Traumatic Spinal Cord Injury & Mental Health

By Matt Lalande in Spinal Cord Injuries on June 13, 2022

Spinal cord injuries (SCI) are devastating injuries that have the potential for long-lasting physical and psychological effects. Spinal cord injuries have significant medical/physical consequences, leaving the individual paralyzed below the level of the injury (quadriplegic or paraplegic). These injuries require tremendous changes to one’s life

The onset of these changes introduces many physical impairments to change a person’s ability to carry out activities such as ambulation, grooming, toileting and many other activities of daily living. In addition to the physical impairments, there are major psychological consequences that have a profound impact on a person’s perception of himself or herself.

Along with the devastation of life-altering physical changes, our spinal cord injury lawyers have seen time and time again that the major change in lifestyle as well as a variety of factors relating to the experience and treatment of spinal cord injuries often have a serious effect on the psychological state of the victim. Many people understandably, develop the onset of severe negative emotions in response to spinal cord injuries, which often becomes a threat to psychological and social re-integration.

What causes traumatic SCI?

Our spinal cord injury lawyers represent spinal cord injury victims who have been injured in traumatic accidents caused by:

• car accidents
• trucking accidents
• pedestrian accidents
• bicycle accidents
• motorcycle accidents and;
• slip/trip and falls

The extent of physical injury in SCI depends on where the injury to the spinal card occurs – meaning the outcomes of SCI depend on the severity and location of the lesion and may include partial or complete loss of sensory and/or motor function below the level of injury. Lower thoracic lesions can cause paraplegia while lesions at the neck level are often associated with quadriplegia. In other words, a traumatic injury to the spinal cord may produce symptoms that are temporary or permanent impairment of function that may be incomplete or complete.

An incomplete spinal cord injury is one in which certain amounts of motor and sensory function below the level of the injury will be intact whereas a complete lesion is one in which sensory and motor losses total below the level of injury. Consequently, the implications for future functioning may be significantly different for two individuals who are injured at the same vertebral level if one is a complete lesion in one has an incomplete lesion.

A complete spinal cord injury means that the nerves below the damages part of the spinal cord (lesion) are not able to communicate at all with the brain anymore. This leads to total paralysis below the location of the injury – resulting in quadriplegia or tetraplegia.

A Summary of Quadriplegic Injuries

Our spinal cord injury lawyers have represented quadriplegic victims who suffered injuries, such as:

• those who suffered injury at C1 and C2. Victims with injuries at this level will have no motor function below the head and they will be unable to breathe without the use of a respirator. They will require total assistance and independent function will be limited to the use of the muscles in the face.
• those who suffered injury at the C3 level. Injuries at this level lead to paralysis below the neck but there may be a bit of shoulder function intact. Breathing will typically be by use of respirator and the victim will require assistance with almost all activities.
• individuals with injuries at C3 or above. Injuries at this level may be able to use an electric wheelchair controlled by head movements or shoulder movements or that is equipped with a portable respirator.
• individuals who suffered injuries at the C4 level. Independent respiration is possible for those injured at C4, since the diaphragm is innervated at this level. However the upper extremities will be paralyzed and assistance will be needed for almost all activities.
• individual who suffered lesions to the C5 level. Persons with C5 functional level will be able to use their shoulder and biceps which will permit some upper arm mobility. Powered hand splints will provide some hand function and an electric wheelchair will be the mode of transportation. Assistance with most activities of daily living will be necessary.
• individuals with injuries to the C6 level. Victims with injuries at this level have the potential for independence is absolutely present. Because of the ability to extend the rest, the victim and might be able to carry out many of their activities of daily living. Independent living may be possible but attainment will require physical effort and time. An electric wheelchair will often not be necessary and a person may be able to drive a modified vehicle with hand controls. At the C7 level independence is definitely probable, although finger dexterity will be markedly impaired. Independent function will be time-consuming and will require much energy but the option is absolutely there. At the C8 levels some finger function is present and thus independent living is assured, depending on the person.

Spinal Cord Injury Increases Risk for Mental Health Disorders

There are many ways in which develops for individuals following a spinal cord injury.

Pain almost always continues to be a problem for persons with spinal cord injury. Ongoing pain has been shown to be associated with the onset of mental health issues, such as depression. Pain severity is often always associated with emotional and cognitive factors.

Periods of isolation have been found to lead to disturbances of thought and cognition and and thus result in psychological consequences.

Medical complications and body image – for some people, the massive changes in body image can cause significant psychological trauma and require psychological intervention in order to help victims reintegrate into their new state.

Cognition problems are also an issue for many, particularly those who suffer comorbid brain trauma. Brain trauma is a very common occurrence with traumatic spinal cord injury. Symptoms of brain trauma which can influence mental health includes difficulty with forgetfulness, attention, word finding, concentration, memory, problem solving, abstract reasoning, new learning and higher level cognitive skills as well as changes in one’s personality and emotional state

Victims can also suffer discrimination issues. Discrimination against people with disabilities, inaccessibility and negativity, can absolutely increases the level of impairment experienced by the person with SCI.

