Coping With Limb Loss: Tips and Strategies

More than 2 million Americans live with limb loss, and every year, nearly half a million people undergo limb amputation or are born with a limb difference. Limb loss is a challenging and often traumatic experience that impacts all parts of a person's life, including their relationships, career, dreams, and psychological state. Many people who have lived through limb loss face mental health challenges like anxiety or grief.

Although living with an amputation comes with a set of new challenges, healthy coping techniques can help you or your loved one navigate your new journey and manage overwhelming emotions. If you or a loved one recently underwent an amputation, know that many people live a fulfilling life once they adapt to changes. The first step to healing from limb loss is acknowledging your feelings and the various factors impacting your mental health. From there, you can apply coping strategies that work for you.

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The Emotional Effects of Amputation

An amputation significantly affects a person's life and psychological state for several reasons. First, the amputee must handle the sensation of losing a limb and a loss of function. They may experience challenges with mobility and need to depend on others until they adapt and regain independence. Some patients experience phantom limb pain, which can negatively impact their quality of life.

Amputees must also cope with the emotions attached to a new body image. These factors combine to produce complex thoughts and feelings. According to the Eurasian Journal of Medical Investigation, patients with amputations frequently experience decreased self-esteem and a fear of the future early in the healing process. However, all of these emotional effects can be addressed and improved.

Social Factors That Impact the Emotional Effects of Amputation

Although limb loss commonly triggers grief and depression, not all amputees experience these effects. Everyone copes with amputation in their own way, and certain factors influence each person's reaction. The following factors can significantly impact how someone copes with limb loss:

Age: A person's age impacts how they psychologically cope with an amputation. Children and adolescents may adapt to an amputation more quickly than adults, but face greater emotional challenges related to their identity, acceptance and rejection. Adults are typically more vulnerable to difficult emotions associated with daily functioning, financial matters and family relationships. Any age can experience depression, anxiety or post-traumatic stress disorder after limb loss.
Personality: Different personalities react to limb loss in different ways. For example, people who tend to experience depression or anxiety may have more difficulty coping with limb loss than others. Likewise, highly self-reliant individuals might struggle more with amputation than someone comfortable accepting help from others.
Occupation: If a person's career involves motor skills, they are more likely to experience tough emotions related to limb loss. If someone did not rely on the limb to perform their work, they may experience less emotional impact.
Support: Support from friends, family and a medical team is critical during recovery from an amputation. According to a HealthMED review, a lack of social support is correlated to high levels of anxiety and depression in patients with lower-limb amputations. People with sufficient social support experience lower levels of anxiety and depression. Individuals with an amputation who need more support might consider connecting with others affected by limb loss.

Medical Factors That Impact the Emotional Effects of Amputation

Various medical factors also impact how someone copes with an amputation. These factors include:

Current condition: People experience limb loss differently depending on their overall condition. For example, a patient who had mobility issues before a lower-limb amputation may be less emotionally impacted than an athlete with a recent amputation. However, a healthy patient who lost a limb due to a traumatic event may adapt physically to the change better than a patient with chronic illnesses.
Reason for the amputation: A person who loses a limb due to combat or an accident will experience the amputation differently than a patient who chooses surgical amputation. A patient suffering from peripheral vascular disease, for example, may accept the surgery and view it as a form of relief.
Preparation time: Patients who plan an amputation have time to go through grief stages before they experience limb loss. They can meet with others who have undergone the procedure to set realistic expectations and gain a sense of hope. Individuals who experience an accidental amputation do not get to grieve first. They may be more prone to experiencing post-traumatic stress disorder.
Complications: If patients undergo a poorly performed surgery or traumatic amputation, they may be more likely to experience complications like pain or an infection. These factors can impact rehabilitation and a person's emotions.
Prosthesis application: Individuals who receive a prosthetic limb shortly after the amputation typically experience less emotional distress than someone who does not get a prosthesis. Prosthetic rehabilitation helps patients adapt to a new body image and focus on future goals rather than the loss.
Vocational rehabilitation: Vocational rehabilitation can be a critical aspect of a person's recovery. Through vocational rehabilitation, patients might learn new skills or get assistance finding a meaningful job. It can help the person resolve financial stress, rebuild self-esteem, and decrease depression symptoms.

Amputation and Grief

Losing a limb can trigger grief in the same way as losing a loved one. Grief is how people naturally react to losing anything or anyone they love. It encompasses various stages and emotions as a person processes the loss and adapts to changes. As time goes on and the person adjusts to a new life, the pain of grief lessens.

