When we get injured we often only focus on the physical implications an injury causes rather than the mental effects it can bring as well. However, it has been proven that both are closely linked.
When we hear or know of someone being physically injured we instantly focus on the physical effects this has on a person. It is easy to disregard something that we cannot see, compared to a visible injury somebody is suffering from. Although we are beginning to put a lot more focus on mental health, it is still important to understand how it affects people through physical injuries too.
Within hand and wrist injuries mental health can be affected as many mobility functions are lost making life very different for someone. A large change like this can be extremely challenging. Moreover, for people already suffering from mental health conditions, this can be either worsened or new mental health conditions may appear.
What do we mean by Mental Health?
The term ‘Mental Health’ refers to the condition of a person’s psychological and emotional well-being. Anyone who can support themselves efficiently as well as give back to their community is considered to be within a state of ‘well-being’.
Mental health is something everyone is affected by, no one is constantly stress free and that’s completely normal since physical & mental health are almost always linked. During an injury, we may feel our mental health being affected more than usual. This is usually due to the stress and implications the injury brings us. The main mental health problems people suffer during these circumstances are the following.
Depression
One of the most common mental illnesses prone to appear during a physical injury is depression. Depression can be caused by living environments as well as life situations.
If stuck at home with an injury you may begin to feel unhappy. For example, a wrist injury can affect your ability to cook meals for yourself and get dressed in the morning. These small changes in someone’s lifestyle can end up impacting their mental health drastically. Knowing you can’t complete simple tasks that you once were able to, can become extremely frustrating and upsetting. After time, these feelings may become more intense and can then lead to depression.
On the other hand, depression can also appear due to changes in life situations.If your job involves needed the function of your hands/wrist, a physical injury in this area may mean that you can’t work until it is healed. Depending on the injury you could be expected to not work for 2-8weeks or even longer. With this much time off work, it is easy for people to become stressed over their finances with things to pay such as their home, food, bills, etc. Constantly being in an environment on your own makes it difficult to think about anything else. This stress can easily lead to depression.
Prevention
If you are suffering from a physical injury to the hand or wrist and are concerned about how this may impact your mental health, here is some guidance that you may want to follow.
The first way to avoid depression from an injury is to understand the situation in a logical and realistic way. Understand that there was no way to control the events that happened leading up to your injury, however, you can control how you let it affect you.
Another thing to understand through an injury is that you are not the only person in the world going through something like this. Thousands of people get injured every day, it could help to find and talk to people going through a similar thing to yourself so you don’t become feeling isolated and alone. This can easily be done through different groups online such as; Limb Care, the NHS, and Intensive Care Society. You can also find more groups and charities for support.
A key way of dealing with an injury – especially one that may affect your motor functions – is to learn how to adapt your lifestyle to fit your needs specifically. This way you can find a new routine that suits your needs and you won’t begin to feel helpless when trying to do something you would usually be able to do. By adapting your lifestyle you can also try to find new hobbies that suit your needs too. Hobbies can take your mind off of your injury and you can find enjoyment and peace in them too.
Finally, you can improve your feeling of self-worth and confidence by making contributions to the people around you. It can be easy to begin feeling useless when having an injury as you may not be able to complete small tasks. However, contributions to either family, friends, or even local people will help to build your self-worth and self-confidence again. Another key way to contribute can be through volunteering.
Treatment
If you find yourself already going through many of the symptoms of depression, there are still plenty of ways to get help. Many of the above points can be used as a form of treatment for depression. For example, it is still recommended to make lifestyle changes to suit your needs, even small changes can make a large difference in your attitude to everyday life. Recommended lifestyle changes range from exercise to sleep. Depending on your injury, regular exercise can play a huge role in treating depression. With a hand or wrist injury, you can still complete simple exercises such as walking, stair walking, squats, lunges, etc. Exercise boosts serotonin and endorphins – both of these hormones improve our mood and feeling of well-being. By getting into a regular exercise routine, even if it is something simple, your mood can be improved drastically.
Your nutrition is also important in maintaining your mood and physical well-being. Eating healthy portion sizes throughout the day will ensure you have a good amount of energy and will keep you from being drawn to sugary foods. Sugary foods are more likely to give you an unbalanced mood throughout the day as well as cause sugar crashes. They can also have an impact on your injury healing time, as some sugary foods can be bad for your joints. You can read more about foods and how they affect your joints.
Finally, you want to ensure you are getting enough sleep as this can strongly dictate your mood. Not having enough sleep can lead to being irritable and moody. The recommended amount of sleep is between 7-9 hours.
