The Pain/Depression Cycle

By: Ryan Lawrence

Over the decades, medical professionals have begun to recognize that depression can have a significant physical impact on our bodies. Studies have shown that depressed people are more prone to suffering from physical ailments, such as heart problems and osteoporosis. That said, above all else, depression appears to be tightly linked to physical pain.

A Complex Relationship

Researchers know that pain and depression have a real but confusing relationship. Physicians often struggle to identify the source of certain physical ailments when they are combined with depression. Like the chicken and the egg, it's not always clear what is causing what. When depressed patients visit the doctor, they often complain of vague, insistent symptoms, such as abdominal pain, headaches, or musculoskeletal pain in the neck, joints and lower back.

This often leads physicians to test for all sorts of ailments before finally attributing the problem to depression. Many times, antidepressants and cognitive therapy help to resolve symptoms of vague, chronic pain. On the other hand, just as often, this treatment strategy proves ineffective, because it's actually focusing on a symptom rather than the source problem, itself.

When Pain Causes Depression

  Years ago, health professionals believed that people who suffered from both pain and depression experienced the former, because they were somehow denying an emotional disorder. Now, more and more experts believe that it's actually pain that makes people depressed in the first place.



According to Dr. Donna Blair, who treats people suffering from temporomandibular disorder, many of her patients have experienced improved mood once they received treatment for the source of their chronic pain.

"I see people whose teeth are worn down to a fraction of the length of what they used to be from years of grinding," she said. "They've been in pain for years, but didn't know that a problem in their jaw joint could have been the cause; and they're amazed at the increase in quality of life that they get when their teeth are restored and their bite is corrected."

An Endless Cycle

  Unfortunately, chronic pain and depression can promote one another. This is especially true when one or the other promotes sleeping difficulties. According to Blair, research has shown that insufficient sleep can promote both pain and depression, leading to a seemingly endless cycle that can send people into a downward spiral.



"Sleep is so critical to our well-being, and when we don't get enough of it, our bodies suffer," she said. "When you add pain to the mix, people have trouble sleeping and it sets a vicious cycle in motion. Depression is just part of what frequently happens in this cycle, but it's one of the signs and symptoms that people are more aware of. Things like increased risk of heart attack and stroke usually go unnoticed until it's too late."

Getting Help

Chronic pain has been proven to keep depressed people depressed, while robbing them of their ability to function in professional and social arenas. That said, when patients receive treatment, they tend to show significant improvement.

When seeking help, patients would be well-advised to seek counsel from physicians who are open to all potential causes, instead of those who are focused on purely physical or psychological catalysts.

Citations:

• Journal of American Medical Association depression study
  

Featured images:

•  License: Creative Commons image source 

Ryan Lawrence writes for Off-Topic Media. Thanks to Dr. Blair for contributing to this story. Dr. Blair treats migranes and other TMJ symptoms at her office in Fresno, California.

Cathartic Writing - Can Letting It All Pour Out Heal Your Heart And Mind? (Guest Blogger Luke Casey)

Writers are often seen as tortured souls and many have admitted to using their writing to help them face their demons with prime examples of this being Virginia Woolf and William Syron. Questions have been asked when it comes to writing as to whether or not it is the act of writing that releases tension and allows the writer to find peace, or is it opening up about the past that brings back bad memories and causes the depression in the first place. This is not purely fanciful thinking but has been the subject of research by Susan Nolen-Hoeksema, a Yale Psychologist.

When Writing About Experiences Leads To A Best Seller

Many fans of Stephen King found that his books changed after he had been involved in a road accident and at one stage he considered not writing anymore. Only he knows for sure how much writing helped him get through the dark times he faced, but he has certainly portrayed a similar incident to his own in Misery. Could he have been showing how his life could have ended up if he had not been able to contact the authorities to come and help him?

