Living with chronic pain is incredibly difficult. If you’re exploring spinal cord stimulation (SCS) as a treatment option, you’re likely also facing a wave of medical appointments, decisions, and fears. But one question that might surprise you—and possibly concern you—is: Can mental health issues affect your eligibility for spinal cord stimulation?
This blog post will walk you through what you need to know in a clear, supportive, and research-based way. We’ll explore how mental health is assessed as part of the spinal cord stimulator (SCS) evaluation process, how to manage psychological challenges during this time, and what support is available to help you through it.
Let’s make sense of it all—together.
Can Mental Health Issues Affect Your Eligibility for Spinal Cord Stimulation?
Yes, mental health issues can impact your eligibility for spinal cord stimulation, but this doesn’t necessarily mean you will be disqualified. It’s more about ensuring that you’re emotionally prepared for the procedure, recovery, and lifestyle changes that follow. Mental health evaluations are often required as part of the pre-surgical screening process to help ensure the best possible outcomes.
Why Mental Health Matters in Spinal Cord Stimulator Screening
Spinal cord stimulation is a significant medical decision. You’re being asked to undergo a surgical trial of a device that may affect your quality of life. Physicians and pain management teams want to ensure you have the coping tools, realistic expectations, and emotional resilience to handle the process and outcome.
Here’s why mental health is so important during this phase:
- Mental health can influence pain perception. Depression, anxiety, PTSD, and other conditions can magnify pain or reduce your ability to cope with it.
- Your mindset impacts recovery. Optimism, support systems, and stress management play a major role in your recovery and adjustment to having a medical device.
- Some conditions may complicate post-op success. Untreated or unmanaged psychiatric conditions can make it harder to adapt to the lifestyle changes that come with SCS.
- It’s about preparation, not punishment. A psychological screening isn’t there to judge you—it’s designed to support your overall treatment success.
What to Expect During the Psychological Evaluation for Spinal Cord Stimulator Surgery
Many people feel nervous when they hear they’ll need a psychological evaluation to proceed with spinal cord stimulation. This can trigger feelings of shame, fear of being misunderstood, or concerns about being denied care.
Let’s break down what actually happens:
1. A Licensed Mental Health Provider Conducts the Evaluation
This evaluation is often done by a psychologist, therapist, or psychiatrist who specializes in pre-surgical psychological assessments. They understand chronic pain and will approach you with care and professionalism.
2. You’ll Talk About Your Pain and Medical History
They may ask about:
- Your pain history and how it affects your life
- Any medications you take (including opioids or mood stabilizers)
- Your understanding of what SCS does
3. Mental Health Symptoms Are Explored
They may assess for:
- Depression
- Anxiety
- PTSD
- Substance use
- Past trauma
- Sleep difficulties
You might complete questionnaires or standardized tests, such as the MMPI-2 (Minnesota Multiphasic Personality Inventory), to help clarify your coping strategies, thought patterns, and emotional health.
4. Your Support System Is Evaluated
Your provider may ask:
- Who helps you day to day?
- How do you cope with stress?
- Are there any relational or environmental factors that could affect your recovery?
Common Mental Health Concerns and How They Affect SCS Eligibility
Here’s a closer look at how specific mental health issues might be considered:
Depression
Mild to moderate depression is very common among people with chronic pain. If you’re actively working on managing your depression—through therapy, medication, or both—it likely won’t disqualify you. However, untreated or severe depression may need to be addressed first.
Anxiety
Anxiety can be heightened before surgery. But if you’re struggling with panic attacks, health anxiety, or avoidance behaviors that could interfere with recovery, this may require additional support before proceeding.
Post-Traumatic Stress Disorder (PTSD)
PTSD can impact how your nervous system reacts to pain and medical procedures. If left untreated, it can complicate your experience with an implanted device. Working with a trauma-informed therapist beforehand can improve your chances of success.
Substance Use Disorders
Current or recent substance abuse may pause your eligibility for SCS. That said, many people are able to move forward after addressing their substance use in therapy or addiction recovery programs.
Personality Disorders or Severe Mental Illness
These conditions may require a more complex care plan, but they do not automatically disqualify you. If you’re under consistent psychiatric care, your team will work with your mental health provider to ensure you’re supported.
How to Strengthen Your Mental Health Before Spinal Cord Stimulator Surgery
No matter where you’re starting from emotionally, there are ways to improve your mental readiness and boost your eligibility:
1. Work with a Mental Health Professional
Therapy can help you:
- Process fears about surgery
- Build realistic expectations
- Improve coping strategies for pain and stress
- Reduce depression or anxiety symptoms
👉 If you’re looking for a trauma-informed, compassionate therapist to support you through this journey, consider scheduling a session with me at Onesta Therapy Co. I specialize in helping clients prepare mentally for medical procedures and manage chronic conditions.
2. Join a Support Group
Connecting with others who’ve gone through SCS surgery can help you feel less alone and gain perspective on what to expect. Consider:
- Facebook groups for spinal cord stimulator patients
- Local chronic pain support communities
- Online forums like Inspire or Spinal Cord Stimulator Support
3. Practice Nervous System Regulation Techniques
Simple tools like deep breathing, progressive muscle relaxation, and mindfulness can calm your body and brain. These tools can help before surgery—and after.
4. Be Honest About Your Fears
It’s okay to feel overwhelmed. Saying it out loud to a therapist or doctor doesn’t make you weak—it makes you prepared.
What If I’m Told I’m Not Emotionally Ready for SCS?
First, please know this is not a permanent “no.” It’s a “not yet.”
Most providers will recommend steps you can take to improve your readiness, like:
- Attending therapy sessions
- Taking medication for anxiety or depression
- Stabilizing your sleep schedule
- Reducing substance use
In many cases, patients can return in a few months and get approved after following a mental health care plan.
Getting Professional Support: You Don’t Have to Do This Alone
If you’re feeling uncertain, discouraged, or afraid about how your mental health might affect your SCS eligibility, please know that support is available—and it can make a difference.
At Onesta Therapy Co., I help clients like you navigate medical stress, chronic pain, trauma, and anxiety with personalized, evidence-based care. Together, we’ll work to build your emotional resilience and confidence, no matter where you are in the spinal cord stimulator journey.
Let’s Take the Next Step Together
Facing surgery and chronic pain is hard enough—you don’t have to carry the emotional burden on your own.
📅 Book a confidential therapy session today with Onesta Therapy Co.
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Let’s get you feeling emotionally ready for the life you deserve—whether that includes spinal cord stimulation or simply more peace in your daily life.
Jennifer Adair, LPC 
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