Psychological ConcernsHaving a SCI necessitates a lot of adjustments to your daily life as well as to your self image. Some of the challenges people with SCI might face include changes in body image, loss of self esteem, loss of energy, mood changes, increase of pain or unpleasant sensations, loss of sexual function, increased stress, fear of the unknown and loss of privacy and independence. The issues that we will be exploring in this part of the course include depression and substance abuse.
Depression
Depression is two to three times more common in people with SCI than uninjured people. The signs and symptoms may include, but not be limited to: feelings of worthlessness, hopelessness, despair, suicidal thoughts, disinterest in activities that used to cause pleasure, social isolation, sleep disturbances, weight changes, decrease in energy, loss of enthusiasm, mood swings and neglect of physical, social, spiritual or emotional needs. If not treated, depression can worsen or lead to decreased health status, suicide or drug and alcohol abuse. Luckily, depression can be treated, through counseling, support groups or medicine. Antidepressants have many side effects that can be particularly concerning for people with SCI. For instance, many cause weight gain or changes in bowel habits and sexual functioning. If you suspect your client or loved one has depression, you should open a discussion with them about it. Let them know what your observations and concerns are and encourage them to see a medical practitioner or mental health expert. Some non-pharmacological ways to prevent or help to treat depression include seeing a counselor, joining a support group or, establishing regular contact with a person who has been living well with SCI.
Follow this link to get more info on depression and a self test questionaire.
Substance Abuse
Challenging life adjustments, loss of independence and altered body image and self esteem can all contribute to the development of substance abuse problems. This may involve over use of alcohol and/or prescription and recreational drugs. Some possible signs of a substance abuse problem may include self imposed social isolation, extreme mood swings, financial losses, unusually large or small pupil size, slurred speech or incoherent thoughts.
Numerous screening tools have been developed to identify potential alcohol or drug abuse issues. The CAGE alcohol questionaire and the Drug Abuse Screening Test (DAST) are among the most commonly used tools. The Michigan Alcohol Screening Test is a bit more indepth than the CAGE.
A Please visit the Counseling Resource web site to read about and take the CAGE questionaire. Then, take the Drug Abuse Screening Test (DAST) and the Michigan Alcohol Screening Test (MAST). Come to class prepared to discuss the differences between these screening tools.
If you suspect someone you care about has a substance abuse problem, it's important to talk to them about it and encourage them to seek counseling. Many organizations provide free counseling or support such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA). Online counseling is also available for a fee and can easily be found doing a google search. One on one counselors can be found through your local yellow pages or mental health association.