Burn survivors may face several challenges in the aftermath of their injury. Whereas each individual experiences psychological distress differently, people with burn injuries often report:
Feeling…
Sad, anxious or irritable
Helpless
Hopeless
Upset about depending on other people for assistance
Distant from family, friends or the general public
Alone
As if the injury was happening again or reliving it
A physical reaction (e.g. heart pounding, trouble breathing, or sweating) when something reminds you of the injury
Jumpy or easily startled
“Super alert” or watchful and on guard
Difficulty falling asleep due to thoughts like:
“I worry about bad things that might happen”
“I keep thinking about the way I was injured”
Difficulty finding enjoyment in things that used to give pleasure
Difficulty staying asleep
Avoiding situations that remind you of the accident
Avoiding thinking or talking about the injury and how it occurred
While in the hospital, survivors may find they have a lot of time to focus on their burn injury. Many people report having psychological distress several days or a few weeks after they were injured. For most, periods of distress become less frequent and less upsetting after a couple of weeks to a couple of months. However, problems that continue for more than a month or two, or thoughts about wanting to die or hurt oneself, indicates a need to seek treatment.
Causes of psychological distress after burn injuries
Major burn injuries can be extremely upsetting and distressing for the survivor, as well as for family members, and friends. Depression or anxiety before the burn injury increases the chances of those symptoms after the injury. Common causes of distress include:
Thinking about the event itself – both in sustaining the injury and/or witnessing others who were also seriously injured or died
Worries about the future
Concerns about finances and the impact the injury has had on family members
Changes in appearance because of scars and contractures
Physical discomfort
Pain while the wound is still healing (especially during the repeated dressing changes) and pain that continues for months afterward as nerves are healing
Itching
Difficulty adhering to range of motion and Physical Therapy exercises
Limitations in physical abilities
Loss of independence
Difficulty in returning to work or school
Loss of property, residence, pets, etc.
Interruption of daily life activities and roles
Challenges with sexual interests and intimacy
Effects of psychological distress on health and recovery
Psychological distress has been shown to affect the way the mind works (e.g., poor memory, short attention span) and the ways the body functions (e.g., immune system, digestion). Distress can also worsen other medical conditions (e.g., blood pressure, glucose control) and can interfere with recovery from the burn in many ways, such as:
Making pain and itching feel even worse
Reducing your effort and persistence in participating in rehabilitation therapies and wound care
Making communication with burn team members difficult
Reducing your interest and pleasure in daily activities
Disrupting sleep
Causing tension in interpersonal relationships
Treatment Options
It is critical to seek emotional support from professionals and other survivors to help with your psychological distress. There is a caring community that understands your experience. Always let your burn team know about challenges in your emotional recovery.
Keep connected with friends and family and ask for support
Take one step at a time during the recovery process. Acceptance of your injury and the changes in your life take time, and recovery (psychological and physical) can proceed at a slow pace
Get sufficient sleep and eat healthy foods
Try to avoid napping during the day so that you will sleep better at night
Avoid tobacco, illicit drugs and/or excessive use of alcohol because they can lead to low mood and increase anxiety
Stay focused on tasks that you can do rather than those things that are no longer possible because of your injury
Stay active and exercise regularly
Return to a normal routine as soon as possible. Get up, get dressed, groom yourself and get out of the house every day to avoid feeling more depressed
Engage in one positive, pleasant activity every day
As soon as you are medically cleared, get back to doing the things you did before the injury like going to work or school and doing chores around the house
Peer Support
Seek support from professionally led support groups. Ask your health care provider how to locate the right group for you
Seek support from other survivors.
Copyright © 2016 Model Systems Knowledge Translation Center (MSKTC).
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