Understanding the Patterns and Breaking the Stigma
When life is divided into before and after, as it often is following a spinal cord injury, healing becomes about much more than just physical recovery. It involves rebuilding a sense of self, regaining confidence, and learning to cope with loss, change, and uncertainty. For me, one of the most valuable tools in that process has been therapy. I want to speak openly about my experience.
What Is Depression?
Depression, also known as major depressive disorder, is a medical condition that affects how a person feels, thinks, and functions. According to the American Psychiatric Association (2013), it involves persistent sadness and a loss of interest in activities that once brought joy. Depression is more than just feeling down for a day or two. It can make even simple tasks feel overwhelming and interfere with sleep, appetite, and concentration.
Recognizing depression is the first step. Seeking support is the next. That was true in my own life, and therapy helped me take that step forward.
My Experience with Therapy and CBT
After my injury, I felt I had to handle everything on my own. I believed that being strong meant not needing help. I, like many others, thought that I would be the exception. That I could defy the odds and conquer paralysis. These beliefs kept me stuck in a place where I could not fully move forward. Physically, I began missing important therapy appointments and rapidly lost weight. I was hit with a huge wave of sadness (I recognize it now as a depressive episode) and lost all motivation. I thought, what was even the point? Eventually, I started therapy and was introduced to Cognitive Behavioral Therapy (CBT). It turned out to be one of the most helpful decisions I made.
CBT taught me how to identify negative thought patterns that were shaping how I viewed myself and my future. For example, I used to correlate being disabled with being a burden. CBT helped me challenge that thought and replace it with something more realistic and helpful. I started recognizing the unique skill sets that I bring to the table and began seeing all of the ways that I bring value into relationships and my community. I never stopped doing these things, but what I had stopped doing was recognizing these strengths. Changing my thought patterns was not easy and certainly did not come after one or two sessions with my therapist. It took a lot of time and a lot of practice outside of therapy.
Over time, therapy helped me manage anxiety, interrupt the cycle of negative thinking, and practice more kindness toward myself. I still rely on what I learned during those sessions whenever depression or doubt starts to creep in.
Therapy helped me regain a sense of control over my life. It didn’t fix everything, but it gave me tools to keep moving forward.
Why It Matters to Talk About Mental Health
Many people living with disabilities feel pressured to stay strong or stay “on” all the time. This is something that I struggle with in my daily life. After my injury, I became fixated on the concept of leaving a legacy. Admittedly, that’s why I started this blog to begin with. I had almost died and I felt like I had nothing tangible that represented my life, my existence. I worked through this thought process with my therapist, but truthfully, I have not been able to turn it off. I fill my schedule with stressors of my own making and plug away at them for months and months until I hit the inevitable wall. Then I work through this short spout of a depressive episode and repeat the process. I recognize this, so why can’t I stop it? Admitting you’re struggling can be hard, especially when society already tends to view disability through a limited lens. Some feel that asking for help might make them look weak or incapable, or in my case, that slowing down means giving up.
Opening up about mental health challenges helps create a culture where support is seen as a normal and healthy part of life. When we talk openly about mental health, we reduce isolation and make it easier for others to get the help they need too.
Study Spotlight: Depression After Spinal Cord Injury
A research study by Bonanno and colleagues (2012) tracked 168 people with spinal cord injuries over a two-year period. The researchers identified four main emotional patterns or “trajectories”:
- Stable Low Depression (66.1 percent)
These individuals maintained low levels of depression throughout the study. They may have had strong social support or effective coping strategies. - Depression-Improvement (13.3 percent)
These individuals started out feeling depressed but improved with time. I personally relate to this group. The turning point came when I committed to therapy. - Chronic High Depression (10.7 percent)
This group experienced consistently high depression levels. They may have needed more ongoing mental health intervention. - Delayed Depression (9.8 percent)
Depression levels increased after the first year. This shows that emotional struggles can develop even after the physical recovery process has started.
How Depression Can Vary by Age
Although the Bonanno study did not break results down by age, other research offers helpful insight into how different age groups may experience depression after becoming disabled.
- Young Adults (ages 18 to 35)
People in this age range often face disruptions in identity, independence, and future plans. I was part of this group when my injury occurred, and I can say that it challenged every part of how I saw myself. Research shows that younger adults with disabilities are at increased risk for untreated depression (Turner et al., 2017). - Middle-Aged Adults (ages 36 to 55)
This group may face added pressures from family responsibilities, career changes, and financial strain. Depression in this phase is often related to feeling overwhelmed and uncertain about the future. - Older Adults (ages 56 and above)
Depression among older adults is often missed or underreported. With increasing physical limitations and shrinking social circles, older individuals can feel isolated. Research shows that ongoing emotional support is critical (Chou & Chi, 2005).
What Can We Do to Support Mental Health?
- Talk About Therapy
Sharing your story can help others feel less alone and more willing to reach out for help. That was a huge factor for why I started this blog. - Understand That Mental Health Changes Over Time
Depression might show up months or even years after the injury. Regular check-ins can make a difference. - Make Mental Health Resources More Available
Whether it is through rehabilitation centers, community groups, or peer support, people should have easy access to professional help. Locating these resources can seem overwhelming, especially during a depressive episode– which is why I have a compiled resource list for you.
Final Thoughts
Having a disability does not mean living with depression. But emotional health needs to be a priority, just like physical care.
Therapy helped me see that I did not have to carry everything by myself. Through CBT, I learned how to navigate fear, challenge my own thinking, and build healthier habits. It didn’t remove every obstacle, but it gave me the strength and clarity to keep going.
You are not alone. Your struggles are valid. And support is always worth seeking.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
Bonanno, G. A., Kennedy, P., Galatzer-Levy, I. R., Lude, P., & Elfström, M. L. (2012). Trajectories of resilience, depression, and anxiety following spinal cord injury. Rehabilitation Psychology, 57(3), 236–247. https://doi.org/10.1037/a0029256
Turner, R. J., Lloyd, D. A., & Taylor, J. (2017). Physical disability and mental health: An epidemiology of psychiatric and substance disorders. Rehabilitation Psychology, 62(1), 1–20.
Chou, K. L., & Chi, I. (2005). Prevalence and correlates of depression in Chinese oldest-old. International Journal of Geriatric Psychiatry, 20(1), 41–50.