One of the sources of depression among injured workers is the change in their sexual role. Prior to injury, most injured workers have a specific role and simply cannot adapt to the change.
Sexual stereotypes are more common among those who do manual, production, and repetitive or semi-skilled work.
They believe in very specific roles for males and females.
The males often feel their sexuality has been impugned by their sudden reduction in income. Also, unable to engage in physical tasks, whether for productivity or leisure, suggests to them that they are somehow _less of a man_ than they were prior to injury.
For women, pain often makes them less sexually available or motivated, and they fear abandonment. Unable to remain active, like their male counterpart, they gain considerable weight, leading to a decreased sense of value or personal worth.
The women, as we have noted before, often respond with expressions of helplessness and hopelessness, and the males respond with anger and resentment. Both are equally likely to abuse prescribed and other substances to deal with these emotions.
While their focus initially is upon full recovery, as debt and family conflict mount, their focus becomes that of futility.
Both injured males and injured females engage in counterproductive means of re-establishing their sexual identity. The females may become increasing passive and dependent. The males become negativistic and noncompliant as a means of exhibiting what they feel to be _strength._
The longer these factors operate before they are diagnosed, the more entrenched becomes the problem and the more resistant becomes the patient.
The earlier the patient can be made aware of probable outcome of injury treatment and administrative closure achieved, the better it is for the patient, his/her family and those attempting to clinically manage that injury.