Grief after limb loss is normal. Here are 5 things you need to know about coping with depression and anxiety after an amputation.

It’s clear that an amputation affects limb loss survivors in physical ways. But the emotional and psychological impacts of losing a limb are sometimes just as serious as the physical ones. The relationship between amputation, grief, and depression is very real and, often, very strong.

Limb Loss and Grief

If you’re experiencing grief or even battling clinical depression after limb loss, please know that you’re not alone. Many limb loss survivors go through this. It doesn’t mean that you are weak in any way, or that you’re being negative. And it doesn’t mean that your situation won’t get better in time.

Why does grief often accompany an amputation? Feelings of grief can arise from any kind of meaningful loss – and the loss of a limb certainly counts. In the case of amputation, the absent body part itself isn’t the only loss you suffer. Amputation also leads to many other kinds of losses.

Physical Changes Due to Limb Loss

Physically, the loss of the limb may represent the loss of function. Without your leg, how can you stand or run or dance? Without your arm, how will you write, draw, type, throw a ball, or cook a meal?

Your limb loss can also leave you with physical pain. In addition to the pain you experience in your residual limb, you might suffer from phantom limb pain. This pain can be difficult to relieve since your missing limb isn’t physically present to be treated. Of course, being in pain affects your physical wellbeing – and your emotional wellbeing, too.

Emotional Effects of Limb Loss

An amputation can make you feel less than whole emotionally. Along with the loss of function, you might experience other losses, too: the loss of the joy of doing your favorite activities, the loss of your dreams.

You don’t have to feel hopeless because of the amputation. Prosthetic limbs can help you regain some of the functions you have lost. You can find different ways to achieve your dreams and get involved in your favorite hobbies. You can also set new goals for life after the amputation and discover new pastimes that you can enjoy without your missing limb.

However, it’s still okay – healthy, even – to grieve for what you have lost even as you search for ways to move forward.

Dealing With Limb Loss Alterations in Body Image

Another common cause of emotional turmoil for amputees is the change in appearance that results from missing a limb. The link between limb loss and body image is complex. When you lose a limb, you might feel self-conscious about your appearance and what others think of you.

Choosing a natural-looking, life-like prosthetic limb can help you blend in more after your amputation if your body image concerns revolve mostly around looking different or standing out from others. It’s also important, though, that you accept these changes in yourself.

Remember that you have plenty of good points to celebrate. Focus on what you like, not just on your appearance, but about your whole self. Work with your medical care providers to make lifestyle decisions about diet and exercise that will help you feel better physically and emotionally – because when you feel great, you’re more likely to develop a positive body image, too.

The Grieving Process

After going through limb loss, grieving is a normal process. It’s also normal, however, for people to experience limb loss grief in different ways.

The grieving process may last longer for some people than for others. You may go through several stages of grief – but not everyone goes through every stage in the same order, or even at all. You may find that the coping mechanisms that worked well for other amputees aren’t the most effective for you. All of this is okay. Your grief is personal, and so is the process of coping with it.

Read on to learn more about ways to cope with your grief and the relationship between amputation and depression.

Five Steps to Coping With Limb Loss Grief

1. Recognize your feelings.

There’s no shame in feeling, angry, frustrated, sad, or dozens of other negative emotions when you’ve been through something as traumatic and life-changing as an amputation. Often, working through the complicated emotions that accompany loss requires you to first acknowledge those feelings – and accept that it’s okay to feel that way.

It’s true that a positive attitude can help you through the challenges of rehabilitation. However, it’s just as true that no one can be completely positive all of the time. In fact, trying to ignore or hide negative feelings like anger, rather than accepting and coping with them in healthy ways, can lead to the development of depression, the Amputee Coalition reported.

What you’ve been through has been difficult. There’s no one right way to feel after an amputation. You may feel like your emotions are all over the place – roller coaster-like highs and lows of emotion. Whatever your feelings are, they’re valid. They deserve to be expressed and addressed, not hidden.

With time, those feelings will become less intense and you will feel them less frequently, according to the Amputee Coalition – especially if you find new meaning or a purpose to focus on.

2. Don’t hold in negative feelings – express them.

There are many different ways you can express these feelings. Some limb loss survivors prefer to write down their thoughts. You can keep a journal or write a letter, even if you never plan to send that letter.

If you don’t feel that words do enough to convey your feelings of grief, consider another medium that does. Draw or paint a picture. Sing or play a song that means something to you. Build something. You don’t have to be a skilled artist or crafter. The quality of however you choose to express yourself doesn’t matter. All that matters is that you have the opportunity to deal with these emotions – that you’re not keeping them inside.

Finding methods of self-expression that allow you to vent negative feelings is important. However, sometimes you need support from others. That’s why the Amputee Coalition also recommends talking to the loved ones you trust most about your feelings.

