Depression After Spinal Cord Injury

WHAT YOU SHOULD KNOW:

• Depression is a condition that causes feeling of sadness and hopelessness. Depression may be so bad that you think about committing suicide (killing yourself). Many life events can cause depression. Some life events may be getting divorced, having a loved one die, losing a job, or even retiring. Having a spinal cord injury (SCI) can cause depression. It can make you feel tired, and you may lose your appetite. You also may develop pressure sores and chronic (long-term) pain. You may be very sad and grieve for the way your life was before the injury. You may be angry and blame yourself or others for what happened to cause the spinal cord injury.
  
  
• Suddenly going from being independent to having to depend on others for your care may make you feel depressed. Not being able to do the things you like to do can make you sad or depressed. Some medicines that you take for your SCI or other health problems, like pain, also may make you feel depressed. Depression may be short term or long term. Treatment for depression may include taking medicine, and talking to health care professionals.

AFTER YOU LEAVE:

Take your medicine as directed:

Call your primary healthcare provider if you think your medicine is not working as expected. Tell him if you are allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs you take. Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

How is depression treated?

The most important first step is accepting that you want to feel better. Talk to your caregivers so they can help you with treatment. Caregivers may suggest you go to psychotherapy (si-ko-THER-ah-pe). You may also need special medicine to treat depression.

What is psychotherapy?

This is talk therapy where you have a chance to talk to a specially trained caregiver. This caregiver is trained to listen to you and help you find the cause of your depression. You may meet with this caregiver alone, or with a family member. You and your caregiver may meet together with other people who have similar problems. It is very important to be honest with your caregiver. You need to tell him or her what you are thinking and feeling or your caregiver will not be able to help you.

What special medicines may I need to treat depression?

Medicines may be given to you to help improve your mood (how you feel). The medicines can help you think more positively so that you do not feel hopeless, sad, or worthless.

• Antidepressant medicines: There are many different kind of antidepressant medicines. Your caregiver will work with you to find the right medicine, in the right amount for you.
  
  
  • You may need your blood tested regularly to see if the amount of medicine you are taking is correct.
    
    
  • Many medicines have side effects. Some of these side effects can be unpleasant. Some medicines do not work well with one another, and cause unpleasant side effects. Tell your caregiver if you are having side effects. Your caregiver will work with you to change the type or amount of medicine to decrease the side effects.
    
    
  • It may take four to six weeks for the medicine to help you feel better. Do not stop taking the medicine, or give up hope that it will work. Talk to your caregiver if you have any questions or concerns about your medicine.
  
  
• Other medicines: There are other medicines that you can buy without a prescription from a doctor. One of these medicines is called St. John's wort. This is an herb that is being tested because it may help with depression in some people. St. John's wort and other herbs, vitamins, or supplements may interact badly with prescription medicines. Tell your caregiver if you are taking any over-the-counter medicines, vitamins, herbs, or supplements.

Where can I go for support?

• Having a spinal cord injury is life changing for you and your family. Accepting that you have a spinal cord injury is hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. Let them help you. Encourage those close to you to talk to your caregiver about how things are at home. Your caregiver can help your family better understand how to support a person with a spinal cord injury.
  
  
• You may want to join a support group. This is a group of people who also have spinal cord injuries. Ask your caregiver for the names and numbers of support groups in your town. You can contact one of the following national organizations for more information:
  • Paralyzed Veterans of America
    801 Eighteenth Street NW
    Washington, DC , 20006
    Phone: 1- 800 - 424-8200
    Web Address: www.pva.org
    
  • National Spinal Cord Injury Association
    1 Church Street, Suite 600
    Rockville , MD 20850
    Phone: 1- 800 - 962-9629
    Web Address: www.spinalcord.org
    
  • American Spinal Cord Association
    2020 Peachtree Road, NW
    Atlanta, Georgia , 30309-1402
    Phone: 1- 404 - 355-9772
    Web Address: www.asia-spinalinjury.org
    

Wellness Hints:

• Eat a variety of healthy foods. Eating healthy foods may help you feel better and have more energy. It may also help you heal faster. Ask your caregiver if you need to be on a special diet.
  
  
• Drink six to eight (8 ounce) cups of liquid each day. Follow your caregiver's advice if you must change the amount of liquid you drink. Good liquids to drink are water, juices, and milk. Limit the amount of caffeine you drink. Caffeine may be found in coffee, tea, soda and sports drinks and foods.
  
  
• Having a spinal cord injury can be very stressful. Stress may slow healing and cause illness later. Since it is hard to avoid stress, learn to control it. Learn new ways to relax (deep breathing, meditation, relaxing muscles, music, or biofeedback). Talk to someone about things that upset you.

CONTACT A CAREGIVER IF:

• You are eating too much or too little.
  
  
• You feel hopeless or worthless.
  
  
• You have trouble thinking clearly or making decisions.
  
  
• You do not care about how you look. Call if you have stopped bathing, changing clothes, brushing your teeth, or using deodorant.
  
  
• You do not care about things you used to enjoy, like sports or movies.
  
  
• You are sleeping too much or too little.

SEEK CARE IMMEDIATELY IF:

• You are unable to cope with normal daily activities.
  
  
• You are thinking about or trying to commit suicide.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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