Here is another example of the great fun that is my life:
So, as most of you know, I have dealt with depression for a long time. "Officially" (with diagnosis) for about 10 yrs, unofficially for much much longer. I know from many years experience that, for me personally, medication is the most effective treatment for my depression. It allows me to feel normal, most of the time (I really don't want to start a conversation on the most appropriate treatment for depression - just hear me out and listen to me vent).
The interesting thing (from what I've read) is that the centers in the brain that deal with emotional pain (depression) also deal with physical pain, so much so that one can trigger or aggravate the other and they can play this nice game of circling round each other and blaming each other and chasing each other's tails. You know those Cymbalta commercials, "Depression Hurts"? That's because depression can actually cause physical pain (but according to my Drs, this is usually a diffuse or vague pain, achiness etc - NOT usually a distinct pain pattern along a nerve route that fits a specific disorder, such as my trigeminal neuragia. Just in case you were wondering.;). The flip side is, of course, that physical pain can cause, or aggravate, depression. Not only do you have the obvious loss of meaningful and pleasurable activities, and adjusting to a new kind of life, and fear of what the future holds, guilt for not being able to do as much, fatigue and other fun side effects from meds, etc etc etc - but biologically, the center that lights up and says "holy crap our body hurts!" also flips the nearby switch that says "oh crap now we're dealing with depression too." And then feeling depressed also makes it so much harder to cope and deal with the pain. The perception of pain is intricately subjective and entirely individual. You could subject 2 people to the exact same pain and they would perceive it, and feel it completely differently. And how we "feel" plays into how we feel. Things really do hurt more when we feel vulnerable, alone, discouraged, and hopeless.
So then, here we are. As the pain continued for months and months . . . and months, I began to notice that my meds for depression just didn't seem to be cutting it, even though I'd been feeling rather stable and well for a couple yrs before this developed. And frankly, I needed to be feeling a bit uh, perkier to even begin to feel like I could cope with the stress of constant Dr appts and tests and the normal life of 4 kids while being in pain all the freaking time. So I saw my Dr and we increased my dose. So far so good. Not sure it helped a lot, but I still held a lot of hope for finding a solution soon to the pain.
Then more time went on and I continued to feel like, oh my goodness I could deal with this constant pain-that-may-never-go-away perhaps just a little better if I weren't already depressed. And now my Dr tells me that we just need to wait and get my pain under control and that will help my depression. He won't increase my dose. Yet. And so I'm stuck in another circle. Feel like I can't cope very well with the pain on top of depression, can't get help for the depression until the pain is well controlled. The meds for the pain take a really long time to even begin to help, in the meantime I have nothing to help me deal with it. Not dealing well with it makes it hurt even more. Hurting physically makes me feel even worse. Feeling worse makes me hurt more physically. Umm . . .
Really?!?!
5 comments:
That is sooo sad! I hope that you find some relief!
One without the other would be bad enough but to have to deal with both that probably feed off each other has got to be terrible. I'm so sorry and wish there were something I could do to help.
I find this blog post very interesting because I, too, have personally felt and observed a linkage between physical and emotional pain. It’s true that on rare occasion, pain can make me feel like having a personal pity party and throwing an impatient tantrum. It makes me feel sorry for myself. But that’s quite rare. I suppose that could be because I have a very high pain tolerance. High enough that when I broke my clavicle clean through as a 12 year old and told the docs all the ways in which I could and couldn’t move my arm, and when and where it hurt, they didn’t x-ray me because they didn’t consider it possible that I had broken it because it wasn’t hurting me enough. So no sling, no brace. I just carried my left arm around using my right arm until it was healed enough to not bother me, and went back 6 weeks later when I had a big bone callus. Now it’s crooked. And when I was 5, I insisted that my dad try to get my first loose tooth out with a pair of pliers. My mom said I made him work on it for a half hour, until she lost her stomach for it and made him stop. I got a big kick out of self-suturing my thumb with a friend. Granted, we didn’t have a choice about it at the time, but I was kind of glad we had to DIY. And sometimes, pain feels kind of good. Like when you help someone move and are sore the next day. Or when you fall down the stairs and are sore the next day. It makes you feel alive. Like you did something, accomplished something. Like sure, you’re getting older and you get sore, but you’re still tough enough to do those things that made you sore. So as you point out, people have different thresholds for physical pain and mine happens to be on the high end. But I have always found it interesting that I am the only person in my nuclear family who has never been on anti-depressants, and I have always thought that the rest of my nuclear family was pretty wimpy when it came to physical pain. My mother avoids physical activity because it will make her sore the next day. I feel satisfied (or amused, depending) if I am sore the next day. My grandparents were in pretty severe pain for many of their later years, but it never stopped them from getting out there and doing things. My grandma was still out in the garden, bending over at the waist to plant her bulbs since her knees didn’t work, even though the screws in her hip replacement were coming loose and pinching nerves. My granddad didn’t want false teeth but was allergic to analgesics, so he had his teeth put on posts and drilled into his mandible and maxilla just a few at time over many visits, since he had to do that with no pain management of any kind. I think it could be argued that that dude also had a high pain tolerance. They were also never depressed. So I think you are right that one’s personal experience of physical pain will be different from another’s, and maybe how you personally experience physical pain makes a difference in how likely it is to exacerbate or contribute to emotional pain. I’m glad you made me think about that explicitly. Maybe I can remember this the next time I am frustrated with my mom for not exercising to help her depression even though she always says that she does feel better when she’s exercising. Maybe. Truthfully, I’m not so good at being patient with it anymore. But new ways of thinking about it are always helpful.
But there is another facet to this connection that I wanted to share with you. A different difference. When I am in intense emotional pain, physical pain can distract. For me, physical pain can be like a switch. And that is probably why I am “a cutter.” I have only acted on my cutting tendencies on one occasion, but two things were really, really fascinating about that event. One is that the moment I had cut myself and realized I needed sutures, I went into problem-solving mode and the intense, acute emotional pain I was dealing with at that moment evaporated. Two is that the cuts never hurt. They didn’t hurt in the moment. They didn’t hurt when the doc was pulling the tissue around to see how much damage I had done. They didn’t hurt when the doc injected lidocaine to sew them up. That was crazy. I’ve had enough sutures to be quite sure that that always hurts! They didn’t hurt later that evening after they’d been sewn up. They didn’t hurt the next day. They NEVER hurt. It was astonishing. And fascinating. Those cuts did their job. They got me out of an acute emotional crisis, into a rational state, and I dealt with the thing that caused the acute emotional crisis later, more slowly. Of course there’s a big difference between self-inflicted physical pain and physical pain you don’t control. And I recognize that there’s a big difference between extreme pain and moderate pain. And I am not in any way arguing with you or dismissing the linkages between physical and emotional pain you articulated. I just wanted to explore this idea of linkages between/among different types of pain a little further.
I think this is true.
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