How Mental Health Can Affect Recovery from a Complex Traumatic Hand Injury

Complex traumatic hand injuries have been identified as stressful and life-changing events. Given the importance of the ability to use the hand in all aspects of life, individuals with complex traumatic hand injuries may experience serious consequences in physical, psychological, and overall social wellbeing. Current research has described the effects of complex traumatic hand injuries including, but not limited to, mental health issues that can limit functional outcomes.

Psychological issues of complex traumatic hand injuries include depression, anxiety, post-traumatic stress disorder (PTSD), suicide risk and psychological distress. Depression has been reported to affect between 7% and 71%; anxiety, between 23% and 71%; and PTSD, between 3% and 95%. Furthermore, depression was the most common psychological status of interest. Given the strong evidence that psychological conditions such as anxiety and depression occur with complex traumatic hand injuries, it is essential to take a proactive approach in addressing these debilitating factors.

Why is your mental health important during your recovery?

Mental health conditions like anxiety and depression can have strong physiological effects on the body, potentially slowing down the healing process and increasing the risk of complications that may delay recovery. Symptoms of depression and high levels of stress can also heighten pain and hinder overall recovery of hand and arm. Furthermore, complex traumatic hand injuries have been shown to negatively impact life roles such as spouse, parent, and worker due to stress, fear, shame, and embarrassment. Additionally, symptoms relating to PTSD, anxiety, and depression are often noticed.

Mental health conditions from a traumatic hand injury can cause avoidance of everyday activities, difficulty performing daily activities of living, such as playing catch with your child or going for a hike. These conditions can also affect your motivation to adhere to your hand therapy appointments, impact your effort to follow up with your home exercise program, and affect your follow up with medical advice regarding your healing process.

What can you do to prevent mental health conditions during your recovery?
Given the strong evidence that mental health conditions such as anxiety and depression occur with severe hand trauma, it is essential to take a proactive approach in addressing mental health conditions. If you’re experiencing symptoms of anxiety, depression, PTSD, or any other mental health condition, seek support from your medical providers. This can be your hand therapist who is overseeing your recovery. Hand therapists bear an ethical duty to address mental health conditions that are identified during your recovery process. Many times, they can offer resources to seek out a mental health professional in your community.

It is important to maintain open communication with your healthcare providers, family members, and friends. Share your concerns, feelings, and progress with them. Having a strong support system can provide emotional validation, encouragement, and promote functional independence in your daily life. It’s also important to be kind to yourself throughout your recovery. Take the time to acknowledge your achievements, even if they are small achievements. Something as simple as being able to blow dry your hair or opening a jar should be celebrated.

Addressing mental health conditions can help manage negative emotions, alleviate anxiety, stress, and feeling of helplessness. Social support enhances treatment adherence with complex traumatic hand injuries and contributes to better quality of life and return to work. It helps regain a sense of normalcy, self esteem, and independence during recovery.
 
This blog was contributed by the American Society of Hand Therapists. To learn more, please visit www.asht.org.
 
 

References
Ghițan AF, Gheorman V, Pîrvu D, Gheorman V, Udriștoiu I, Ciurea ME. A Review of Psychological Outcomes in Patients with Complex Hand Trauma: A Multidisciplinary Approach. Curr Health Sci J. 2023 Apr-Jun;49(2):143-150. doi: 10.12865/CHSJ.49.02.143
Hamasaki, T., Pelletier, R., Bourbonnais, D., Harris, P., & Choinière, M. (2018). Pain-related psychological issues in hand therapy. Journal of Hand Therapy, 31(2), 215-226. 10.1016/j.jht.2017.12.009
Kurrus, M. B., Jewell, V. D., Gerardi, S., Gerg, M., & Qi, Y. (2022). Psychosocial factors addressed by occupational therapists in hand therapy: A mixed-methods study. Journal of Hand Therapy, 10.1016/j.jht.2022.07.006
Ladds, E., Redgrave, N., Hotton, M., & Lamyman, M. (2017). Systematic review: Predicting adverse psychological outcomes after hand trauma. Journal of Hand Therapy, 30(4), 407-419. 10.1016/j.jht.2016.11.006
MacDermid, J. C., Valdes, K., Szekeres, M., Naughton, N., & Algar, L. (2018). The assessment of psychological factors on upper extremity disability: A scoping review. Journal of Hand Therapy, 31(4), 511-523. 10.1016/j.jht.2017.05.017
Maddison, K., Perry, L., & Debono, D. (2022). Psychological sequelae of hand injuries: an integrative review. SAGE Publications. 10.1177/17531934221117429