A Primary Care Provider’s Guide to Depression After Spinal Cord Injury: Is It Normal? Do We Treat It?

People with spinal cord injuries (SCI) are at a higher risk of developing major depressive disorder, but resilience is more common. Depression in SCI patients is often overlooked, and standard screening tools like the PHQ-9 can help guide treatment. Effective treatments for depression in SCI patients include antidepressants and cognitive behavioral therapy. Treating depression can also improve non-neuropathic pain and reduce the feeling that SCI interferes with life. Counseling to help people resume enjoyable activities and increase physical activity can also lower depression severity. Integrating depression care into standard outpatient care using a collaborative care model shows promise in reducing both depression and pain.

• 1
  Major depressive disorder is a common comorbidity in people with SCI, occurring at three times the rate of the general population.
• 2
  The PHQ-9 is a valid screening measure for major depression in spinal cord injury patients.
• 3
  Antidepressants and cognitive behavioral therapy can improve depression in people with SCI, while grief symptoms do not merit treatment within the first year following SCI.