When disability leads to depression

One day you’re working – and then you’re not. Developing a disability as an adult, whether it’s from an injury or a chronic illness, creates a multitude of challenges. You find yourself unable to work or enjoy the activities you love. Sometimes this shift is temporary, but in some cases, it’s permanent. Either way, disability has the potential to generate negative feelings and, for many individuals, depression. If your disability is permanent or due to a progressive/degenerative condition, it can feel like there's no hope. Depression is a serious psychiatric disorder that involves persistent feelings of sadness, worthlessness or hopelessness. Physical symptoms are common as well and often include fatigue, pain with no apparent cause, loss of appetite, and digestive problems. Depressed individuals may also become irritable and forgetful. Sleep problems are common with many individuals battling insomnia while others sleep excessively. In addition, depression raises the risk for suicidal thoughts and actions.

Disability and Depression Risk
Several risk factors increase the potential for depression, and living with a disability is one of those. Studies have found that living with a chronic disorder raises the risk for depression. For example, degenerative conditions that limit mobility, have been linked to depression, especially among those diagnosed with early-onset degenerative conditions.

Why Disability Leads to Depression
There are several reasons why becoming disabled can make an individual vulnerable to depression. The disability – a loss in and of itself – leads to other painful losses as well, which is a common theme in each of the following:

Loss of a life direction or purpose – Many individuals work hard to achieve a certain career goal. Acquiring a disability that no longer allows you to work at that job has a significant impact on your direction in life and may also impact your sense of purpose. For example, an Airline Pilot who develops visual impairment and loses his licence to fly or the Nurse who loses the ability to walk, finds herself in a wheelchair and is no longer fit to practice. Such a devastating loss can easily open the door for depression, particularly if that was the only career he or she had ever wanted.
The painful loss of a sense of purpose affects many disabled individuals who were formerly the primary breadwinner in the home. When you’re no longer able to provide for your family, it’s not unusual to develop the lingering helplessness or frustration that leads to depression. Feelings of worthlessness, another common symptom of depression, can begin to take a firm grip.

Decrease in self-esteem – Becoming disabled affects how you perceive and feel about yourself, as well as your place in society. A study of individuals with traumatic brain injury revealed they had lower levels of self-esteem and higher levels of depression than healthy individuals. Some disabled individuals lack confidence in their ability to control their body and manage their life adequately. The loss of autonomy can take a severe toll on self-esteem.

Sadness, anger or frustration over career loss or changes – A disability prevents you from doing your previous job, but it isn’t always serious enough to keep you out of the workforce entirely. Feeling forced to take a job that isn’t as challenging, fulfilling, prestigious or well-paying can elicit negative feelings such as sadness, anger, frustration or resentment. For example, a heart surgeon unable to operate because of a serious hand injury is still able to teach medical students. However, he or she may regard that as less fulfilling than saving lives. A teaching position also isn’t going to pay nearly as much, which means the former surgeon may have to make substantial lifestyle changes.

Struggle of living with a disability – Quality of life often decreases after a significant injury or illness, especially when it limits the ability to perform normal daily activities. A serious brain injury, for instance, requires a person to relearn any number of tasks, from how to speak to how to button a shirt. In some cases, he or she simply isn’t able to relearn important functions. Likewise, a disability such as vision loss completely changes how someone lives. A newly blind person must learn how to navigate a dark world, losing at least some independence in the process.

Boredom – Some disabilities leave a person housebound, with few opportunities to interact with others. You may find yourself at home alone all day while your spouse is at work or confined to an assisted living center where community activities don’t match your interests. Boredom fosters negative emotions, including loneliness and frustration, which can trigger symptoms of depression.
Disability definitely raises depression risk; however, depression can also make the disability worse. For example, depression can make it more difficult for you to take proper care of your health. You are more likely to miss important appointments, such as a doctor visit or physical therapy. You may neglect to take your medications as directed. The result is a cycle in which the injury or illness triggers depression, which, in turn, makes the disabling condition worse.

