by Omal Bani Saberi, LCSW, CCHT

This article is about depression during the holiday season, specifically for new amputees. It will include a brief description of depression and practical guide to help you through the holiday season and into the New Year.

All of us experience some type of depression during the holiday season for a variety of reasons, including weather & seasonal changes, the pressures of family traditions, shopping, deciding which gifts to buy, as well as living up to our own expectations and those of others. So naturally, in the midst of what is supposed to be a joyous season, you may find yourself feeling down, especially those of us with disabilities. For the new amputee, this may even be a harder struggle. What are these feelings and how you can work through them and ward them off?

Signs & Symptoms of Depression:

• Loss of appetite, changes in eating patterns
• Lack of energy
• Sleeplessness or sleeping more than usual
• Poor concentration
• Diminished interest in or enjoyment of activities
• Loss of interest in sex
• Social withdrawal
• Feelings of hopelessness, worthlessness, or inappropriate guilt
• Emotions that are flat– expressed robotically rather than with feeling

Grief Process

When a part of our body is gone; we experience a grieving process much like a death. Death is permanent and time eases the pain without losing the memories; however, with the loss of a body part, it is a moment-to-moment reminder and this can be difficult.

The cycle of grief does not flow easily. Emotional recovery is the same as physical recovery, 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 prior to your limb loss, support or lack of support from family or friends, cultural values and norms and socioeconomic factors.

The cycles may include:

Denial
You are in shock that a part of you is gone and may experience disbelief and numbness. In the early stages of survival, belief and disbelief are often experienced at the same time.

Anger
The direction of your anger will vary depending upon your situation and your personality. You may become angry with God, wondering how God would allow this to happen. You may become angry at the injustice and unfairness of the world - after all, the force that is supposed to keep things fair hasn't done its job! You may experience anger towards other people and even yourself. It is vital for anger to be vented. Scream, hit a pillow, tear up a directory, hit a punching bag, or use whatever means you can to release your feelings without hurting yourself or others. Memories of the past before your amputation may be constant. Clothes may not look the same on your body now and this may make you angry and sad. You may have a whole mixture of intense feelings now.

Acceptance
Acceptance will not come easily but it will come gradually. Whether you are a new amputee or one with many years of adjustment, it is hard to come to full acceptance.

How to Survive Holiday Depression

Physically:
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. 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.
5. Accentuate your best features; don't focus just on the loss. For example, if you have wonderful skin, eyes, smile, figure and personality, this is the time to value your assets.

Emotionally:
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, conserve your energy – so extensive shopping for gifts may have to be put aside. Instead send people cards, and try not to feel guilty. Spend more quality time with friends or family, 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 and often they 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. Contact an Amputee Coalition Support Group. If there isn't one in your area, contact the Amputee Coalition office toll-free at 1-888/AMP- KNOW for information and help.
9. Laughter is a healer of depression so add humor, make light of something that is serious, and laugh at yourself.
10.Get professional help if the depression becomes over whelming and no small changes are occurring. Everyone needs help at some point in his or her lives. Be a thriving statistic. You are worth it. If finances are a problem, call your local county mental health office or the Amputee Coalition office (1-888/AMP- KNOW) for information on financial resources available.
11.Most importantly, know that these feelings will lessen over time; however, for now, get support!

Mentally:
1. Commit yourself to work with the medical staff, physicians, nurses, occupational and physical therapists, prosthetists, even when you don't want to.
2. Do not make big decisions such as beginning or ending a relationship buying or selling a house or car when you are depressed. You may regret this later.
3. Go to a psychiatrist for evaluation and medication if necessary.
4. Seek alternative medicine, massage, acupressure, acupuncture, and hypno therapy for pain management, phantom pain, sleeplessness, anxiety and depression.
5. Replace negative self-talk about your body and life with positive cognitive messages.

Spiritually:
1. Forgive yourself; don't judge. Dr. 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 should be, and we untie ourselves from the burden of judging the way they are.”
2. Learn to redefine yourself.
a) Forgiveness. Keep your dreams and reshape and create a new definition of success.
b) Receiving help - Accepting support from loved ones while remaining independent.
c) Making new rituals/ memories thus creating hope for the present and future. A part of you is only physically gone or altered; the core of you is still the same as before. Make goals and objectives for the New Year and start small.
3. If religion or spirituality is important in your life, spend more time and become more in touch with those things that are important to you.

Summary:

Amputation is an enormous loss and learning to adjust is a process that takes time - so be gentle with yourself. Try not to isolate or withdraw from people; use your experiences to build new memories and start new traditions to reach your goals. Sure, there will be adjustments for your disability along the road to success - but it is still your path. Who you are has not changed. Always remember, you are much more than your physical experience. n

RESOURCES:

National Mental Health Information Center
1020 Prince Street
Alexandria, VA 23314-2971
(800) 969-6642

How To Heal Depression
Harold H. Bloomfield, M.D.& Peter McWilliams

Contact your local County Mental Health Association.

About the Author

Omal Bani Saberi is an above knee bilateral amputee. She is a Licensed Clinical Social Worker, (LCSW) and a Certified Clinical Hypnotherapist (CCHT), with Masters Degrees in Social Work and Counseling Psychology. Currently, Ms. Saberi is in private practice, contracting her services to the State of California providing counseling and psychotherapy at Corcoran State Prison.

Last updated: 08/18/2014
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