Sunday, December 2, 2007
Dealing With Grief and Depression in Veterans
WHEN A PART OF OUR BODY IS LOST, WE EXPERIENCE A GRIEVING PROCESS MUCH LIKE WE DO FOR A DEATH. IN HER BOOK ON DEATH AND DYING, DR. ELISABETH KUBLER-ROS HAS OUTLINED FIVE STAGES OF THE GRIEVING PROCESS THAT OCUR IN CONJUNCTION WITH DYING.
These stages, in the context of limb loss, are:
1. Denial and Isolation. “This is impossible. It’s not really happening! I feel nothing at all.”
2. Anger. “Why is this happening to me? I’m enraged! God is unjust.”
3. Bargaining. “If I promise to do such and such, maybe I’ll get my old life back.”
4. Depression. “I feel hopeless. Everything is beyond my control. Why bother trying? I give up.”
5. Acceptance. “I don’t like it, but the amputation is a reality. I’ll find ways to make the best of it and go on.”
The cycle of grief does not flow easily. Emotional recovery, like physical recovery, is based on your own timetable and other factors. These include age, gender, circumstances of your limb loss (accident, disease, birth), how you coped with problems in your life before your limb loss, support or lack of support from family or friends, cultural values and norms, and socioeconomic factors.
The new amputee may experience feelings of depression that are difficult to ward off. What are these feelings and how can you work through them?
Signs & Symptoms of Depression
Loss of appetite, changes in eating patterns
Lack of energy
Sleeplessness or sleeping more than usual
Diminished interest in enjoyable activities
Loss of interest in sex
Feelings of hopelessness, worthlessness, or inappropriate guilt
Emotions that are flat – expressed robotically rather than with feeling
Following are some suggestions for overcoming your depression, physically, emotionally, mentally, and spiritually.
1. Get your rest. Each day, get out of bed, get dressed, and, if possible, go out of the house.
2. Make sure you eat well – not too many sweets. Foods with sugar will give you quick bursts of energy then quickly let you down, taking you deeper into depression.
3. Get involved in physical and recreational activities that do not cause you pain. Exercise and gentle movement will release endorphins to help decrease depression.
4. Practice deep breathing. This will help relax muscles, decrease pain, and relax and focus the mind.
5. Decrease alcoholic beverage intake. Alcohol is a depressant. Eliminate other drugs that you use to self-medicate. If using prescription drugs, make sure you take them when prescribed.
6. Accentuate your best features; don’t focus on the loss. For example, if you have beautiful skin or eyes, a bright smile, a terrific figure or a great personality, this is the time to value your assets.
1. You are not alone.
2. You are not to blame. It is important that you feel the anger because if you don’t, it will lead to depression.
3. Write letters and don’t mail them. Journal your feelings.
4. Increase contact with supportive family and friends.
5. Assert yourself and communicate clearly. Tell those around you what you need and don’t need. For example, you may need to expend less energy this year so conserve your energy. Go to a movie or rent a video, especially if the weather is harsh.
6. Tell your loved ones you are experiencing grief and talk about your loss together. This gives your loved ones the chance to express their feelings since they, too, have to adjust to your loss. So don’t skirt around the issue, walk on eggshells or ignore the problem. Be honest and talk it out. This will give you and yours a greater chance to heal and adjust.
7. Remember, people want to help but often don’t know what to do to support you. So ask, ask, ask! You can remain independent – but let go of the controls for now. Allow others to give to you so you can replenish your energy.
8. Explore the potential benefits of meditation, guided imagery and hypnotherapy.
9. Contact a support group. If there isn’t one in your area, contact the ACA office toll-free at 888/267-5669 for information and help.
10. Laughter is a healer of depression, so add humor. Make light of something that is serious, and laugh at yourself.
11. Get professional help if the depression becomes overwhelming and no small changes are occurring. Everyone needs help at some point in his or her life. Be a positive statistic. You are worth it. If finances are a problem, call your local mental health office or the ACA at 888/267-5669 for information on financial resources.
12. Most importantly, know that these feelings will lessen over time; however, for now, get support!
1. Commit yourself to work with the medical staff, physicians, nurses, occupational and physical therapists, and prosthetists, even when you don’t want to.
2. Do not make big decisions such as beginning or ending a relationship, or buying or selling a house or car, when you are depressed. You may regret this later.
3. Go to a mental health professional for evaluation and medication if necessary.
4. Seek alternative medicine, massage, acupressure, acupuncture and hypnotherapy for pain management, phantom pain, sleeplessness, anxiety and depression.
5. Replace negative self-talk about your body and life with positive cognitive messages.
1. Forgive yourself; don’t judge. Dr. Harold H. Bloomfield, co-author of How to Heal Depression, states, “The primary reason to forgive is for your peace of mind and the quality of all your future relationships. That’s what we do when we forgive – let go of the imaginary (but painful) control of the way we think things could be, and we untie ourselves from the burden of judging the way they are.”
2. Learn to redefine yourself.
• Keep your dreams and create a new definition of success. Make goals and objectives for the future, and start small.
• Accept support from loved ones while remaining independent.
• Make new rituals/memories thus creating hope for the present and future.
• If your religion or spirituality is important to you, become more involved with it.
• Remember: A part of you is only physically gone or altered; the core of you is still the same.
About the Author
Chaplain Mark H. Stevens, M.Min was a MSgt in USAF, he served in combat operations all over the world as a Airlift Control Element Mission Support Team Chief. He now is a disabled vet suffering from Sarcoidosis and Lymphedema. He is a Chaplain at Ancora Psychiatric Hospital in NJ. Chaplain Stevens has had part of his foot amputated because of complication from Sarcoidosis and the loss of his sight in his right eye. Depression is a reality many veterans have to deal with, be patient with them and understand the sacrifice they endured...FOR YOU!
National Mental Health
Association Resource Center
2001 N. Beauregard Street, 12th Floor
Alexandria, VA 22311
(Or contact your county mental health association)
How to Heal Depression
Harold H. Bloomfield, MD, and Peter McWilliams
On Death and Dying
Dr. Elisabeth Kubler-Ross
(New York: MacMillan Publishing, 1969)