Mental Health After SCI — Depression, Anxiety, and More

Mental health challenges are very common after a spinal cord injury. You’re not alone — and help is available.

Living with a spinal cord injury is hard. It changes your body, your routines, your relationships, and sometimes your sense of who you are. It’s no surprise that mental health challenges are common. But a major new study confirms just how significant those challenges are — and how important it is to take them seriously.

The study, published in JAMA Network Open in 2025, found that people with traumatic SCIs were far more likely to develop depression, anxiety, and substance use disorders compared to people without SCIs.

The numbers are sobering. People with SCIs were more than twice as likely to develop depression — and in some cases, nearly three times as likely. They were also significantly more likely to develop anxiety disorders and to misuse substances, including opioids. In fact, the risk of opioid use disorder was 6 to 10 times higher in people with SCIs than in those without — a stark reminder of how important pain management after SCI needs to be handled carefully.

The study also found something important: people with SCIs who developed depression or substance misuse after their injury were more likely to die earlier than those who didn’t. That means mental health isn’t just about quality of life — it’s literally a matter of life and death.

Why are these risks so high? Chronic pain, loss of independence, changes in relationships and identity, financial stress, and social isolation all take a toll. There’s also a biological component — the injury itself can disrupt the brain chemistry that regulates mood.

The important message here is not to feel shame about struggling. These challenges are a real medical consequence of SCI, not a sign of weakness.

What you can do: Be honest with your healthcare team about how you’re feeling emotionally. Ask for a referral to a mental health professional who has experience working with people with physical disabilities. If you’re taking opioids for pain, talk openly with your doctor about the risks and about non-opioid pain management options. Peer support — connecting with others who have SCIs — can also be a powerful tool for mental wellness.

Source: Mashlah A, et al. JAMA Network Open, November 2025.