Treatment for Disability-Related Depression
Treatment is imperative if you’ve developed depression or are starting to notice symptoms. Research has shown that if the first episode of depression goes untreated, you’ll have a 50 percent chance of experiencing a recurrence. Furthermore, an untreated episode can last from six months to a year, and possibly much longer. It’s critical that you seek treatment from a mental health professional. A skilled therapist can help you work through the issues contributing to your depression. Doing so will help you learn to better manage your life and cope effectively with the emotional challenges of living with a disability.

Depression is usually treated with a combination of talk therapy, lifestyle changes and, in some cases, antidepressant medication. These medications are intended to rebalance brain chemistry, enabling you to focus on learning healthy ways to manage negative emotions. Therapy will also address the need for new expectations. For example, you may no longer be able to work long days like you once did or perform basic household tasks. A therapist will work with you to develop a sense of what the “new normal” looks like, allowing you to feel less stress and anxiety about meeting previous expectations.
It’s also important to receive good medical care for your disability. Proper management of an injury or chronic illness will increase your quality of life, reducing your risk for depression. Investigate all possible legitimate treatments for your particular condition, including alternative therapies such as meditation, yoga, acupuncture or chiropractic care.

In addition, the isolation of disability often makes depression symptoms worse, so it’s also vital to receive support. Accept help when it’s offered, and find supportive friends or family members to spend time with regularly. If you don’t have local loved ones to lean on, seek out other support networks. For example, a self-help group focused on disability or depression will connect you to others living through the same struggles.

Disability is challenging enough to cope with; developing related depression will make your life even more difficult. Treatment is available. Contact a mental health professional so you can begin to take action toward managing your disability and depression.

Grieving the loss of your career due to chronic disability or illness

Most people don't realise that the sadness and frustration felt after losing your career due to chronic disability or illness is actually a complex form of grief.
Losing your health can bring on many of the emotions of grief usually associated with the death of a loved one. It is a deep sadness.

The loss of your health and the loss of your career are both major life stresses but both are present together. They lead to a complex type of grief that often goes unnoticed by the rest of the world, so you may not get the same support as you would if a loved one had passed away.

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There is so much grief for:

• the loss of mobility
• the loss of career
• the loss of colleagues and possible friendships
• the loss of health
• the loss of financial security

There is also much stress and anxiety about finances and the future.
This grief and loss can be overlooked by others who don't realise you are grieving.  It is a traumatic time. Shock, numbness and disbelief can be as great as if a loved one was lost. It is a huge lifestyle change.

The emotions you might be feeling can be similar to those experienced after a bereavement. The coping mechanisms are very similar too.

Ways of coping with a loss your career to chronic disability or illness

• Learn to live with your new limitations. You can live a full and worthwhile life, adapt to change. Your life is still precious and useful.
• Sort out your medical help, housing needs, mobility needs and support groups.
• Work out your finances. Make sure you have applied for all the support you are entitled to?
• Prioritise your essential needs. Do you need to change homes due to wheelchair access?  
• Get yourself an Occupational Therapist. They give practical help on how to adjust housing needs.
• Ensure you can access your garden/outdoor space in your wheelchair. Spending time with nature can help to ease the anxiety and stress.
• Do you need to change your car, or have adjustments made to allow safe driving?
• Look after your general health, get adequate sleep, eat well and get fresh air.
• Organise physiotherapy for exercise. Keep all your appointments.
• Accept help!
• Do you need a carer to help with your everyday needs?
• Keep busy and get yourself a new hobby.
• Get a new job. There are still many skills you have that are valued in the workplace.
• Volunteer. From a wheelchair you can still work in a charity shop, listen to children read in schools, make things.
• You can still use a computer, play bridge, join a choir, learn a language.
• You can study. Universities and colleges have a lot of support for disabled students to allow them access to courses.

At first there may be feelings of inadequacy, but you still have many skills and your friends and family still love you.
Do grieve. You have every right. However, do try to think positively for your own and your family’s sake.