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A spinal cord injury dramatically alters everything about your existence. Whether and how you work, leisure activities, your ability to hold your child, your relationships, your body image, and your fundamental sense of self may all change. Appropriate mental care after a spinal cord injury is vital for helping you manage your rapidly changing life.

How Spinal Cord Injuries Affect Mental Health

A spinal cord injury affects virtually every system of your body, and every area of your life. You will have to rethink how you go about even the most mundane activities -- using the bathroom, traveling to and from work, eating dinner with your family, using the phone, using the computer, and so much more.

Any time your life changes, your mental health can suffer. But when you lose the capabilities you once took for granted, things can feel particularly overwhelming. It’s no wonder that so many people with spinal cord injuries experience mental health difficulties. One study found that spinal cord injuries doubled the risk of mental health problems, with 48.5 percent of spinal cord injury survivors experiencing depression, 37 percent facing anxiety, 8.4 percent experiencing post-traumatic stress disorder (PTSD), and a quarter experiencing clinically significant levels of anxiety.

Spinal cord injuries frequently trigger chronic pain, which is associated with steadily worsening mental health. Many SCI survivors also find that people react differently to them. Wait staff may talk to their spouses or children instead of them. Doctors may refuse to answer their questions, and random strangers may stare, or assume that using a wheelchair is a signal of incompetence. These experiences can steadily erode self-esteem and identity, worsening mental health.

How Mental Care After Spinal Cord Injury Affects Physical Health

In a world that still stigmatizes mental health conditions, many spinal cord injury survivors are reluctant to admit they need mental health care. This reluctance can be exacerbated by a sense of reduced efficacy. A spinal cord injury survivor who needs 24/7 care may be especially hesitant to seek help.

But mental health concerns aren’t all in your head. Ignoring your pain won’t make it go away, and the presence of psychological suffering does not mean you are weak. Biological changes in your brain trigger mental illness, which means you can’t just think your way out of suffering. Treatment helps you get back on track.

Perhaps even more important thing to note is the fact that mental health can affect your physical health. Consider the following:

  • Poor mental health can undermine your ability to follow through on treatment recommendations such as getting exercise and showing up for doctor’s appointments.
  • People in poor mental health are more likely to suffer physical health problems. A spinal cord injury already makes you more vulnerable to infections, and untreated mental illnesses can compound these risks.
  • Mental illness changes your behavior. This can harm your relationships with your care providers. Some research even suggests that mental illness alters the way doctors treat their patients. Prompt treatment may improve your physical care.

Why All SCI Survivors Deserve Mental Health Care

Many SCI survivors don’t seek mental health care until they already have symptoms. But treating symptoms once they appear is much more difficult than proactively taking steps to prevent symptoms in the first place. Moreover, because the majority of SCI survivors experience some form of mental health issue after their injury, and almost all experience difficulties with adjustment, high-quality mental health care is one of the best gifts you can give yourself.

Options for Mental Care After SCI

Many SCI survivors mistakenly believe that mental care after SCI means taking drugs, but there are myriad options for care. Proven treatment options for SCI-related depression and other mental health issues include:

  • Lifestyle interventions that improve your health and psychological well-being, such as exercise, a healthy diet, meditation, and healthy sleep.
  • Finding new ways to engage in activities you previously enjoyed. An athlete might enjoy wheelchair basketball, for example. An SCI may limit your mobility and your activities, but it does not have to rob you of every hobby you once indulged in.
  • Medication to treat your symptoms. Oftentimes medication can be used on a temporary basis as you work through your issues in therapy.
  • Psychotherapy. Therapy teaches you coping skills, offers you a safe space to vent, and helps you address problematic thought and behavior patterns. For example, the false belief that you'll never again enjoy life can make you feel worse, but therapy can snuff out this problematic thought pattern.
  • Support groups. No one understands the struggles of life with a spinal cord injury like other SCI survivors. Support groups at your local hospital or rehab facility can get you on the road to recovery.
  • Occupational and physical therapy. By steadily improving your physical capabilities, and by learning ways to work around your injuries, you may find that your life improves.

Accessing Mental Care After SCI

Many people aren’t sure where to start when they realize they need mental health care. At minimum, you need to talk to a doctor about your treatment options. You should also see a therapist, since virtually every other treatment works better when combined with therapy. A competent, resourceful provider who specializes in SCI is your best ally. To find your provider, try asking your SCI treatment team for a referral, consulting with other SCI survivors, or asking your occupational or physical therapists whom they recommend.

Don’t shy away from asking your chosen therapist plenty of questions. Feeling comfortable with your provider is key to success, and not every therapist is a good match for every patient.

Payment and Insurance Concerns

A few years ago, getting mental health coverage was difficult. Federal laws now require almost all insurance carriers to cover mental health conditions at the same level they cover physical health conditions. You also cannot be denied care because of a pre-existing mental health condition.

You might have to choose an in-network provider or get a referral from your primary care provider. But once you do, your treatment should be covered. Even if you have a high deductible, the costs of treating other SCI symptoms mean you may quickly reach this deductible, ensuring your care is covered.