Still, grieving is difficult, and everyone experiences grief in their own way. Some people will go through all the stages of grief. Others may only experience a few. The grieving process also does not occur in a particular order, nor can it be rushed. Understanding what grief looks like can increase self-compassion and help you determine your needs. Here are the different stages of grief and how they relate to limb loss:

Denial: Denial helps reduce the pain of a significant loss. It may feel like numbness, shock or confusion. People in the denial stage may avoid thinking or talking about the loss. For example, a patient about to undergo a surgical amputation might refuse to talk about the impending procedure or answer questions. Someone who experienced an amputation in a traumatic event might be in a state of disbelief that the loss occurred.
Anger: People may feel angry as they start to release emotions related to their loss. During the anger stage, a person might feel frustrated, resentful, irritable, or pessimistic. Patients might express anger toward doctors or nurses after amputation for "tricking" them into getting surgery, for example.
Bargaining: Bargaining can feel like guilt, fear and anxiety. Someone in the bargaining phase might dwell on the past and wish they did something different. They will try to think of ways to avoid the pain they are feeling or anticipating. For instance, a patient might try to postpone their surgery despite it being necessary for their health.
Depression: At some point during the grieving process, a person realizes bargaining is not an option. They start to look at the situation realistically and feel the intensity of their loss. Depression is characterized by sadness, despair, hopelessness, and disappointment. Someone who is depressed might experience decreased energy and withdrawal from others.
Acceptance: When someone reaches acceptance, they no longer fight reality or try to bargain for something different. They may still experience sadness, but they are less likely to feel anger or denial about their loss. They may be able to live in the present moment, cope with difficult emotions in a healthy way, and communicate honestly about how they feel. Individuals with an amputation may not reach the acceptance stage until they are in a rehabilitation program.

Coping With Amputation Depression and Anxiety

Experiencing sadness and a depressed mood is often part of the grieving process for individuals with an amputation. It is common for patients to feel depressed, particularly if limb loss happened recently. According to a 2018 review, rates of depression symptoms decline during the years following an amputation.

When depression does not get better or becomes overwhelming, it is time to reach out for professional help. Symptoms of major depression include:

Persistent feelings of sadness, worthlessness, guilt, or hopelessness
Thoughts of suicide or self-harm
Difficulty sleeping or oversleeping
Loss of interest in hobbies or activities you once enjoyed
Significant weight loss
Fatigue or lack of energy

Know that major depression is highly treatable. Psychotherapy, antidepressants, and physical rehabilitation can help relieve depression symptoms after an amputation. There are also things you or a loved one can do at home to manage depression, such as:

Spending time with supportive friends and family and talking about your feelings.
Setting realistic expectations and accepting that your mood may improve gradually rather than immediately.
Trying to exercise and eating a healthy diet.
Learning about depression so you can understand what you are going through.
Waiting to make major decisions until you feel better.
Practicing deep-breathing exercises to relax your body and mind.
Focusing on your assets rather than the loss.
Asking others for help when you need it.
Getting in touch with a support group.
Replacing negative thoughts with positive ones.
Remembering you are not alone.

Anxiety is also a common side effect of an amputation or any stressful, traumatic event. Like depression, anxiety is often strongest in the months following an amputation and declines over time. Anxiety usually relates to changes in body image, identity, and social roles.

Patients with anxiety might experience symptoms like insomnia, fear, or trouble controlling worrying. If anxiety disrupts your life and feels difficult to control, it is best to speak to your doctor. Staying active and keeping in touch with caring people can also help calm anxious feelings.

How to Cope With an Amputation

It takes time to process the emotions you feel and adapt when experiencing an amputation. It is important to remember that difficult feelings will decrease over time. In the meantime, surrounding yourself with supportive people and trying different strategies can help you cope with the loss. Here are a few positive ways to cope with limb loss:

1. Acknowledge Your Feelings

Acknowledging your feelings can help you heal and move through the grieving process. Know that it is OK to feel angry or sad after your loss. You might experience a vast range of emotions until you adapt to the changes in your life. Allow yourself to feel all the different emotions that arise rather than force them aside. If you feel stuck in an emotion, consider speaking with a mental health professional.

2. Express Negative Emotions

It is better to express negative emotions than ignore them. You might write about your feelings in a journal, paint a picture, or play a song — whatever appeals to you. The point is to let your emotions out so you can deal with them in a healthy way. Consider adding talk therapy or counseling into your recovery plan to learn healthy forms of expression and get professional guidance navigating the changes in your life.

3. Connect With Others

Connecting with others can help prevent a sense of isolation. It is essential to contact friends and family members who are good listeners and optimistic. You might also join a support group to connect with people who have gone through what you are going through. By sharing your experience with supportive people, you can learn new coping strategies and better understand your feelings.

The Amputee Coalition Peer Support Team and Support Group hosts virtual meetings if there are none close to you.

4. Find a Purpose

Try to find something that makes you excited to start each day. You might focus on a career change, pick up a new hobby, or volunteer in your community. No matter how big or small, having a purpose is a way to lead a satisfying life.

5. Set Meaningful Goals

Setting realistic and meaningful goals adds purpose and structure to life. When you have dreams you are pursuing, you may also experience a boost in self-esteem. During rehabilitation, your therapy team can help you establish goals that are important to you.

6. Create a Daily Routine

Having a daily routine is comforting and can help you focus on goals rather than dwell on the past or negative emotions. A routine can also help keep you motivated. Try to include something physical, creative, and social in your daily routine. For example, you might exercise, engage in a hobby, and contact a friend every day. Make sure your routine includes self-care and doing things you love.