It is not uncommon for spinal cord injury victims to feel guilty about feeling like a burden on family and friends. The feelings of being a burden can potentially lead to psychological breakdown and imposed multiple stresses not only for the victim, but for their family. Victims may think they are a burden on their families and friends, and conversely, families and friends may have difficulty adapting to the care required. Our spinal cord injury lawyers have also seen that family relationships can be radically changed and in some cases, chronic health problems, feelings of frustration, isolation guilt and even resentment have been reported in family members of victims who suffer spinal cord injuries.

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Lastly, spinal cord injuries may impose marked changes on various aspects of sexual relationships and sexuality. Although medical literature indicates that many people following a spinal cord injury report sexual relationships to be satisfying, for many a lifetime of frustration can lead to complete emotional breakdown.

Common Psychological Conditions suffered by Spinal Cord Injury Victims

Once an independent person, a spinal cord injury victim now must deal with a constellation of medical issues, comprehensive rehab, bowel care, bladder care, skin care, ongoing medical concerns, lung care as well as the modification of nutrition related issues, activities of daily living, mobility, home modifications and just as (if not more) important, psychological care. Now, no longer dependent, spinal cord injury victims must now deal with grief and loss as well as other common mental health conditions such as depression, anxiety, and other inevitable psychological sequalae of spinal cord injury. More detailed:

Grief: Individuals that suffer spinal cord injury may experience feelings of denial and the refusal to accept that their loss is permanent. Some may no doubt experience feelings of sadness, personal loss, hopelessness and worthlessness. Others may react to their injury with strong feelings of anger directed towards themselves or others. Some may go back and forth between stages of grief. Grieving after a life-changing loss such as a spinal cord injury is extremely common Grieving reactions carry many similar symptoms depression but unlike depression, grieving will dissipate overtime as individuals learn to live with their injuries an impairment. Despite this, however, the emotional shock and bereavement for many, is very real.

Posttraumatic stress disorder: is a type of pathological anxiety that affects people who have been through severe trauma, either through individual experience, or witnessing severe trauma that constitutes a severe threat to one’s own life or personal integrity. In most cases, the PTSD victim responds with intense helplessness, horror or fear. Later, that particular person develops characterizations wherein he or she persistently relives the event, which eventually results in numbness, avoidance or hyperarousal.  The incidence of PTSD in traumatic spinal cord injury victims is very high.  Many adults who suffer traumatic spinal cord injury report acute symptoms such as patterns of avoidance, hyper anxiety and intrusive traumatic memories. It’s been reported that often times, both depression and PTSD end up impeding disability acceptance by reinforcing negative cognitions about oneself. PTSD is certainly a burden for spinal cord injury victims

Depression: in 2015, the Journal of Spinal Cord Injury Medicine reported that depression was the most common psychological issue suffered by individual who suffered spinal cord injury (SCI).  Moderate to extremely severe symptomatology was reported by 25% of individuals with a traumatic spinal cord injury,¹ with up to 26% of individuals meeting the criteria for Major Depressive Disorder.^2,3 The journal further reported that if depression was left untreated, depressive symptoms could absolutely become chronic and cause a serious negatively impact on a person’s health-related quality of life and overall recovery. Depression among spinal cord injury victims was known to include secondary health problems leading to recurrent hospitalisations,⁴ fewer functional gains,⁵ and reduced life expectancy.⁶

Other emotional reactions: there is nothing predictable about the psychological sequelae following a spinal cord injury. Psychological response is very much individual but for most, psychological intervention is warranting. Spinal cord injury has been associated with a variety of emotional reactions, including sadness, crying, despair, fear of losing control, disbelief, panic, anxiety, helplessness, confusion, loneliness, isolation, withdrawal – many of which are caused by the complete loss of independence, lack of privacy, uncertainty about the future, the inability to control basic bodily functions and the overall changes in physical health and functional ability.

Have you or a loved one suffered a spinal cord injury?

Our spinal cord injury lawyers have witnessed that people with spinal cord injuries, on average, tend to experience high levels of distress and grief and have an increased risk for suffering mental health disorder. Victims must deal with the devastating instantaneous effects of an SCI along with the total life disruption and the lifelong adjustment process, both physical and psychological that accomanies the injury.   

If you have suffered a spinal cord injury caused by someone else’s carelessness or negligence we can help. Spinal cord injury victims require a lifetime of funding to assist with optimizing their functional outcome and healthcare concerns. Our spinal cord injury lawyers have experience with assisting victims and securing compensation in order to assist with the significant financial impact caused by spinal cord injury. Psychological therapy, to assist in mental health and emotional stability, requires extensive post injury rehabilitation that goes on for many years. It’s important that you help secure the financial means necessary to assessed with ongoing psychotherapy and psychological care in order to maximize recovery.

We understand that pain you and your family are going through and we are here to help. Call us no matter where you are in Ontario at 1-844-LALANDE or local in the southern Ontario region at 905-333-8888. Alternatively, you can send us a confidential email through our website and one of our spinal cord injury lawyer will get back to you promptly. We do not charge for consultations and if we decide to work together, the fee is free. Our spinal cord injury lawyers only get paid, if and when we win your case. Our experienced spinal cord injury lawyers will take all the time you need to answer your questions, inform you or your legal rights, and inform you of your best legal course of action.