A new study released at the beginning of January this year found that adults with cerebral palsy are at a higher risk for developing mental illnesses. Focusing primarily on depression and anxiety, the study revealed adults with CP ( no intellectual disabilities) had almost a 2- to 3-fold increase in the likelihood of being diagnosed with these two conditions than adults without CP. For the general public, these results may seem shocking, but for individuals with physical disabilities and caregivers, the data comes as no surprise.

Individuals with physical disabilities sustained from birth injuries, illnesses, or accidents later in life, are often so focused on their physical needs it can be easy to neglect their mental health. Adults with cerebral palsy, for example, have such specialized and unique medical needs to address their physical impairments they could see anywhere between 14 specialists a year, in addition to their primary care visits or emergency needs: clinical nurse specialists, endocrinologists, neurologists, occupational therapists, orthopedic surgeons, speech and language pathologists, urologists, physical therapists, pain management specialists, and more.

Balancing medications, doctor’s appointments, adaptive equipment, and constantly worrying about the logistics of getting anywhere takes a physical and emotional toll on a person that can over time lead to mental illness. In addition to being more prone to mental illness, people with physical disabilities are also less likely to seek treatment due to a serious and dangerous stigma surrounding mental health.

Common Barriers Leading to Poor Mental Health

People with physical disabilities, both congenital (from birth) and acquired (from accidents and injuries), face numerous challenges in their everyday life that can bare negatively on their mental health. Tasks that some people do on autopilot are major stressors for someone who is unable to walk, stand, climb, reach, or perform other typical physical movements on their own. These seven barriers, highlighted by the Center for Disease and Control (CDC) are the most common challenges people with physical disabilities face can lead to the onset of mental illnesses:

• Communication (trouble reading, hearing, or speaking that would affect effectively communicating with others)
• Physical (steps, curbs, sidewalks, or other barriers people with disabilities cannot physically get over, through, or around in public)
• Attitudinal (stereotyping, stigmas, prejudice, discrimination from friends, family, co-workers, and strangers)
• Programmatic (healthcare problems people with disabilities run into, such as scheduling, lack of accommodating equipment, lack of understanding by healthcare professionals)
• Transportation (lack of access to public transportation systems or other forms of convenient transportation)
• Social (more likely to struggle with school, friends, relationships, employment)
• Policy (denied access to qualified programs due to lack of awareness or knowledge of the law)

Running into these barriers on a daily and weekly basis can weigh heavily on individuals who are already battling internal struggles to be accepted, fulfilled, and healthy. Over time, these seven barriers can lead to secondary consequences that can also increase the onset and severity of mental health conditions such as depression and anxiety:

• Isolation: At least a quarter of Americans with disabilities feel lonely. This can happen from self-isolation or from feeling left out by others. Some individuals have no way of getting out of the house to participate in activities even if they felt up to going.
• Unemployment: The unemployment rate for individuals with disabilities is twice the amount of those without. Many people with disabilities who want to work can be passed over by employers (even though it is technically illegal) because they believe their disability may affect their efficiency.
• Poverty: People with physical disabilities are more likely to live in poverty, particularly families with disabled children. Expensive treatments and lack of employment can often leave little money left to cover expenses that insurance and assistance programs do not cover.
• Health Risks: The CDC reports people with physical disabilities are more susceptible to health conditions such as obesity, cardiovascular disease, fatigue, further injury, and chronic pain due to reduced physical activity and other factors.

All of the above are considered risk factors for depression and anxiety, even if only one of them is present. The fact that people with physical disabilities endure multiple risk factors, if not all of them at the same time, is extremely concerning.

The Dangerous Mental Health Stigma

If and when an individual with physical disabilities does recognize they are experiencing trouble with depression or anxiety, it is not very likely they are going to seek help voluntarily.

For centuries there has been a stigma surrounding the mental health industry, labeling those unfairly who do seek treatment as ‘weak’, ‘fragile’, ‘sensitive’, or ‘crazy’. Individuals with physical disabilities already have deep-rooted fears of being rejected and identified only for their disabilities. Seeking treatment for their mental health as well as their physical health can be difficult to accept, especially when the assistance could come with another label.

Untreated cases of mental illness such as depression and anxiety can spiral out of control, leading to serious risks including:

• drug use
• alcohol abuse
• ruined relationships with family, friends, significant others
• difficulty recovering from serious illnesses
• clinical depression
• malnutrition
• sleep disorders
• self-harming behavior or suicide

How To Take Care of Your Mental Health

It is never too late for anyone to improve their mental health. There are several methods individuals with physical disabilities can take to starting focusing on their mental health, some including:

• Educate and advocate: The only way to break down stigmas surrounding mental health is through education. Spreading awareness of the prevalence of mental illness and advocating for more acceptance in the community can help others feel more comfortable with seeking treatment and opening up.
• Find a therapist: Trained therapists are the professionals in the area of mental health. There are several different types that use various methods of providing coping strategies and increasing positive thinking. Finding the right therapist for your needs can make all the difference in how effective your sessions will be.
• Talk to your primary care doctor: If you do not know where to start with a therapist, your primary care doctor can be a great first outlet to voice your concerns. They may even have recommendations for therapists that would be the best match for your personality and needs.
• Make socializing a priority: Everyone needs support and something to look forward to. Finding social outlets that you feel comfortable and excited to attend can help you build valuable relationships and supportive friendships. These outlets could be anything from a hobby class to a sporting event to a book club- as long as you are out and about and interacting with others who you enjoy.
• Exercise: If your doctor is on board, exercise can be an excellent mood booster and another activity to get you moving around in any way you are able.
• Practice mindfulness: Medication apps and mindfulness videos can help you center yourself in a healthy way and reduce the need for stress and anxiety that can weigh you down throughout the day.

Explore transportation: More transportation companies are offering their services to individuals with disabilities in an effort to become more inclusive. Explore the options in your area to help give you another reason to get out in the community.