7. Embrace Optimism

Keeping a positive attitude can help people cope with limb loss. Focus on the things you can do and ways you have grown since the loss. Many individuals grow psychologically after an amputation. For example, a person with an amputation may experience more motivation to pursue their goals, greater resilience, and improved coping skills. Staying positive does not mean you need to ignore your feelings. Instead, it is a way to focus on your strengths and move forward in life.

8. Find Alternative Ways to Enjoy Hobbies

You can still live a fun, fulfilling life after limb loss. This could be a great time to try out a new activity — for example, swimming is a very inclusive and low-impact pastime. Look up adaptive classes in your area or find a virtual one that teaches you something new.

You can also try new strategies for enjoying your old hobbies. For instance, hiking can be more adaptive if you invest in a good set of hiking poles to use as a weight balance. Backpacks with harnesses can be helpful for upper body limitations.

The key to returning to your usual activities is taking it slow and focusing on rebuilding your stamina and stability. If your hobby takes you outside the home, have practice sessions in a controlled environment before you try the real thing again. If hiking is your goal, you could practice falling down and getting back up at home on carpeting so you have the strategies in place if it happens outdoors.

Adaptive tools and prosthetics have also come a long way — there are prosthetic attachments that can do everything from assisting with playing instruments and video gaming to cooking and baking.

9. Leverage Available Resources

Those who have undergone limb amputation have several resources available to them. For example, the Amputee Coalition has countless resources in its limb loss resource center and can help connect you with support groups through its Community Connections database. Limbs 4 Life is another organization with dozens of helpful articles on its website and steps to help you find funding.

If you are a college student, try searching for scholarships and aid for students with limb loss, such as the Christina Skoski, M.D. Scholarship or the Scott Decker, M.D. Memorial Scholarship.

If you feel inspired to participate in advocacy for those affected by limb loss, the Amputee Coalition has several resources online to help you make a difference.

The U.S. Department of Veteran Affairs heads the Center for Limb Loss and MoBility, which helps connect veterans with resources and assistance.

The Importance of Rehabilitation

Rehabilitation has multiple faces after limb loss, and sticking to your recovery plan is essential for helping you return to a healthy, independent lifestyle. Consistency is essential, especially in the weeks and months following your amputation or limb loss.

Your rehabilitation plan will integrate care from several professionals, including physical and occupational therapists and psychiatric counselors. Your care team will help with things like:

Stump care and hygiene practices
Restoring activities of daily living
Artificial limb fitting
Use of assistive devices
Pain management and wound healing
Emotional support
Nutritional counseling to support a stronger body
Vocational counseling for adapting your existing career or entering a new one
Adjusting your living environment to be more accessible and practical

If you choose to use a prosthetic device, you will require additional rehabilitation and adaptive exercises to help you learn how to integrate it into your life.

Avoiding Maladaptive Coping Styles

Maladaptive coping styles can be signs that a person is not adjusting to the amputation well. While it is not easy for anyone to cope with limb loss, maladaptive coping styles can prevent individuals from healing. Here are three maladaptive coping styles:

Overcompensation: Overcompensation is behaving in a way that is opposite to how you feel. Individuals with amputations might overcompensate by refusing help even if they need it.
Avoidance: Avoidance means a person changes their behavior to avoid thinking about or dealing with a problem. Avoidance coping strategies may include isolating oneself from others or engaging in addictive, self-soothing activities like substance abuse.
Surrender: With the surrender coping style, a person allows themselves to depend on others beyond what is needed. For example, someone might refuse to enter rehabilitation and demand a great level of care instead.

If you or a loved one struggles with maladaptive coping styles, speaking with a therapist can help you develop more effective, healthy ways of managing your emotions. It is never too late to replace negative thinking patterns with ones that promote growth.

Managing Phantom Limb Pain

If you feel pain where your limb used to be, you are experiencing phantom pain. You might also feel sensations that are not painful but still bothersome, like itching, pressure, or vibrations. Phantom pain and sensations are fairly normal — over half of people with limb loss experience it — but there are ways to cope.

The first step should be informing your doctor and care team so they can run tests to rule out any issues with blood flow or infection. If you are in pain or the sensations are disrupting your sleep or interfering with your life, a doctor can help you determine which treatment method may be most effective. Examples include:

Transcutaneous electrical nerve stimulation (TENS) therapy
Stump revision therapy
Meditation practices
Acupuncture
Neurostimulation

Learn More About Our Amputation Rehabilitation Program

Coping with limb loss is challenging. However, with rehabilitation and positive coping strategies, you can enjoy an improved quality of life. At Post Acute Medical, our dedicated clinicians are ready to develop an individualized treatment plan for your needs and provide ongoing support.

Our Amputation Rehabilitation Program aims to help patients reach their highest level of independence. Through our program, you will receive personalized care for your physical and emotional needs, including physical and occupational therapy, psychology services, and a prosthesis evaluation. To learn more about our program for amputees, contact a Post Acute Medical rehabilitation center today.