Scoliosis and its treatment can cause pain and affect a person’s self-image, physical abilities, and social interactions. These and other factors can contribute to or worsen depression, especially in adolescents.
Research suggests there are links between scoliosis and depression.
Scoliosis can cause pain and physical changes and may require treatment, such as back bracing and surgery. It is most common during late childhood and adolescence, when young people may be more self-conscious and desire to be like their peers.
These and other factors can affect a person’s self-image and participation in social and physical activities, which may lead to or worsen depression.
Treatment that includes psychiatric support for scoliosis and depression may help a person manage the mental health difficulties associated with the condition.
Having scoliosis may increase a person’s chances of developing depression.
Those with scoliosis may be twice as likely to have depression than the larger population and may also be more likely to develop other mental health problems, such as anxiety.
Scoliosis may indirectly lead to or worsen depression in several ways. These include limiting a person’s physical abilities, causing pain, and causing physical differences that may result in low self-esteem and social isolation.
What is scoliosis?
Scoliosis is a sideways curve in the spine that usually occurs during late childhood and adolescence. The curve may be S-shaped or C-shaped and can affect either side of the spine.
Scoliosis
The condition may be mild and without symptoms in some people. In others, it may cause pain, breathing difficulties, and an uneven appearance in the body.
There is a high prevalence of mental health issues in people with scoliosis. One 2024 study found that 58% of participants with scoliosis reported that they had a mental health disorder diagnosis. The diagnoses included depression, anxiety, body image disturbances, and eating disorders.
Mental health issues
Mental health disorders occur at much higher rates in children and adolescents with scoliosis than in the larger population.
According to the National Institute of Mental Health,
The National Alliance on Mental Health reports that in 2020, 1 in 6 (16.67%) adolescents in the United States experienced a major depressive episode, and 1 in 10 (10%) experienced a serious mental illness.
In a 2024 study that included 162 children and adolescents with scoliosis, the prevalence of mental health disorders was:
- 83% for depression
- 71% for anxiety
- 62% for body image disturbances
- 12% for eating disorders
Researchers link higher rates of mental health disorders in people with scoliosis to various causes, including body dissatisfaction, physical limitations, and other factors.
Treatment challenges
Scoliosis treatment, as well as the condition itself, may cause distress and mental health issues.
Nonsurgical treatment, such as back bracing, can require children and adolescents to wear a brace for 12 to 20 hours daily. This can lead to physical restrictions, self-isolation, and fears of not fitting in with peers.
Corrective spinal surgery for scoliosis may cause an initial improvement in body image for adolescents, but some people may experience body dissatisfaction in the long term.
People with scoliosis can also find surgery to be daunting and may experience anxiety and fear about pain, surgical complications, and post-surgical physical limitations.
Courtney’s story: Scoliosis and depression
“Although I’ve struggled with depression for most of my life, I recently added a scoliosis diagnosis to the mental and physical load. Growing up, I was treated for depression because I did not want to leave my room and was always exhausted and in pain. I was so young that they did not figure out that I had Ehler’s Danlos Syndrome or chronic pain. Of course, that pain of not being validated or believed added to the depressive state I was in.
There is this fog of stress when preparing to leave the house. I already have feelings of doom when heading out, disliking how my body moves and looks to others. My thoughts are pessimistic about being socially weird or whether it’s worth it to leave. Then, I also have to consider the physical factors: will there be rest spots to sit at when my spine and knees are over it? Will everyone be irritated if I have to take breaks?”
Having scoliosis can have various psychological effects that can lead to mental health difficulties. These include problems with body image, social isolation, and physical limitations.
Body image and depression
Scoliosis most commonly occurs in people ages 10 to 19 years. Researchers have identified these years as a core risk period for the onset of mental health difficulties, such as depression and anxiety.
A 2021 study indicates that many adolescents already face various body image issues associated with bodily changes due to puberty and a heightened desire to be like their peers.
Scoliosis and its treatment may cause physical changes that can increase adolescent body image issues. Researchers have found that adolescents with the condition are more likely to report body image dissatisfaction than adolescents without scoliosis, which may contribute to higher rates of depression.
Isolation
Some adolescents with scoliosis may feel as if they are physically and emotionally different from their peers, which can lead to isolation. Some may also self-isolate out of fear of rejection from their peers.
Researchers link social isolation and loneliness with depressive symptoms. Isolation and depression may be bidirectional, which means they can each affect the other. Social isolation may increase a person’s risk of depression, and depression may worsen social isolation.
Physical limitations
People with scoliosis may experience physical limitations due to pain, fear of pain or injury, and a reduced range of motion from the condition or its treatment.
This may make people feel like they are missing out, which can increase feelings of social isolation and issues with self-esteem.
Sometimes, physical limitations may contribute to feelings of shame and body inferiority, which can increase the risk of depression.
Courtney’s story: Scoliosis and depression
“Overthinking is something I’ve worked on with therapists since I was 14, yet now, the additional increase in pain symptoms and constant injuries to my body is something that I have to anticipate. Finding the balance of being prepared without worry and eventual depression is nearly impossible on my own.
I believe emotional and verbal support from a partner is the most important. Next is giving yourself care and empathy, then coping with frustration via cognitive therapy, and setting physical boundaries that may change daily. One will likely affect the other for the rest of my life, and I’ve come to accept that it isn’t fair.
However, the self-defeating thoughts surrounding things like that, instead of adapting, are what can lead me into deep and harmful depression. I have to fight off those negative thought processes about myself and what I’m capable of physically to live.”
Due to the high prevalence of depression and other mental health disorders in adolescents with scoliosis, some researchers suggest psychiatric screening. This may help broaden the care for those with scoliosis, including psychiatric and mental health services early on.
Treatment for scoliosis depends on various factors, including the location, severity, and cause of the spinal curve. It may
- Observation: A doctor may closely monitor mild scoliosis if the child’s skeleton is still growing.
- Back bracing: A doctor may suggest bracing for moderate scoliosis in growing children or adolescents. Wearing a back brace may help prevent the curve from worsening.
- Physical therapy: Physical therapy, including stretching exercises, may help strengthen muscles.
- Surgery: Some people with scoliosis may require surgery. Procedures include spinal fusion to help straighten the curve or the insertion of an expandable rod, which a surgeon will lengthen as the child grows.
Treatment for depression
- Psychotherapy: Talk therapy, such as cognitive behavioral therapy (CBT), may help people change their thoughts, feelings, and behaviors.
- Medication: A doctor may prescribe antidepressants.
- Support: Support from family, peers, or support groups may help reduce feelings of isolation.
Awareness of the association between scoliosis and depression may help people seek holistic treatment that includes the management of mental health difficulties.
Scoliosis most commonly affects adolescents, who are already at risk of body image issues and mental health difficulties.
The physical changes and limitations of the condition and its treatment can further contribute to body image issues, isolation, pain, and other factors that can lead to or worsen depression.
Awareness of the associations between scoliosis and depression may help people seek appropriate care for both. Treatment, such as psychotherapy and peer support groups, may help people with scoliosis manage the mental health challenges of the condition.