Losing all or part of a limb is a life-changing event. It can cause grief, pain, and a change in how you perceive yourself.
Grieving
When you lose a limb, you lose part of your physical self. Any loss can lead to a period of grief. It always varies from person person, but most will experience 5 stages of grief:
- Denial and isolation
- Anger
- Bargaining
- Depression
- Acceptance and hope
Some may pass through each stage quickly. Others may get stuck in one stage or skip others. The stages may also happen in different order. The important thing is to realize that everyone moves through grief in their own way. There is no wrong way or specific timeline.
Problem can occur when someone gets stuck. A care team can help if grief is stopping a return to everyday life. Age, the area of loss, and cause may all play a role in reaction. For example, a sudden loss to a trauma may cause more intense denial than those with a long illness. People in denial may be less likely to seek help they need to move forward. Everyone needs time to mourn in their own way. Be on the lookout for depression that lasts more than 2 straight weeks. This may need medical care. Counseling or support groups may help.
Body Image
How we see our bodies can affect our self worth. This can also affect how we interact with others. It is common to compare ourselves to what we think is a perfect body. Anything we see as a flaw becomes far more important than they actually are.
Age can again play a role. Children may feel different from their peers. This may make them unhappy about school or group activities. Adults may find that their negative self-image affects their relationships. If you don't feel good about yourself it is hard to enjoy time with others or feel confident at work. It can also affect sexual relationships. Avoiding others can increase the chance of depression and decrease quality of life.
Problems with body image come from our own thoughts. The first step is to be kinder to yourself. Be aware of harmful thoughts. Most are unkind exaggerations. Instead, focus on positive things, like "I'm a good cook, I'm a good friend". Keep good people around you. Spend less time with people who are negative. Challenge yourself to do something that you may not have done because of body image. The more you grow the easier it will be.
Taking Action
An amputation can be a major life change. It is normal to need some time to adjust. Resist the urge to isolate yourself. Reach out for help when you need to. During this time:
- Reach out. Let your family and friends help you out. This may be hard at first because they do not know exactly what you are going through. Give them a chance. Talking about your needs may help both of you.
- Exercise. The benefits of exercise go beyond the physical. It can help you learn to love and respect your body again. Regular exercise can also help mental health. It can help ease stress, anxiety, and depression. Finally, the physical. Being physically can give you more energy and help you feel better overall. Look for activities you enjoy. There are a number of resources to support you return to activity. Work with your physical therapists, care team, and amputee groups to find solutions.
- Talk. It can be helpful to talk to someone else who has had an amputation. They have been through it and can offer experienced advice. If possible, this may help before the surgery. Ask your care team for programs they may know about. Look for local or online support groups. Professional therapy may help as well. It can be taken as one on one or group support.
- If possible, go back to work. Returning to work will help you rebuild your sense of self and purpose.
RESOURCES
American Physical Therapy Association http://www.apta.org
Amputee Coalition of America http://www.amputee-coalition.org
CANADIAN RESOURCES
Amputee Coalition of Canada http://amputeecoalitioncanada.org
The College of Family Physicians of Canada http://www.cfpc.ca
References
Axelrod, J. The 5 Stages of Loss and Grief. Psych Central website. Available at: http://psychcentral.com/lib/the-5-stages-of-loss-and-grief/000617. Accessed January 4, 2019.
Fisher K, Hanspal RS, et al. Return to work after lower limb amputation. Int J Rehabil Res. 2003;26(1):51-56.
Gallagher P, MacLachlan M. Psychological adjustment and coping in adults with prosthetic limbs. Behavioral Medicine. 1999;25(3):117-124.
Raising low self esteem. NHS website. Available at: https://www.nhs.uk/conditions/stress-anxiety-depression/raising-low-self-esteem/. Updated March 31, 2017. Accessed January 4, 2019.
Wetterhahn KA, Hanson C, et al. Effect of participation in physical activity on body image of amputees. Am J Phys Med Rehabil. 2002;81(3):194-201.