Diabetes and Mental Health: Dealing with Amputation
Diabetic amputation is largely preventable, yet a limb is lost to diabetes every four minutes. Every year, over 150,000 non-traumatic amputations occur in the United States alone. And each amputation burdens the patient who undergoes surgery, leaving a wake of devastation in its path. Let’s talk about diabetes and mental health.
When people experience the loss of a limb, there’s a huge emotional impact. The psychological effects of amputation can be just as traumatic, if not more, than amputation itself. This serious surgery can cause depression and anxiety, even post-traumatic stress disorder or PTSD.
How does amputation affect mental health?
To begin, let’s discern between traumatic and non-traumatic amputation. Some amputations are the result of a traumatic event, like an accident or injury to the limb. Others are non-traumatic, the result of chronic illness that precedes the amputation, and are usually discussed with doctors before surgery.
However, just because post-traumatic stress disorder is less common in non-traumatic amputations doesn’t mean that it doesn’t take a toll. A WHO study found that 14.1% of amputees suffer from depression. Another found significant increases in both depression and anxiety following amputation when compared with the general population. There are also other mental health effects from amputation, including “psychological morbidity, decreased self-esteem, distorted body image, increased dependency, and significant levels of social isolation” (according to studies on short- and long-term follow-up).
Amputation is life-changing. Even just learning that you need an amputation can cause a spike in anxiety and worry about phantom limb pain or other effects. It’s a huge lifestyle change, as many amputees may require wheelchair assistance and experience significantly lowered mobility following amputation. Everyday life can change in major ways.
There is also a strong psychological component of despair, as the body can feel disintegrated. Physical disability can lead to feelings of powerlessness, frustration, anger, and paralysis. When you can no longer do the things you used to do, you grieve. You feel overwhelmed, even isolated. There is a true sense of loss, and diabetic amputation can certainly cause these feelings.
Why is mental health compounded by the loop of amputation?
What’s particularly disheartening is that diabetic amputations often loop. 19% of patients with diabetes suffer another amputation within one year after their first surgery, and nearly 37% do so within five years (according to a BMJ Open Diabetes Research & Care study).
This means that negative feelings can compound very quickly. If one surgery causes depression, then another occurs within the next five years — then you’ve got quite a lot on your plate. Every lower extremity amputation decreases mobility and increases the risk of anxiety, depression, and other mental health conditions.
What can someone do to heal?
It could be said that this loop of diabetic amputation is one of the hardest complications of diabetes, causing a significant burden on patients’ mental health. The link between depression and amputation, for example, can be the straw that breaks the camel’s back. Diabetes mellitus is already enough of a struggle. When you add amputation on top of it (and possibly other comorbidities and serious health conditions), you’re adding stress on top of stress.
What are some coping strategies for people who suffer from diabetic amputation? For many limb amputees, losing a limb is devastating and significantly impacts their quality of life. There are several coping strategies that can help.
- Find support groups for amputees
- Educate friends and family members about the physical and emotional toll that limb amputation can take
- Work with a therapist to learn coping skills that help alleviate stress, anxiety, and depression
- Talk openly about issues that impact one’s quality of life
- See doctors that can offer treatment or solutions that may help comorbidities and lift the burden
- Be compassionate and understanding with oneself
Likewise, all of these coping mechanisms can also be helpful for friends and family who want to support their loved ones.
Amputation is hard. It impacts the daily lives of patients in ways that can pile on, exacerbating the feeling that it won’t get any better. That’s why it’s so important to think about how we can prevent diabetic amputations, and give people their lives back. This underestimated complication can wreak such havoc. The more we learn about diabetic amputation, and how diabetes and mental health should go hand in hand the more we’re equipped to act on this highly preventable complication of diabetes.
If amputation can be prevented, we absolutely should be doing that. There are proven methods like thermometry that can help prevent diabetic foot ulcers, which account for over 80% of all amputations. To learn more, you can always call us at 1-888-498-6489 from 9am-5pm Eastern.