Dealing with Grief and Depression

By Omal Bani Saberi, LCSW, CCHT

When part of our body is lost, we experience a grieving process much like a death. In her book On Death and Dying, Dr. Elizabeth Kubler-Ross has outlined five stages of the grieving process that occur in conjunction with dying. These stages, in the context of limb loss, are:

1. Denial and Isolation. “This is impossible. It’s not really happening! I feel nothing at all”.
2. Anger. “Why is this happening to me? I’m enraged! God is unjust.”
3. Bargaining. “If I promise to do such and such, maybe I’ll get my old life back.”
4. Depression. “I feel hopeless. Everything is beyond my control. Why bother trying? I give up.”
5. Acceptance. I don’t like it, but the amputation is a reality. I’ll find ways to make the best of it and go on”

The cycle of grief does not flow easily. Emotional recovery, like physical recovery, is based in your own timetable and other factors. These include: age, gender, circumstances of your limb loss (accident, disease, birth), how you coped with problems in your life before your limb loss, support or lack of support from family or friends cultural values and norms, and socioeconomic factors.

The new amputee may experience feelings of depression that are difficult to ward off. What are these feelings and how can you work through them?

Signs & Symptoms of Depression

Loss of appetite, changes in eating patterns

Lack of energy
Sleeplessness or sleeping more than usual
Poor concentration

Diminished interest in enjoyable activities

Loss of interest in sex
Social withdrawal
Feelings of hopelessness, worthlessness, or inappropriate guilt
Emotions are flat – expressed robotically rather than with feeling

Surviving Depression
Following are some suggestions for overcoming your depression, physically, emotionally, mentally, and spiritually.

Physically

1. Get your rest. Each day get out of bed, get dressed, and if possible, go out of the house.
2. Make sure you eat well – not too many sweets. Foods with sugar will give you quick burst of energy then quickly let you down, taking you deeper into depression.
3. Get involved in physical and recreational activities that do not because you pain. Exercise and gently movement will release endorphins to help decrease depression.
4. Practice deep breathing. This will help relax muscles, decrease pain, and relax and focus the mind.
5. Decrease alcoholic beverage intake. Alcohol is a depressant. Eliminate other drugs that you use to self-medicate. If using prescription drugs, make sure you take them when prescribed.
6. Accentuate your best features; don’t focus on the loss. For example, if you have beautiful skin or eyes, a bright smile, a terrific figure or a great personality, this is the time to value your assets.

Emotionally

1. You are not alone.
2. You are not to blame. It is important that you feel anger, because if you don’t it will lead to depression.
3. Write letters and don’t mail them. Journal your feelings.
4. Increase contact with supportive family and friends.
5. Assert yourself and communicate clearly. Tell those around you what you need and don’t need. For example, you may need to expend less energy this year; conserve your energy. Go to a movie or rent a video, especially if the weather is harsh.
6. Tell your loved ones you are experiencing grief and talk about your loss together. This gives your loved ones the chance to express their feelings, since they too, have to adjust to your loss. So don’t skirt around the issue, walk on egg shells or ignore the problem. Be honest and talk it out. This will give you and yours a greater change to heal and adjust.
7. Remember, people want to help but often don’t know what to do to support you. So ask ask ask! You can remain independent – but let go of the controls for now. Allow others to give to you, so you can replenish your energy.
8. Explore the potential benefits of meditation, guided imagery and hypnotherapy.
9. Contact a support group. If there isn’t one in your area, contact the Douglas Bader Foundation on 01883 742 273.
10. Laughter is a healer of depression, so add humour; make light of something that is serious, and laugh at yourself.
11. Get professional help if the depression becomes overwhelming and no small changes are occurring. Everyone needs help at some point is his or her life. Be a positive statistic. You are worth it. 
12. Most importantly, know that these feelings will lessen over time; however, for now get support!

Mentally

1. Commit yourself to work with the medical staff, physicians, nurses, occupational therapists, and Prosthetists, even when you don’t want to.
2. Do not make big decisions such as beginning or ending a relationship, or buying or selling a house or car, when you get depressed. You may regret this later.
3. Go to a psychiatrist for evaluation and medication if necessary.
4. Seek alternative medicine, massage, acupressure, acupuncture and hydrotherapy for pain management, phantom pain, sleeplessness, anxiety and depression.
5. Replace negative self-talk about your body and life with positive cognitive messages.

Spiritually

1. Forgive yourself; don’t judge. Dr. Harold H Bloomfield, co-author of How to Heal Depression, states. “The primary reason to forgive is for your peace of mind and the quality of all your future relationships. That’s what we do when we forgive – let go of the imaginary (but painful) control of the way we think things could be, and we untie ourselves from the burden of judging the way they are.”

2. Learn to redefine yourself.

· Forgiveness. Keep your dreams and create a new definition of success.

· Accept support form loved ones while remaining independent.

· Make new rituals/memories thus creating hope for the present and future. A part of you is only physically gone or altered; the core of you is still the same. Make goals and objectives for the future and start small.

· If your religion or spirituality is important to you, become more involved with it.

Summary

Amputation in an enormous loss and learning to adjust is a process that takes time – so be gentle with yourself. Try not to isolate yourself or withdraw from people; use your experiences to build new memories and start new traditions to reach your goals. Sure, there will be adjustments for your disability along the road to success – but it is still your path. Who you are has not changed. Always remember, you are much more than your physical experience.

About the Author:

Omal Bani Saberi is an above–knee bilateral amputee. She is a licensed clinical social worker (LCSW) and a certified clinical hypnotherapist (CCHT) with Master’s Degrees in Social Work and Counselling Psychology. Currently, she is in private practice, providing mental health services, including counselling and psychotherapy.

© 2004 Amputee Coalition of America. Local reproduction for use by ACA constituents is permitted as long as this copyright information is included. Organizations or individuals wishing to reprint this article in other publications, including other World Wide Web sites must contact the Amputee Coalition of America for permission to do so.