Pain and vulnerability can blind you to the possibility of hope.

When you’re recovering from a major injury, unrelenting pain and sheer exhaustion can make the world bleak and the path to wellness unclear. When that persists and relief seems unattainable, recovery itself is at risk. The body can’t heal when the spirit is broken. Modern medicine is increasingly recognizing that rehabilitation includes the patient’s mental as well as physical well-being.

Though Western medicine has traditionally viewed physical and mental health as separate fields, many providers have begun factoring patients’ mental health into the injury recovery process.

“The interplay between depression, anxiety, stress, pain and other forms of physical illness is often complicated and misunderstood,” explained Merrillville psychologist Shaun Wehle. “The extent of overlap is significant. It’s important to understand that literally everything we experience is mediated by our head. Whether there is a broken bone or an open wound, our mind’s interpretation in blocking or amplifying the pain experience defines the lived experience.”

Jennifer Noonan, a behavioral health consultant with Regional Mental Health Center and Northshore Health Centers, explains the factors that can increase a rehabilitating individual’s risk of mental illness. They include a family history or past episodes of depression or anxiety; other conditions such as diabetes or thyroid issues; previous psychological and physical traumas; and a lack of a strong support system and proper coping strategies.

The connection between physical and mental distress and disorder is complicated, though one directly influences the other. Noonan says she often sees patients whose depression or anxiety has been triggered or exacerbated by recovery from injuries or surgeries. “It has been shown that the brain uses the same areas to register both emotional and physical pain, which may explain why pain produces depression and why depression worsens physical pain,” she said.

Fostering and maintaining hope, optimism and resiliency play a huge role in a patient’s recovery.

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Wehle recalls a patient who was told he’d never walk again after a complete tear in his cervical spine. Wehle was responsible for helping the patient come to terms with his diagnosis. The patient told Wehle of a dream he’d had in which God told him he would walk again.

“I happened to remember that his name in Hebrew meant ‘God is my strength,’ so I shared that with him. He said, ‘Because you shared this with me, I will walk again,’” Wehle recalled. The patient worked hard, soon moved his toe and eventually walked again with assistance. “I learned that hope is powerful, and God surely seemed to be his strength,” Wehle said.

Another patient of Wehle’s, a teenage bystander shot nine times in a drive-by shooting, was grateful that his life was spared and similarly empowered by his faith. “He shared his hopes to use this experience as a growth opportunity and chance to be a voice to motivate his community,” Wehle said. “He prayed for the perpetrators and planned for a future informed, but not defined, by his past.”

Mental health during recovery can also be bolstered by proper sleep, healthy eating and medications.

But even the most faithful, resilient and optimistic patients should seek professional help in certain cases. Noonan says to see a mental health care provider if you experience changes in sleep and appetite, lowered motivation or trouble concentrating. If one is wishing for death or seeking to hurt him or herself, it’s imperative that the individual — or a loved one — call 911 or go to the nearest emergency room, she says.

“Rehabilitation is disorienting, but also provides opportunity,” Wehle said. What recovering patients may view as failure — of their bodies, minds, doctors or themselves — can be reshaped as a perspective of growth and opportunity. “Finding clinicians who can help them see and experience this possibility is priceless," he said.