If you are still finding it difficult to cope with all of this on your own, you can reach out for help from various support lines such as support line & better help. You can also find support on the NHS website too.
Post Traumatic Stress Disorder (PTSD)
PTSD is a mental health condition caused by a traumatic event, or physical injury. 20-51 percent of the people are found to develop PTSD through orthopedic injuries (bones, joints, soft tissue). This means that PTSD can be caused by wrist and hand injuries as it depends on the event that occurred to cause the injury.
Symptoms of PTSD consist of having nightmares or flashbacks of the event. This can then lead to a lack of sleep, which is also a symptom.
There is no specific injury that causes PTSD. Therefore, even with a smaller injury on your hand or wrist, if the event which happened was traumatic such as an accident on the roads or falling from a height there is a chance you could develop PTSD.
Treatment
Although there is no way to prevent or avoid PTSD from occurring, there are various ways to help if you find that you are suffering from this condition.
Much like depression, it is firstly important to understand the events of what happened and the situation you are left in. Trauma can leave you feeling defenseless and powerless so understanding and challenging this sense of helplessness is a key part of overcoming PTSD. Remind yourself of the skills and strengths you are left with, these constant reminders are what will help you through the trauma.
Another way to treat PTSD is to build back your sense of power so you don’t continue to feel powerless. This can be done through contributing to friends and family as well as volunteering. These positive actions, and constantly challenging your feeling of helplessness will help battle the trauma too.
Since PTSD can create an overwhelming amount of stress, it is important to focus on relaxing and easing this stress. There are a variety of relaxation exercises that you can follow such as meditation, massage, yoga, deep breathing, etc.
It is also important to avoid alcohol and smoking. Although both may be tempting as a way to ease stress, they can both worsen PTSD symptoms as well as interfere with treatment. Moreover, smoking can also interfere with your injury healing. You can read more on how smoking affects bone healing here.
If you do suspect you have PTSD it is crucial that you do get professional help. The sooner you get it treated the easier your recovery will be. PTSD is not a sign of weakness but you will need to learn to accept what happened as a part of your life. Learning to confront a traumatic event can be tough and is much easier with professional help. Ignoring or pushing away any memories of the event can make your PTSD worse. You can seek support through organisations such as PTSD UK and the NHS.
Anxiety
Anxiety is the feeling we get when we are apprehensive over something; it can also happen when we are scared. Anxiety usually affects approximately 40% of patients suffering with an injury. It is common after accidents involving an injury, as people become more anxious about their surroundings and paranoid that another accident may happen. There is no specific injury that causes PTSD; it is simply the brain’s reaction to the event afterward. People who were suffering anxiety previous to their injury may experience an increase in their symptoms and feelings of apprehension.
Symptoms of anxiety include hyperarousal (the body going into high alert when thinking of a traumatic event). These include dry mouth, tensed muscles, and increased perspiration. If symptoms become severe a person can go into an anxiety attack, which is where the person may begin to have a ‘racing heart’ or ‘knot in the stomach’.
Prevention
If you have recently gone through an injury and believe you are experiencing some of these symptoms, there are ways to prevent anxiety before it becomes serious and affects your everyday life.
Firstly, it is important to ensure your diet is balanced throughout the day. Ensuring you are eating the right foods can help boost your mood. It is also important to ensure that you don’t consume too much alcohol, caffeine, or sugar as these can each have negative effects on your mood for a period of time after being consumed.
It is also important to make sure that you make time for new hobbies or previous ones. Anxiety is stress related. Therefore, keeping yourself happy and relaxed is key.. This then leads to avoiding activities that you don’t enjoy or those that increase your stress levels.
Treatment
Anxiety can be treated through the same methods as prevention. However, in extreme cases, a person may need medication such as antidepressants or sedatives. Or they may need cognitive behavioural therapy to help them cope with their anxiety. You can find support through mind.org.uk as well as the NHS.
In conclusion, these are just a few mental health issues that can occur from even the smallest injury concerning the hand or wrist. It is important that we all take care of ourselves physically as well as mentally. If you have been injured recently it is important to look after your mental health and keep busy. Don’t let your injury determine what you can and can’t enjoy, and continue to focus on the positives around you. If someone you know has recently been injured or in an accident, make sure to check on them. They may be going through more stress than you know and will appreciate the social support, don’t leave them to deal with their injury on their own.
Ladan Hajipour is a Consultant Orthopaedic Surgeon based in Manchester, specialising in the treatment of hand and wrist injuries. If you have recently gone through an accident and need treatment for your hand or wrist, book an appointment with Ladan Hajipour.