Talk to any well-adjusted amputee, and there is a huge-arse well of simmering what-the-f*ck-is-wrong-with-me below the surface. And those are the ones who have dealt with their demons for years and come out largely victorious.
Many lose. The suicide rate among amputees is incredibly high. And it's not a binary situation, either. Depressive symptoms are so common in those who have had amputations that more serious amputees are on the borderline of a diagnosis of depression that are not. In those who lost a limb in violent circumstances, there is a drastic incidence of PTSD, higher than that in returned soldiers from actual high-contact combat deployments. And this drastic increase in incidence is common to every subgroup tested so far.
It's not just trauma. Amputees are often suffering other problems, either induced or exacerbated by their loss of limb. Anger issues are common, An inability to interact socially is common.
Almost none of these issues are rectified by the provision of an artificial limb. When the user is sufficiently proficient that they can start to take part in something like their normal lifestyle, they tend to be less likely to develop severe psychological problems, but this does little to change the likelihood of developing the minor problems that characterise their life. Even in people who have been fitted with the absolute top-of-the-range equipment, that matches or exceeds human performance in every tested field, end up suffering for having lost a limb in the first place.
This isn't an 'average' either. Governments spend sh*tloads on tracking the recovery of people they spend hundred of thousands of dollars of leg to, to see whether it's worth it. And while it's much better psychologically than having low-quality product that seriously inhibits your life, there are no cases, literally none, in the data I've been able to see of individuals who have been assessed as being as mentally stable and healthy as before their limb loss.
Now what's REALLY interesting is that this does not just apply to serious amputations, like hands, feet, arms, and legs. Any amputation of an entire body part has similar consequences. Yes, more drastic amputations carry larger effects, and yes, amputations that impair activity carry the secondary packages of life-fucking that losing your lifestyle brings. But even losing toes or parts of fingers to frostbite or diabetes, something only you will ever see and that a prosthetic can cover functionally identically and visually indistinguishably, carries some of these same psychological issues. The suicide rate in those who have lost toes is lower than those who have lost legs, yes, but still significantly higher than the population as a whole.
And then there's amputation of sexual features, which compounds all of these effects drastically and adds the third layer of sexual identity to the mix of serious issues.
Now what that tells me is that there's a fundamental component of the whole and complete human body that we need to feel whole as a person. Identity is at the crux of so much of our psychological health. A strong and well-rounded sense of self makes for an extremely robust person. An ill-founded self-identity, an overly-focused one, or one that balances itself on factors that person can't control, is not. But I would suggests that individuals also draw a far greater amount of their indenity from their humanity. Their physical form and its limits. This we never acknowledge because, hell, when do we need to? We KNOW we're human. But because this is such a fundamental concept to our sense of self, and because it is so very robust, when it IS challenged and it DOES crack, then there can be horrendous personal consequences.
And this is in people we see now, where deliberate amputation is a serious mental illness, and prosthetics are not so powerful as to dehumanise.
Imagine a world where a man can strip away every part of himself and become more than anyone else around him, or indeed EVERYONE else around him.
One man goes to work in a mine, and does the labour of three other men, feeling greater than any other their and praised for his efforts. But then he gets home, and spends a half-hour in the shower, just staring at the cold metal myoelectric interface pinning the metal to himself.
Imagine the prostitute, now that aesthetic augmentation is easy. She is better-treated than all the others, and has survived where many others either die, or lose their edge and are sold to darker purpose. She will never have to worry about STDs, which have killed and disfigured many of her friends. But even though none of them own their own bodies, at least some day the others may have their back. Her body has been sold long ago, piece by piece on the surgeon's table. It is difficult enough to convince former sex slaves that they are more than a pretty toy to be f*cked. How much harder to persuade someone for whom this is physiologically true?
Then there's the super-merc, augmented to the bleeding edge of human capacity, and more dangerous than an entire district police force. He's better at his job than anyone else, and has survived what nobody else has, with the vast fortune to go along with it. He has felt the terror of seeing his first augged combatant as a normal man, felt the satisfaction of finally turning the tables with wetware of his own, and finally the sense of power that comes with full augmentation and being a modern day God of War. He is more physically powerful than any human in history; so much so that he has to retard his reflexes and strength by orders of magnitude just to keep those around him safe on the streets. But for all that power, it's a different story as he wakes up in the morning, in that slow semi-dream state. As systems come online and lockdowns lift, but before they rule it safe to respond. Memories of his early life, of childhood sports and fighting with brothers, but before the memory of so many white, clinical hallways and 'now count backwards from ten, please.' When for a second nerve triggers fire down all the old pathways, but before the myoelectric interfaces are able to respond.
For those brief seconds there is the terrifying awareness that, for all his miraculous technology, he is a severed head lying on a bed, without the lungs to scream.
Systems detect full consciousness and un-safe themselves, and he bolts upright, chemical dispensers releasing mild sedatives in response to the stress. He's made it through, again. Like so many other days. And he'll make it through tomorrow, and the next, and the next. Until one day, when the thought of waking up like this every day for the rest of his life is too much, and he makes sure he never has to wake up again.