Wednesday, 28 October 2015

Guest Post: The link between physical disability and mental health

I have been in contact with Kate about writing a blog post for me for a while. She writes her own blog at and her posts are always beautifully written, so I was excited to read what she sent to me.

Kate decided to write about the link between physical disability and mental health, as she is affected by both, and I found it incredibly interesting to read her post, both as a medical student and someone interested in mental health. I felt like I learnt a lot and now have a little more knowledge on the subject, so I hope you enjoy it as much as I did!

I have Cerebral Palsy, a neurological disability I have had since birth, which alters the command pathways in the brain and causes muscle tension and involuntary spasms. I use a wheelchair and require support from a Personal Assistant to do most daily tasks, such as using the toilet and shower, and preparing food.

I also have depression and anxiety, which was formally diagnosed about 9 years ago, although in reality, my symptoms began much earlier. I also have a history of self harm.

I attended mainstream schools throughout my childhood, and as a result, I was always encouraged by my family to participate in activities in the same way as a non-disabled child would – activities like Brownies, football, and going to friends’ houses, and as I got older, going shopping and going to the pub. Whilst I appreciate all the support my family gave me, and don’t disagree with their approach, it highlighted that I was “different” and emphasised the need for extra planning – things like making sure the places I went with my friends had wheelchair access – which was incredibly frustrating, and probably contributed to my depression.

I was determined that I wouldn’t be defined by my disability, and for a long time, I treated my physical disability and my mental health as separate entities, refusing to admit that the two were connected. When I attended counselling, I’d focus on “micro” issues, such as arguments with my parents and exam stress. These were important to me, but they were part of a much deeper issue – my difficulty in coming to terms with my disability and its implications on my life.

I have alluded in part to the frustration I feel when certain things prove more difficult for me because I have physical limitations. This manifests itself in the classic symptoms of depression; for example, anger, low self esteem and anxiety. An example that would encompass all these symptoms is waiting for a bus. I don’t drive, so I’m reliant on public transport, and use the wheelchair spaces on buses.  For the “average” person, waiting for a bus might be mildly irritating. However, because I am often prevented from getting on the bus, especially if there is a pram in the wheelchair space, I find waiting for a bus can cause anxiety. I am worried that if I can’t get on the bus I will be late. I get angry at the bus driver who has refused access, often to the point where I am unable to think rationally and lose control of my actions. My anger is so severe that I cannot see a solution beyond forcing the driver to let me get on the bus and getting to where I want to go. It doesn’t occur to me that texting my friend to let them know I am running late would be an acceptable solution, because my low self esteem means that I think that if I am late, they won’t like me and won’t trust me to organise anything else again and therefore this will jeopardise our friendship.

My physical disability has made it difficult for me to find the right treatment for my mental health conditions. In my teenage years, I voiced concerns that I had depression, but these were not taken seriously, as the psychologist I saw at the time said that as my low moods were always “triggered” by external factors, such as an argument, they were not sufficient to be labelled as depression. More recently, although I have a formal diagnosis, it has been difficult to find medication which is suitable for me. Many of the conventional anti-depressions have side effects such as muscle tension, which aggravate the spasms caused by Cerebral Palsy. It is only in the last month or so that I have been prescribed medication from a different family of anti-depressants that does not have these side effects.

Cerebral Palsy is not a progressive disability; that is, the prognosis and symptoms do not change significantly over time. As a result, it is important that the treatment I receive helps me to deal with the emotions that surround my disability in the long term. So far, I have yet to have therapy which has done this successfully, although I have tried counselling and Cognitive Behavioural Therapy (CBT). I believe this is partly because my anxiety is mostly based on very practical fears; for example, the idea that my Personal Assistant will not arrive for their shift, or I won’t be able to find a taxi to the station after a football match and will miss my train. Therefore, the techniques I was taught in CBT are not as effective for me, as there is evidence that these events could happen, as they have happened before, so looking at possible outcomes in more detail emphasises the negative possibilities rather than reassuring me that my worst fears are unlikely. However, my circumstances are personal, and I would not want to discourage anyone from trying CBT if it is recommended to them.

At the moment, I am seeing a psychiatrist who is helping me to find medication that is useful and I am looking into the possibility of starting group therapy sessions. I am also attending wellbeing classes, where I am (slowly) learning to meditate in the hope that I will be able to respond to situations more mindfully in future. My psychiatrist has recognised the link between my physical disability and mental health in saying that I use a lot more energy to overcome problems, and eventually my energy will run out. I don’t feel I can summarise the situation better than that, and I know my recovery will take time, but with the help of my family and friends, I am hopeful that I can reach this point one day.

You can read more from Kate at or follow her on Twitter @campbellscat.

I would like to say a huge thank you to Kate for writing a very enjoyable post for me. I am always looking for people to write guest posts for my blog, confidential or not, so if you're interested please email me at or tweet me @hannahev19.
Success usually comes to those that are too busy to be looking for it.
                              - Henry David Thoreau

1 comment:

  1. This was a really interesting post, thanks Kate! Something I've noticed a lot in my time in medicine is that there cross-over between mental and physical health is often ignored, and even doctors can forget that a person can have mental and physical health conditions at the same time, that may or may not be related. It's something I try to be mindful of whenever I see patients.
    Jennifer x
    Ginevrella | Lifestyle Blog