day-to-day or regular activities or setting some realistic short and long-term goals.
Who can I ask for help?
See a GP as soon as possible when you are concerned about mental health problems. Ask for a longer appointment time so you have enough time to talk things through. It is important to ask your doctor and other members of your treatment or rehabilitation team about concerns you have. Call the SANE Help Centre on 1800 18 SANE (7263) to seek information about Anxiety, Depression, and local services who can help.
The NSW Greater Metropolitan Clinical Taskforce’s State Spinal Cord Injury Service has produced a Directory of Information and Support which lists available support services. For more information go to: http://www.aci.health.nsw.gov.au/networks/spinal-cord-injury/resources
ParaQuad NSW, the Paraplegic and Quadriplegic Association of NSW, has an Information and Referral Line
(02) 8741 5674. For more details go to: www.paraquad.org.au
For information, support and contact with others call Spinal Cord Injuries Australia on (02) 9661 8855 or visit www.scia.org.au
This factsheet was developed in collaboration with the Greater Metropolitan Clinical Taskforce’s State Spinal Cord Injury Service, ParaQuad NSW and Spinal Cord Injuries Australia.