Let your loved ones know that you’re looking for a place to talk honestly about your grief – not for someone to just cheer you up or get your mind off of the negative. It’s likely that the people closest to you, too, are feeling some grief related to your loss. Sharing your grief with the people closest to you can help strengthen those relationships during such a tough time – as well as communicate your feelings.

3. Focus on the journey, not the destination.

As you work toward physical rehabilitation, you might hear that it’s the journey toward recovery, not just the destination, that counts. For patients coping with a serious injury – and the loss of a limb definitely counts – rehabilitation can be a journey of hundreds of baby steps.

If you focus only on the difference between where you are and where you eventually want to be, you’re likely to get discouraged. Looking instead at the progress you have made – at how much better you’re doing than yesterday, or last week, or last month – can help you see how far you have come. As much as you want to be completely recovered right now, you can’t rush your rehabilitation. It takes time. When you focus on the journey and not the destination, you can see that slow progress is better than no progress.

Like physical rehabilitation, grief is a process rather than a single event. You can’t rush yourself through the process of coping with a life-altering loss. Grieving the loss of a limb – and all that limb represents to you – takes different amounts of time for different people. You may think that you’re over the grief one day, but realize the next day that you’re still struggling with denial, anger, or depressed feelings. There will be ups and downs, but remembering that each day is just one part of a larger journey can help you weather those ups and downs.

4. Talk to someone who’s been through an amputation.

Though you might feel alone in dealing with limb loss, you’re actually one of 185,000 people per year who undergo an amputation. Nearly 2,000,000 Americans are limb loss survivors, the Amputee Coalition reported. And nearly all of them have dealt with grief, just as you’re coping with it now.

Sometimes simply knowing that other people are facing – and somehow overcoming – the same challenges you are can be enough to give you hope. Even venting the frustrations you feel as a result of the amputation to someone who has been there and really knows what you’re going through can help. Whether talking about a problem helps you find actual solutions or just feel that your voice is being heard, the experience can be uplifting.

Many amputees find some comfort by participating in limb loss support groups. In these settings, you can share problems, suggestions, and successes with fellow amputees. You can commiserate with and inspire each other.

This resource from the Amputee Coalition can help you find one of the more than 260 support groups operating across the United States. If you’re not able to make it to a real-world meeting of a support group, you can even look for virtual support groups on Facebook and other social media platforms.

5. Find a purpose that gives your life meaning.

One of the best things you can do while grieving is look for something that gives your life purpose. Some amputees look for some kind of spiritual meaning or “higher purpose” that explains why they had to endure this disability, the Journal of Clinical and Diagnostic Research reported. Others aren’t looking for an explanation or rationalization, but rather a way to feel useful, get involved, or build relationships as part of the adjustment to their new lives.

What kind of purpose should you look for? There’s no single right answer. For some amputees, it’s a cause related to limb loss, like raising awareness for vascular diseases or support for services for limb loss survivors. But your purpose doesn’t have to have anything to do with amputation. Anything that gives you a reason to work toward recovery, a boost to your confidence and self-esteem, and a sense of motivation or belonging can be a positive addition to your life after limb loss.

Amputation and Depression

Most of the time, the emotional changes you experience after losing a limb can be chalked up to normal feelings of grief. Sometimes, though, amputees go on to experience clinical depression after losing a limb.

Distinguishing Depression From Grief

How can you tell the difference between grief and depression? One of the biggest differences is the permanence and completeness of the negative emotions you feel, according to the Amputee Coalition.

Feelings of anger, guilt, sadness, a loss of self-esteem, and even physical symptoms are common among limb loss survivors during the grieving process. However, there are still positive feelings and moments of enjoying life.

In clinical depression, you feel these emotions all or most of the time. Though people may attempt to support you or comfort you, you have trouble accepting their help and may isolate yourself.

If you’re suffering from depression, instead of experiencing normal ups and downs, you may feel a “sense of doom” that prevents you from even temporary enjoyment of life, the Amputee Coalition reported. You might have trouble expressing your feelings of anger in direct and healthy ways. Instead of seeing these emotional changes as a result of your amputation, you might feel that they don’t correspond to any particular life event (which can make it difficult to imagine that things will improve in the future).

Symptoms of Clinical Depression

Limb loss survivors who experience depression might also notice symptoms such as:

• Changes in sleeping and eating habits

• Having no appetite

• Trouble concentrating

• Losing interest in activities you once found enjoyable

• Lack of energy

• Withdrawing from social situations

Getting Help for Depression After Limb Loss

Depression is a serious medical condition, and it should be treated as such. However, limb loss and depression are closely connected, so don’t feel like you’re the only one going through this.

Many of the tips for coping with grief can also help you if you’re suffering from depression – but they aren’t enough to help you overcome it. You need to seek help from a counselor, a psychiatrist, or another mental health professional. In spite of the traumas that have happened in your life, you deserve more than to just survive – you deserve to thrive.