Physical Disability & Mental Health

How physical disability and mental health are connected

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Americans living with physical disabilities face a number of significant challenges that can impact their quality of life. For many, physical disability and mental health go hand-in-hand. As you take care of your physical needs, it can be all too easy to neglect your mental health.

Below are a few common challenges faced by people with physical disabilities, as well as some ideas for taking care of your mental health:

Lack of work

For many individuals, a physical disability can impact their ability to work. Although Social Security, Medicaid or other financial resources may be available, these benefits may not cover all living expenses (the average SSDI benefit was less than $14,000 in 2016). Several studies have linked worry about finances or debt to higher risk for mental health issues.

Beyond financial stress, unemployment can also lead to depression or anxiety for some people. If you are not able to work due to a disability, that can leave a void in your life. Many people find enjoyment and a sense of identity in their work, so missing that aspect of life could affect mental health for some people. This National Institutes of Health study illustrates that impact.

Depression and isolation

Surveys show that people with disabilities often experience a sense of social isolation and loneliness, which can also lead to depression and other mental health issues. Inaccessible environments and misunderstanding from non-disabled individuals can sometimes lead to feeling left out, isolated or even shunned.

Recent research links loneliness to a number of other health concerns, including a greater risk for premature death, dementia and heart disease, as well as decreased immunity. The mental and physical impact of loneliness and isolation can be tremendous.

Acquired disability vs. congenital disability

Whether you were born with a disability, or have experienced the onset of a disability to injury or illness later in life, can affect how you perceive your disability. In turn, how well you cope with the idea of living with a disability can support a better quality of life –  including your mental health.

Researchers have identified eight phases of “responses to a physical disability” in people who acquired a disability later in life:

“The onset of a chronic illness or disability typically triggers a chain of psychological reactions, which correspond to eight phases of responses to physical disability. Phases 1 to 6 (Shock, Anxiety, Denial, Depression, Internalized anger, Externalized anger) include the initial stages of adaptation (representing negative adaptation to disability), which an individual hopefully goes through, in order to reach phase 7 and/or phase 8 (Acknowledgement, Adjustment), which are considered as the final phases of adaptation and represent positive adaptation to disability.” (Source: European Journal of Counselling Psychology)

For those who achieve the Acknowledgement and Adjustment phases, mental health and quality of life outlooks are much better:

“Researchers have found that persons with acquired physical disabilities, who adjust more successfully to their disabilities are physically and psychologically healthier. On the contrary, the difficulty of an individual to accept his/her physical disability has been associated with poor physical health and several psychopathological symptoms.”

In a wonderful piece for BBC Radio’s “Point of View” program, sociologist Tom Shakespeare describes his experience with a congenital disability, achondroplasia, as well as an additional disability that occurred later in his life:

“If you think about it for a moment, you realise that people born with an impairment have nothing to which they can compare their current existence. Someone lacking hearing or sight has never experienced music or birdsong, visual art or a sublime landscape. Someone with an intellectual disability may not consider themselves different at all. Someone like me, born with restricted growth, has always been that way. Even if life is sometimes hard, we are used to being the way we are.

For people who become disabled, there’s a typical trajectory. I can say this from personal experience, having become paralysed in 2008. Immediately after the onset of injury or disease, one can feel profoundly depressed, and even contemplate suicide. Yet after a period of time, people adapt to their new situation, re-evaluate their attitude to the disability, and start making the most of it. Sometimes, they are driven to greater achievements than before.”

Shakespeare points out a common myth that people with disabilities are sad or have a low quality of life. On the contrary, he says, many people with disabilities report high levels of satisfaction and a good quality of life.

Taking care of your mental health

As noted above, living with a physical disability doesn’t have to mean a lower quality of life, and there are several steps you can take to support your mental health. They include:

  • Talking to your doctor. When you visit your primary care physician or specialists, discuss your mental health symptoms as well as your physical ones. Your doctor can often connect you with helpful resources.
  • Working with a therapist. A trained therapist can help you work through the phases of coping with and accepting your disability, as well as give you tools and techniques for changing negative thinking and developing positive coping strategies.
  • Exercising. Exercise has been shown to boost endorphins and support mental well-being. In this article for Psychology Today, wheelchair rugby athlete AJ Nanayakkara discusses the positive impact people gain from participation in wheelchair sports.
  • Finding social outlets. Cultivating friendships and a social network can help prevent feelings of loneliness, isolation and associated depression. Join a local interest group, take a class, try a sports club, or talk to your therapist about other ideas for connecting socially.
  • Developing a mindfulness practice. Numerous studies have shown that mindfulness and meditation can help prevent or offset the impact of stress and anxiety.

About the Author:

Scott Kohner MSW, LCSW is a psychotherapist in Denver, CO working with individuals, couples, and families. To learn more about Scott, visit www.ScottKohner.com.