Neurodivergence or mental health issues can be a disability if it disrupts an individual's ability to function on a day to day basis. This can also be known as a psychiatric disability in policy context to refer to impairments covered by the ADA. The degree and extent of symptoms can range vastly between each individual. Possible example diagnoses include anxiety, bipolar disorder, schizophrenia, ADHD, etc.
Depression and anxiety are common issues after onset or diagnosis of a physical or mental disability. This can be attributed to physical or emotional factors. Physical being possible injury or change in brain/body structure or chemical makeup. There can also be an emotional response to adjusting to temporary or chronic disability, coming to terms with the new identity, or changes in family dynamics. Challenges that disabled individuals face on a day to day basis such as being unable to participate in important activities or facing social isolation or stigma from others are also contributing factors.
Depression and anxiety are common issues after onset or diagnosis of a physical or mental disability. This can be attributed to physical or emotional factors. Physical being possible injury or change in brain/body structure or chemical makeup. There can also be an emotional response to adjusting to temporary or chronic disability, coming to terms with the new identity, or changes in family dynamics. Challenges that disabled individuals face on a day to day basis such as being unable to participate in important activities or facing social isolation or stigma from others are also contributing factors.
About 1/2 of individuals who have a TBI are affected by depression within a year of onset, with 2/3 affected within 7 years of injury (1)
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Prevalence of depression in disabled adults is estimated at 24.9% to 41%, compared to 22.8 to 27.5% (2)
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Prevalence of depression in disabled adults is estimated at 24.9% to 41%, compared to 22.8 to 27.5% (2)
Position of Family in Mental Health
We also need to recognize that people with disabilities function in broader systems of care in which family members or caregivers bear heavy, longitudinal responsibilities. Many family members experience higher levels of stress, depression or caregiver burnout which is “the perception of psychological distress, anxiety, depression, demoralization, and generalized loss of personal freedom attributed directly to caregiving” (3). Families are influential factors that need to be supported when supporting an autistic individual and even the general disability community.
The role of family pans out in multiple respects:
- Higher healthcare costs can create greater financial burdens for caregivers
- Familial psychological distress increases as ASD children become older (4)
- Negative parent attitudes can worsen behavior problems in their child as well, which in turn can cause the child’s disability related symptoms to also worsen (5)
- Can lead to further gender role divisions in the house hold as female family members take on caregiving roles, more often than not
- If onset of disability occurs in adulthood, some spouses may feel a violation of their marital contract and do not make the necessary life-reorganization
- Increased divorce rates or decreased marriage rates following disability onset (6)
Sources
(1)Fann, J., & Hart, T. (2009). Depression After Traumatic Brain Injury | Model Systems Knowledge Translation Center (MSKTC). https://msktc.org/tbi/factsheets/depression-after-traumatic-brain-injury
(2) Shen, S.-C., Huang, K.-H., Kung, P.-T., Chiu, L.-T., & Tsai, W.-C. (2017). Incidence, risk, and associated factors of depression in adults with physical and sensory disabilities: A nationwide population-based study. PLoS ONE, 12(3). https://doi.org/10.1371/journal.pone.0175141
(3) Lawton, M. P., Moss, M., Kleban, M. H., Glicksman, A., & Rovine, M. (1991). A Two-factor Model of Caregiving Appraisal and Psychological Well-Being. Journal of Gerontology, 46(4), P181–P189. https://doi.org/10.1093/geronj/46.4.P181
(4) Koegel, R. L., Schreibman, L., Loos, L. M., Dirlich‐Wilhelm, H., Dunlap, G., Robbins, F. R., & Plienis, A. J. (1992). Consistent stress profiles in mothers of children with autism. Journal of Autism and Developmental Disorders, 22, 205–216.
(5) Vogan, V., Lake, J. K., Weiss, J. A., Robinson, S., Tint, A., & Lunsky, Y. (2014). Factors Associated with Caregiver Burden Among Parents of Individuals with ASD: Differences Across Intellectual
(6) Functioning. Family Relations, 63(4), 554–567. https://doi.org/10.1111/fare.12081
Singleton, P., & Li, L. (2016). The Dynamic Effect of Disability on Marriage: Evidence from the Social Security Disability Insurance Program. In Center for Policy Research Working Papers (No. 190; Center for Policy Research Working Papers). Center for Policy Research, Maxwell School, Syracuse University. https://ideas.repec.org/p/max/cprwps/190.html
(2) Shen, S.-C., Huang, K.-H., Kung, P.-T., Chiu, L.-T., & Tsai, W.-C. (2017). Incidence, risk, and associated factors of depression in adults with physical and sensory disabilities: A nationwide population-based study. PLoS ONE, 12(3). https://doi.org/10.1371/journal.pone.0175141
(3) Lawton, M. P., Moss, M., Kleban, M. H., Glicksman, A., & Rovine, M. (1991). A Two-factor Model of Caregiving Appraisal and Psychological Well-Being. Journal of Gerontology, 46(4), P181–P189. https://doi.org/10.1093/geronj/46.4.P181
(4) Koegel, R. L., Schreibman, L., Loos, L. M., Dirlich‐Wilhelm, H., Dunlap, G., Robbins, F. R., & Plienis, A. J. (1992). Consistent stress profiles in mothers of children with autism. Journal of Autism and Developmental Disorders, 22, 205–216.
(5) Vogan, V., Lake, J. K., Weiss, J. A., Robinson, S., Tint, A., & Lunsky, Y. (2014). Factors Associated with Caregiver Burden Among Parents of Individuals with ASD: Differences Across Intellectual
(6) Functioning. Family Relations, 63(4), 554–567. https://doi.org/10.1111/fare.12081
Singleton, P., & Li, L. (2016). The Dynamic Effect of Disability on Marriage: Evidence from the Social Security Disability Insurance Program. In Center for Policy Research Working Papers (No. 190; Center for Policy Research Working Papers). Center for Policy Research, Maxwell School, Syracuse University. https://ideas.repec.org/p/max/cprwps/190.html