By Nwakaego Nmezi, PhD, Licensed Rehabilitation Psychologist, Medstar National Rehabilitation Hospital, Medstar Good Samaritan Hospital
The loss of a limb is a life-changing experience that often affects many aspects of an individual’s life including your psychological health and wellbeing.
How an individual responds to the loss of a limb might be related to several factors including those that are within their control (e.g., coping style, perceptions about disability) and those that are beyond their control such as sex and age at the time of an amputation, and levels of social support.
The loss of a limb may place individuals at higher risk for changes to their psychological health and wellbeing. It is common for individuals who have experienced limb loss to experience:
- Concerns about body Image
- Symptoms of depression
Body Image: After an amputation it is common to have concerns about your appearance and how this may affect your relationships with others. Changes to body image and self-esteem are especially common among individuals who have experienced a lower limb amputation. Changes to self-confidence may look different for men and women. Men sometimes relate the loss of a limb to the loss of their “manhood,” while women tend to be more concerned about the impact it will have on their sexuality. Persons who have experienced limb loss often worry about how people will view them or that others will stare, ask inappropriate questions, or treat them as a lesser person. It is important to remember that your body image will improve over time. Helpful strategies for improving body-image following amputation are: (a) shifting your focus on the here and now and staying connected to personal values; and (b) staying connected to loved ones.
Depression: Depression is a common psychological condition that may be experienced after the loss of a limb. Nearly 21%-35% of individuals with amputation will experience a depressive disorder and most individuals will experience an episode of depression within the first 2 years following their amputation. Depression can often be overlooked and mistaken for a normal emotional reaction. It is important to appropriately address depression since untreated depression can negatively impact the process of recovery.
Symptoms of depression can include:
- loss of interest in activities once enjoy.
- feelings of sadness, loneliness, agitation, or irritability
- feelings of worthlessness, inappropriate feelings of guilt
- changes to sleep patterns
- changes in appetite
- diminished energy levels
- difficulty with concentration
- feelings mentally and physically slowed down or agitated.
- with increased severity thoughts of death.
Depression can range in severity from mild to severe and can make it difficult to function at home, at work, and in relationships with others. Risk factors for depression among individuals with limb loss include young age, pain, personality traits, and unhealthy coping strategies. Treatment for depression is important and can be tailored to each stage of amputation adaptation. In addition to behavioral strategies for the treatment of depression such as cognitive behavioral therapy (CBT) or Acceptance and Commitment Therapy (ACT) individuals may benefit from the use of medications. The decision to start medication for depression should be discussed with a qualified healthcare professional to determine which medication is best for you.