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Managing your mental health

Common mental health challenges

The toolbox contains many strategies to help manage the following mental health challenges.


Grief is a natural and a common reaction. Grief can leave you feeling angry, anxious, sad, or strange.

Research shows that it helps to accept that grief is a normal response following your injury, but don’t mistake grief for depression. There is no right or wrong way to grieve and everybody can experience grief differently. When grieving, it is important to stay connected with family and friends and to take care of your health by managing your stress and still doing things that you enjoy.


As you learn to live with your spinal injury it is important to remember feelings of grief will often be experienced over the long term, and that this is quite normal! The effects of your injury on your life will change over time as you have new life experiences.  You may feel your life is more challenging at certain times and other times less so.


Anxiety is the body’s physical response to a threat or perceived threat.

Anxiety can be normal in stressful situations, such as speaking in public. Anxiety is a problem when your feelings are overwhelming and interfere with daily life. Anxiety presents in different ways. This may include feeling worried, nervous or tense, panicky, restless or fidgety. You may get a sense of doom, think the worst will happen or avoid social situations.


The traumatic nature of spinal cord injury and the huge change it brings can increase the chance of experiencing depression.

Depression can make everything harder to deal with. If depressed, you may begin to feel helpless, neglect to look after yourself, and begin to have thoughts of self-harm or suicide. Depression is linked with a higher chance of urinary infections and pressure injuries, increased pain, sleep difficulties, relationship hassles, and increased social isolation. Taking care of your mental health is therefore critical for enjoying a good quality of life.

Sleep disturbance

It is quite common for sleep patterns to become disrupted for many people with a spinal injury.

Your injury can make it harder to get to sleep. This may include sleep interruption from obstructed sleep disorder, pain and spasticity. Feeling sleepy during the day can also be a problem. Sleep disturbance can disrupt your ability to work and be productive.

Relationships and life satisfaction

Physical impairments and health problems can introduce challenges to relationships and social participation.

Relationship roles may change including learning different ways to be intimate. Efforts to create positive personal and social relationships involve communication, listening skills, understanding your body and being open to change. See Section 6 of the Toolbox for more information and resources.

“A meaningful life well lived is an essential component when considering the place of ‘hope for better than now’ in the lives of newly-injured individuals.”

Person with C4 tetraplegia

Substance misuse

Substance abuse/misuse can be dangerous to all of us, especially when combined with mental health problems, and also when taking prescribed anti-depressant or pain medications. Alcohol and substance abuse will also damage your physical health.

If you believe you are using harmful amounts of alcohol, medication, or recreational drugs, then you most likely are. It is best to seek a referral for professional help or seek support from family or friends. The skills presented in Section 4 will help you manage this problem.


Not all problems are experienced by everyone or are inevitable.

Other mental health challenges

like problems with memory

Cognitive problems

Cognitive function includes brain activities like memory, attention and language. 

Fatigue, sleep disturbance, chronic pain, anxiety and/or depression affect your brain function. Even taking multiple medications can be problematic. If you notice forgetfulness or poor decision making and/or concentration, it is best to seek professional assessment and help.

Post-traumatic stress

If you sustained your injury as a result of a traumatic accident that was potentially fatal, such as a motor vehicle crash, a fall or assault, then this has the potential to cause post-traumatic stress, a condition than can develop into post-traumatic stress disorder (PTSD).

If you are experiencing high levels of stress related to your injury and symptoms such as nightmares, depression, high anxiety, avoidance of social contexts, numbness of emotions, then strategies for managing post-traumatic stress can be found in the Mental Health Toolbox.

Suicidal thinking

If you are having thoughts or ideas that life is no longer worth living and the possibility of ending one’s own life. Help is available, speak with someone today.