Amputation of an arm or leg has multiple consequences. Common emotional and cognitive changes include grieving, depression, anxiety, and poor body image. The experience of pain is also common following amputation; some pain is in the stump. Other pain has neuropathic origins, such as phantom limb pain (PLP), the pain that is experienced “in” the missing limb. In addition to the pain symptoms themselves, PLP can increase feelings of distress and decrease one’s quality of life.
A person with limb loss loses part of his or her physical self when they experience an amputation and the change in function and appearance are final. Physically, there is limb loss, stump pain, phantom pain and sensation. Emotionally there is grieving, depression, anxiety, and poor body image. These challenges are common consequences of limb loss. These symptoms can be worsened by the presence of phantom limb pain.
Emotional trauma following limb loss is influenced by a person’s age, type of limb loss, and the cause of amputation. Limb loss is more likely to result in ”denial” for people who do not expect it than for people who lose a limb due to a long-term disease (e.g., diabetes). Denial involves a failure to acknowledge the loss, or refusal to accept and adjust to the situation. These responses can increase negative thoughts, negative feelings, physical pain, and seeking needed help.
Grief is a particularly prevalent reaction to limb loss. It is a normal and expected reaction to the limb loss and change in a person’s identity. The grief response includes emotional, behavioral and physical reactions. Overcoming grief involves the process of acceptance that the limb is gone forever. Unresolved anger can prolong the grief process. Anger usually occurs when an amputee feels helpless and powerless at the unexpected, undeserved, and unwanted situation in which they find themselves. A person may think, “Why did this happen to me?”
When amputations occur, body image change is likely to effect self-identity and self-esteem. Loss of a limb by amputation can lead to long-term problems with an individual’s self-image. These changes can include a higher degree of anxiety and depression, lower self-esteem and less satisfaction with life from negative thoughts about one’s appearance and self-worth. In addition, amputated limbs often cause feelings of revulsion in the patient, family members, and society. This is a common and normal reaction to seeing the residual limb. When someone has suffered from limb loss the challenge is to recognize that it does not change the deepest, strongest most valuable part of a person.
Individuals with limb loss may find that their negative self-image affects their sexual and other social relationships. When faced with an amputation, people who feel self-conscious about their residual limb respond by avoiding social situation. Social avoidance/isolation also can trigger depression. Individuals who lost limbs as a result of trauma and those with upper limb amputations appear to be most vulnerable to emotional disturbance.
The support and encouragement of medical staff, friends and family can have a very powerful effect on the ability to heal from the consequences of limb loss and finalize the stages of grieving. In spite of the challenges with amputation, many people with limb loss do adapt to lead normal, productive, happy lives, working, enjoying hobbies, and raising families.
For further resources on limb loss please check out the link below for the Amputee Coalition.
Thank you for reading this article. I’m dedicating my personal and professional life to supporting people with limb loss. My learning journey with the challenges of amputation is a result of my personal experience with limb loss. I was graced with the gift of self-acceptance upon realization that my forearm was amputated. As a result, I’ve learned a lot about what it takes to put an end to self-created emotional pain. And, as I learn and grow, I teach self-compassion and give advice I use myself, in the hopes that it helps you to improve your own life.