The National
Spinal Cord
Injury Association


Homepage - Spinalcord.org
About NSCIA
Resource Center
News Room
Communications desk
Sponsors

 

SpinalCord.org

 

Quick Navigation

Communicate!


SCI Life
Fall/Winter 1998

Depression: What the Consumer Needs to Know

Bryan J. Kemp, Ph.D., Director
SCI Aging Center
Rancho Los Amigos Medical Center

What is Depression?
Depression is a psychological condition involving major changes in mood, outlook, ambition, thinking ability, activity level and bodily processes (such as sleep, energy, and appetite). While about 11% of the U.S. non-disabled population is moderately or severely depressed at any given time, research shows that about 30 - 40% of people with long-term spinal cord injury (SCI) have a depressive condition.

Who is Affected?
Depression affects the person's health, interpersonal relations, work, and ability to enjoy life. People with SCI who are depressed do not look after themselves well; they may not drink enough water, look after their skin, manage their diet or see their doctors. They may appear moody or irritable to others, not go out with friends, and lose interest in romance. Work or other activities suffer because the person loses interest, can't problem solve well or is hard to get along with. Life becomes less enjoyable because the person loses some of the ability to find pleasure, success or meaning on life. Often, substance abuse develops to help cope with painful feelings. If depression is severe, thoughts of suicide often occur.

What Causes Depression?
No one is exactly sure, but a combination of life stress and physical changes in the brain seem most likely. Some depression is inherited, but only in a small percentage of cases. People with SCI can become discouraged and depressed as they age if they lose the ability to perform valued activities or if they find it hard to cope with these changes. Depression is not the result of being "weak", "immature", or "inadequate." Depression is a health condition. Persons with both paraplegia and quadriplegia develop depression in nearly equal numbers.

Isn't Depression Normal?
No, depression is not normal, even in the face of a spinal cord injury. Becoming discouraged, grief-stricken or sad is normal but depression represents a condition that goes beyond these normal reactions and indicates that the person has a new health problem.

What Can Be Done?
Fortunately, most depression is readily treated. Depending upon its severity, most people, when properly assisted, will experience significant improvement within a few weeks and complete improvement within 6 to 12 months. Treatment usually involves medicines and/or psychotherapy. Psychotherapy of a practical, problem-solving variety has proven best. Modern medicines are safe and effective for people with SCI when properly selected and monitored. Improvements in the symptoms of depression quickly lead to improvement in other areas, including personal relations, motivation, health and quality of life.

How Do I Recognize Depression?
Because depression develops slowly, people just kind of slip into it. One way to help determine if you need a formal evaluation is to take the following quesionnaire. Answering "true" to 0 to 4 statements indicates nominal responses to everyday life. Answering "true" to 5 to 10 indicates a moderate degree of depression that can affect health, functioning and outlook. More than 10 "true" answers indicate a possible major depressive problem that severely affects functioning and health.

What to Do Next.
If you answered "true" to more than 6, and definitely if more than 10, you should make an appointment with your primary care provider, a psychologist or psychiatrist and discuss the problem. They also can make arrangements for tests to make sure you're not suffering from something else (like an under-active thyroid or an infection). After that, treatment can be started and you can begin feeling better soon.


QUESTIONNAIRE

My daily life is not interesting.

TRUE FALSE
It is hard for me to get started on my daily chores and activities.

TRUE FALSE
I have been more unhappy than usual for at least a month.

TRUE FALSE
I have been sleeping more for at least the last month.

TRUE FALSE
I gain little pleasure from anything.

TRUE FALSE
I feel listless, tired, or fatigued a lot of the time.

TRUE FALSE
I have felt sad, down in the dumps, or blue much of the time during the last month.

TRUE FALSE
My memory or thinking is not as good as usual.

TRUE FALSE
I have been more easily irritated or frustrated lately.

TRUE FALSE
I feel worse in the morning than in the afternoon.

TRUE FALSE
I have cried or felt like crying more than twice during the last month.

TRUE FALSE
I am definitely slowed down compared to my usual way of feeling.

TRUE FALSE
The things that used to make me happy don't do so anymore.

TRUE FALSE
My appetite or digestion of food is worse than usual.

TRUE FALSE
I frequently feel like I don't care about anything anymore.

TRUE FALSE
Life is really not worth living most of the time.

TRUE FALSE
My outlook is more gloomy than usual.

TRUE FALSE
I have stopped several of my usual activities.

TRUE FALSE
I cry or feel saddened more easily than a few months ago.

TRUE FALSE
I feel pretty hopeless about improving my life.

TRUE FALSE
I seem to have lost the ability to have any fun.

TRUE FALSE
I have regrets about the past that I think about often. TRUE FALSE

Published by the Rehabilitation Research and Training Center on Aging with Spinal Cord Injury, Rancho Los Amigos Medical Center, Downey, CA.

Supported by a grant from the National Institute on Disability and Rehabilitation Research, US Dept. of Education.

 
 

Back to SCI Life

Browse the NSCIA Archives

 

 
 
 
 
This site maintained by AYA Web Publishing
Copyright 1995-98 NSCIA. All rights reserved.