People can lose all or part of an arm or leg for a number of reasons. Common ones include

• Problems with blood circulation. These may be the result of atherosclerosis or diabetes. Severe cases may result in amputation.
• Injuries, including from traffic accidents and military combat
• Cancer
• Birth defects

Some amputees have phantom pain, which is the feeling of pain in the missing limb. Other physical problems include surgical complications and skin problems, if you wear an artificial limb. Many amputees use an artificial limb. Learning how to use it takes time. Physical therapy can help you adapt.

Recovery from the loss of a limb can be hard. Sadness, anger, and frustration are common. If you are having a tough time, talk to your doctor. Treatment with medicine or counseling can help.

Amputation of a limb, whether due to trauma or disease, can have major psychological impacts. It is not uncommon for someone who has lost a limb to experience grief. Although grief is often associated with the death of a loved one, it is a normal emotional reaction to the loss of anything or anyone that is important to you. This can include divorce, loss of health or safety, the belief that a lifelong dream will never be achieved, loss of a career, or in the case of amputees, loss of a limb.

While many people experience grief, everyone grieves differently, and there is no right or wrong way to grieve. Many people go through various stages of grief, which may include:

• Denial – thoughts of “this can’t be happening.”
• Anger – the anger may be at a specific person or group, or generalized anger.
• Bargaining – thoughts of “make this situation go away and I promise I will…”
• Depressed feelings – some experience an emptiness or numbness, withdraw from family and friends, or do not want to participate in work or other activities.
• Acceptance – occurs when you accept the loss, have worked through the physical and emotional pain, adjust to life without the amputated limb, and begin to move on with life.
• Guilt - while not considered one of the stages of grief, feelings of guilt are not unusual. Feelings may include wishing that you had done things differently, or responded to a situation differently. It can also include “survivor’s guilt,” or feeling guilty that you survived when others did not.

Moving through the stages of grief is not a neat, orderly process. You do not have to move through the stages in order; in fact, some people may skip entire stages. It is even possible to bounce back and forth between the stages.

It is normal to have feelings of sadness, anger, or depressed mood after the loss of a limb, but there is a difference between grieving and clinical depression. Individuals who are grieving can still experience positive emotions such as peace and happiness. As the grieving process continues, there will be longer periods of positive emotions between the negative feelings. On the other hand, those who are suffering from depression have a difficult time feeling positive emotions at all.

Symptoms of major depression not explained by grief may include:

• Constant thoughts of being worthless or hopeless
• Thoughts of death or suicide
• Loss of interest or pleasure in hobbies
• Intense guilt over things done or not done at the time of the injury
• Difficulty sleeping, waking early in the morning, or over-sleeping frequently
• Extreme weight loss

If you or someone you know is in immediate danger, call 911. If you believe you are experiencing depression or would like to talk with someone about what you are going through, contact your healthcare provider.

Not only can you move past grief, there is growing evidence that many individuals who have experienced a limb amputation experience psychological growth. You are a warrior and have likely overcome many obstacles throughout your life, emerging a little stronger each time. This new chapter in your life is no exception. Examples of psychological growth following an amputation can include:

• Greater resolve in pursuing personal goals
• Stronger relationships with loved ones
• Resilience and psychological adjustment beyond previous levels
• Improved coping abilities

When will I be able to move forward?

Much like everyone experiences grief differently, there is no set amount of time that the feelings will last. For some, it will take weeks or months for the grief to subside. Others may take years. The duration will depend on many factors including past experiences, culture, personality, and physical and psychological health prior to the injury. The time it takes to grieve is not an indicator of strength. Taking longer to come to terms with your amputation than someone else does not mean they are stronger than you.