Physical Disability and Depression

Contending with a mental health issue, such as depression, can become even more taxing and complicated when also faced with a physical health issue. Whether one develops depression due to physical disability, or has to deal with the coexistence of both, the combination of disability and depression can feel truly overwhelming. Read on to better understand how these two occurrences might influence one another.

What Constitutes a Disability?

The Center for Disease Control (CDC) defines disability as a condition of the body or mind that hinders an individual’s ability to perform certain activities, or interact with the world around them.

The World Health Organization (WHO) somewhat expands on the above definition, citing a loss of physical or mental structure or function, such a loss of limb or memory loss, in addition to activity and participation limitations.

Finally, the Americans with Disabilities Act (ADA) offers both a definition for disability in general, and a distinction between mental and physical disabilities. According to the ADA, a physical disability is a physiological disorder, condition, anatomical loss, or cosmetic disfigurement that impacts one or more bodily systems. It defines mental impairment as a mental, or psychological disorder that limits one or more major life activity.

One in five individuals in the U.S. contends with a disability. Taken together, they represent 15% of the global population, making up the largest marginalized community in the world.

Physical Disability in an Ableist World

Physical disability is a wide field that covers anything from birth defects, accident-sustained injuries, heart conditions, and degenerative illnesses. Such physical health issues can present many everyday obstacles. Not providing wheelchair access to a store is one example of ableism—bias or discrimination against those with disabilities.

Ableism has been shown to be an extremely common form of bias, with 76% of individuals admitting to harboring an implicit bias toward those with disabilities—even those who face disabilities themselves. Ableism was found to be more common than gender bias, racism, sexuality bias, or weight bias, and is second only to ageism.

Ableism can appear in different levels of society, including:

• Institutional Ableism: Places of business, or more established infrastructures, such as the healthcare system promote ableism, often put the onus on the individual with the disability to meet their own needs or existing layout, instead of the other way around.
• Interpersonal Ableism: This type of ableism happens in social gatherings, or in one-on-one interactions. It includes telling one’s child to “toughen up,” instead of acknowledging their struggles and offering them assistance. Interpersonal ableism can also lead to social isolation, particularly in cases lacking the necessary support system.
• Internalized Ableism: In this form of ableism, the individual has internalized bias around them, to the point where they become critical of themselves, due to their disability, and as a result suffer from low self-worth. Negative body image has also been found to develop among those with internalized ableism.

Depression and Disability: Facts and Statistics

Finding it difficult to navigate on one’s own, having to wait for an elevator, or being more prone to viral illness due to a preexisting condition, can all cause a sense of limited independence, helplessness, or a lack of hope—all symptoms of depression.

The following factors can stem from a physical disability, decreasing one’s quality of life beyond their actual, physical impediment, and facilitating the appearance of depression:

• Restricted Mobility: Not directly due to their disability, but due to a public transport system or public walkways that fail to accommodate their needs.
• Accessibility: At present, most U.S. businesses do not meet the ADA requirements for accessibility.
• Social Barriers: The above-mentioned prejudice, which can cause others to distance themselves from an individual with a noticeable disability, can bring about feelings of loneliness and rejection, particularly when it comes to romantic relationships.
• Limited Employment: Employers may balk at the possibility of hiring someone with a physical disability, worrying they may not be able to perform the jobs requirements—at times, regardless of whether their disability has anything to do with the potential position.
• Inadequate Healthcare Services: More directly related to the actual condition, healthcare services that do not meet the needs of an individual with a health condition may exacerbate their situation, causing it to become a greater impediment than it is at present.
• The ‘Invisibility’ of Certain Conditions: Not all physical (or mental) disabilities are easy to spot. As a result, a seemingly fit individual riding the bus, whose neurological disorder hampers their ability to stand, may arouse judgment or anger from those around them, if they were to ask someone to give up their seat to allow them to sit down, instead.

As mentioned earlier, the reality of contending with a physical condition can also affect one’s mental health. Specifically, the risk for depression rises, as physical disability can lead to feelings of frustration, hopelessness, shame, or deep sadness. As a result, depression has been found to exist at significantly higher rates among individuals also suffering from a physical disability. This has been shown to be the case regardless of sex, and beyond across age groups. Certain studies have cited 2 to 10 times higher rates of depression among those with a physical condition, in addition to depression being one of the most common secondary conditions to appear with a physical disability.

The following variables have been shown to predict the appearance of depression among those facing physical disability:

• Stress
• Chronicity
• Social Support

Helping Promote Change and Acceptance

Greater media coverage of those facing disability, as well as of existing ableist practices, is helping destigmatize disability and the individuals contending with it. Addressing discriminatory policies, non-accessible pathways, and derogatory attitudes can all contribute to a more accepting experience for those dealing with bodily limitations, and help ease their mental stress, as well as symptoms of depression linked to their physical condition.