What to Expect: Mental Health & Emotional Well-Being

Written by James A. Bosch MA, LMFT on January 13, 2024

Depression + Anxiety
Trauma / PTSD
Survivor Stories

At 8 months old, I was burned when a hot water humidifier fell into my crib. This was more than 50 years ago—there were no comprehensive burn centers with social workers and peer support. My parents were young, from families that didn’t talk about mental health issues.

As a result, I was left to navigate the hostile landscape of being a kid with visible differences alone. Since no one talked to me about possible emotional challenges, I didn’t have the vocabulary to talk about them myself.

I went inward, suffering in silence. I tried to medicate my feelings with unhealthy behaviors and substances. This led me down many paths, and I eventually found healing through therapy and peer support.

My experience led me to become a therapist who works with burn survivors. Though my adversity may have led to me becoming a gifted healer, many of my struggles could have been prevented by knowing what to expect and where to get support.

If you hear nothing else, know that you are not alone, and you do not have to suffer in silence.

In this article, I hope to highlight some of the common responses to burn trauma and some of the mental health challenges you may face on your journey.

The emotional recovery after a burn often does not begin until we get home.

During the acute phase of healing, your focus is on surviving your injuries and physical healing. There is often a huge network of burn staff and visitors to keep us distracted. When we go home, we’re faced with caring for ourselves for the first time. We’re finally alone with our thoughts.

Don’t be alarmed if you fall into fear or depression shortly after arriving home (or wherever you’ll be staying for the early rehab stages). This is a common experience once the reality of your journey sinks in.

Depression and anxiety are normal responses to a horrific life-altering event like a burn injury.

It is okay to acknowledge how hard it is, talk about your feelings, and reach out to your burn team with questions. You and your home support team will be figuring out a lot of things you never expected having to think about!

Shame is one of the most prevalent emotions in burn recovery.

We are often full of self-judgments: “I should be able to get through this on my own.” “I need to be strong for others.” “I can’t show weakness when everyone is rooting for me.” The most common one I hear is, “I should be past this by now!”

But when you’re recovering from a traumatic injury, emotional healing isn’t a straight line.

Just when you think you’re doing great, something triggers you, and you’re back in the darkness of depression, or you’re full of fear and anxiety. I don’t say this to scare you, but to prepare you if it happens. I like to look at healing as a spiral, generally moving upward, with lots of twists and turns.

Acknowledge this journey is hard and give yourself lots of breaks and self-compassion.

Post Traumatic Stress Disorder (PTSD)

PTSD refers to certain symptoms a trauma survivor experiences that persist over 30 days after the traumatic event. Symptoms include hypervigilance, easy startle responses, flashbacks and nightmares of the event, avoiding topics or anything that reminds you of the event, and mood disturbances.

Some of these things are normal after a life-threatening experience and the traumatic experience of burn treatment. Not everyone who has a trauma develops PTSD, but it is important to get professional help if you’re having a hard time moving past feeling frozen or fearful all the time.

Sleep and pain management are two of the big issues once you are home.

One is often the result of the other. Many things can help with sleep, such as looking up sleep hygiene practices and over-the-counter remedies. Explore relaxation apps and YouTube for sleep hypnosis and guided imagery to help with both sleep and physical discomfort.

It is easy to want to play pharmacist and try to adjust your own medication, but be sure to call your doctor if your pain is not being managed. We are often given open prescriptions for pain medicine—but not told how to ween off them.

Once the physical pain decreases, survivors often discover the medication also numbs emotional pain. This is a pathway to addiction. Talk to your burn team about how to move off of the narcotics to other pain meds or pain management techniques.

Once the wounds heal, the rehab phase of your recovery begins.

Around this time, self-motivation is very important—and often very difficult! We get exhausted by daily physical therapy, massaging, and stretching. The work on our body and relearning to do things independently is frustrating enough, yet the physical changes to our body are often the most emotionally taxing in this time.

Accepting changes in our appearance and the structure of our bodies can be the most difficult part of emotional healing.

Developing a sense of identity with a visible difference or coming to terms with an altered body image is hard but important work. Lots of self-love and self-compassion are needed in the path to seeing our differences as beautiful and accepting ourselves. As Sonya Renee Taylor says in her book of the same name, “Your body is not an apology!”

Phoenix Society has many resources to help with image and body acceptance. From make-up tutorials for burn survivors and fashionable ways to cover up to social media campaigns like #BurnsAreBeautiful, there are many ways to foster confidence and self-love.

Today I accept my scars, but that was not always the case. I’m a big proponent of not only focusing on what’s beautiful on the inside but also finding things we love about our outside—scars and all.

Connecting with other burn survivors is so important.

After all, no one can relate with losing a body part or having a scar if they haven’t been there. Being able to talk to someone who knows exactly what you mean and doesn’t get all awkward trying to offer sympathy is life changing. It removes shame by letting us know we are not alone and offers hope by providing a role model for life after a burn.

Phoenix Society holds this at the heart of their mission and will help get you connected to a trained peer supporter or burn support group.

Professional help is incredibly important and helpful, but in my own journey, it wasn’t until I met other burn survivors and found others who related with my experience that my healing truly began.

You are on a courageous journey with many hills and valleys.

I hope these few words on navigating the early emotional land mines after your burn has given you some solace. There is a large community of burn professionals and burn survivors that are here to walk the journey with you!

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