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DEPRESSION AFTER SPINAL CORD INJURY

(NEUROLOGICAL REHABILITATION)
Depression After Spinal Cord Injury

WHAT YOU NEED TO KNOW:

What is depression? Depression is a mood disorder. A mood is an emotion or a feeling. Moods affect your behavior and how you feel about yourself and life in general. Depression is a sad mood that you cannot control. Depression may be short-term or long-term, and it can be treated.

What causes depression? A spinal cord injury (SCI) can cause depression. 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 SCI. You may have a hard time adjusting to being dependent on others for your care. You may also be sad or depressed because you are not able to do the things you enjoy. Some medicines that you take for your SCI or other health problems, like pain, also may make you feel depressed.

How is depression diagnosed? Depression can start slowly or suddenly. Other people may see changes before you see or feel them. Your healthcare provider will ask questions about your health and your signs and symptoms. You may have depression if you feel depressed or lose interest in doing things you enjoy nearly every day for at least 2 weeks. You also have 4 or more of the following symptoms:

  • Your appetite changes. You may lose your appetite and lose weight without trying. Your appetite may also increase and you may gain weight.

  • Your sleeping habits change. You have trouble going to sleep or staying asleep at night. You wake up in the middle of the night or very early in the morning. You sleep too much or you feel very sleepy all day long.

  • You feel tired or have less energy than usual.

  • You are restless, irritable, or withdrawn.

  • You feel worthless, hopeless, and discouraged. You feel very guilty all the time.

  • You have trouble concentrating and remembering things. You have trouble doing daily tasks or making decisions.

  • You think about hurting or killing yourself.

How is depression treated?

  • Psychotherapy: During therapy, you will talk with healthcare providers about how to cope with your feelings and moods. This can be done alone or in a group. It may also be done with family members or a significant other.

  • Medicines: You may be given antidepressant medicine or other medicines to decrease or stop the symptoms of depression. You may need to take antidepressants for several weeks before you begin to feel better. Do not stop taking antidepressants unless your healthcare provider tells you to. Healthcare providers may try a different antidepressant if one type does not work. You may need to take antidepressants for up to 1 year. If you have had more than 2 episodes of major depression, you may need to use antidepressants longer. Do not take any herbal, vitamin, or food supplements unless your healthcare provider tells you to. It may not be safe to take some of these supplements with your other medicines.

Where can I find support and more information?

  • National Spinal Cord Injury Association
    1 Church Street, Suite 600
    Rockville , MD20850
    Phone: 1- 800 - 962-9629
    Web Address: www.spinalcord.org

  • National Institute of Mental Health (NIMH), Public Information & Communication Branch
    6001 Executive Boulevard, Room 8184, MSC 9663
    Bethesda , MD20892-9663
    Phone: 1- 301 - 443-4513
    Phone: 1- 866 - 615-6464
    Web Address: http://www.nimh.nih.gov/

When should I contact my healthcare provider?

  • You cannot eat or you are eating more than usual.

  • You are not able to sleep well or you are sleeping more than usual.

  • You feel anxious, restless, angry, or you have a panic attack after starting antidepressant medicine.

  • You feel that you are becoming depressed again after starting antidepressant medicine.

  • You cannot make it to your next visit.

  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • You are unable to cope with normal daily activities.

  • You think about killing yourself or someone else.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.