Diabetes-Related Amputations and Mental Health

Part of amputation recovery is getting the mental health support you need.

Diabetes can lead to a lower-limb amputation (or LLA – removal by surgery of a toe, foot, or leg). After an LLA, it’s important to consider not only your physical recovery, but also your mental recovery. Some people may have feelings that are hard to cope with.

Diabetes Burnout or Feelings of Failure

For some people, amputation feels like the worst that could happen. They may wonder whether it’s worth it to continue managing diabetes. This is known as diabetes burnout— feeling overwhelmed or defeated by diabetes care. Some people also have feelings of failure. But it’s important to know that some things happen outside a person’s control, even despite their best efforts. Having an LLA may feel like a setback, but it is possible to still live an active and healthy life with time, practice, and help.

Identity, Body Image, and Self-Confidence

An amputation is a big change, and some people may feel it changes who they are. It can also affect their body image, or how they feel about their appearance. Both body image and sense of identity can have a big impact on self-confidence. It’s natural to feel disconnected after an LLA, but these feelings are usually temporary. Having diabetes or an LLA is a part of someone’s life; it doesn’t define who they are. A mental health counselor can provide support during this life transition.

Grief

Some people compare having an LLA to losing a loved one. It’s natural and understandable to grieve the part that was lost. Knowing and expecting the different stages of grief can help. These stages can happen more than once and in a different order:

• Denial, or acting like it didn’t happen. Sometimes people in denial will try to go back to their old routines too quickly, without addressing the loss they’ve experienced.
• Anger is an extremely common feeling after a loss. Some people feel angry at themselves, and some feel angry at other people or their situation.
• Bargaining is when someone wishes to make a deal with fate or a higher power to change circumstances. In this stage, people often try to see a permanent situation as temporary, giving themselves false hope.
• Depression happens when someone feels lost, empty, hopeless, unmotivated, or uninterested in even their favorite activities. These feelings are expected after an amputation, but if they last, a doctor or mental health professional can help. The earlier depression is treated, the better likelihood of managing symptoms.
• Acceptance is when someone has processed the loss they’ve experienced and is figuring out how to move forward.

Healthy Coping

Healthy coping means having a positive attitude towards managing a health condition and having positive relationships with others. People recover better when they’re honest with themselves and others about how they’re feeling so they can move forward. It helps to return to routine or create new routines after an amputation. Having realistic goals and plans for the future allows many people to feel like themselves again.

Many people find it helpful to journal or talk to a loved one about how they’re feeling. Others benefit from talking to a mental health professional. CDC’s How Right Now site provides mental health resources that can help with amputation recovery.