Some psychiatrists will recommend that people write down their fears as a way of facing them. For some this will work, but for others there will be a greater fear as they cannot bear to see what scares them laid out in black and white. For people with sick members of the family there is the continual fear that the life of the person will end soon and no amount of writing about it can take their fear away. It often helps if they write about them after the event and whether this is a eulogy for the funeral service or a full book paying tribute to their life it can give a sense of closure.

I Know It Can Work

I have found that writing down my feelings can prevent a row and lift a lot of tension. Many times I have been able to turn on the computer – or take out the pen and paper in the pre computer days – and write a letter to someone telling them exactly how I feel. I can honestly say that I have never sent any of these letters, but by the time I have faced the other person, a lot of the anger has been diluted and I have been able to put my point across in a calm and collected manner. The click of a button or the striking of a match is all that was needed to make sure I was the only person who ever knew my real anger or hurt.

Be Accurate and Be Prepared To Be Challenged

Other people have done the same sort of thing, but in much more detail and have actually published what they have written. Sometimes there are family disputes caused and fairly recent books “Angela’s Ashes” by Frank McCourt and “A Child Called It” by Dave Pelzer have led to there being criticisms regarding the accuracy of the events described. For Dave Pelzer in particular there have been further problems as the abuse as he remembers it has been disputed by siblings.

Beating Addiction

Writing about life events is also a big issue for people who are undergoing treatment for addiction and the belief is that once they can confront the problems of their past they will not retrace them. Writing can be cathartic for some people so on the next occasion you face difficult times, see if it works for you.

The author, Luke Casey, is a popular freelance writer and a serial blogger. He writes articles on a multitude of topics. He says if you ever need to get an essay written then essayjedi.com is the best place to go.

My Interview with Michigan Hedgehog: A Closer Look at My Own Story of Mental Illness

I had the great privilege to participate in an interview by the owner of Michigan Hedgehog. Ms. Emily devotes each Friday to introducing her readers to a different voice of mental illness.  And today was my day :)  You can check out my interview at Feature Friday: Mental Illness Interview with Bipolarly.  Make sure to look at her other content as well!

The Language of Mental Health

Let's face it: mental illness can be confusing.  Our symptoms make sure of that!  Add in the fact that doctors don't always have the time to fill us in on all the psychological jargon that we will hear used, quite repeatedly, throughout the rest of our treatment process.  Here you will find a few of the most common terms decoded:

Mental Health is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively, and is able to make a contribution to his or her community. In this positive sense, mental health is the foundation for individual well-being and the effective functioning of a community.

Mental Illness is defined as “collectively all diagnosable mental disorders” or “health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning.” Under these definitions,substance use might be classified as either a mental health problem or a mental illness, depending on its intensity, duration, and effects.

Mental Health Promotion consists of interventions to enhance the ability to achieve developmentally appropriate tasks and a positive sense of self-esteem, mastery, well being, and social inclusion and to strengthen the ability to cope with adversity. This ability to cope is referred to as resilience.

Mental Health Treatment is the provision of specific intervention techniques by a professional for conditions identified in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM). These interventions should have proven effectiveness, the ability to produce measurable changes in behaviors and symptoms, and should be person- and family-centered and culturally and linguistically appropriate.

Prevention is a step or set of steps along a continuum to promote individual, family, and community health; prevent mental and substance use disorders; support resilience and recovery; and prevent relapse. 

Recovery is a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential. People with mental illnesses can and do recover from these conditions, and hope plays an essential part in overcoming the internal and external challenges, barriers, and obstacles. Controlling or managing symptoms is part of this process. Reducing or eliminating substance use is critical for recovery from addiction.

Recovery Support Services include a focus on providing for the health, housing, vocational, and social support needs of people with mental health problems. These include peer- and family-operated services.

Substance Abuse is defined as the use of alcohol or drugs despite negative consequences.

Substance Use is defined as the consumption of low or infrequent doses of alcohol and other drugs, sometimes called experimental, casual, or social use.

Trauma results from an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or threatening and that has lasting adverse effects on the individual’s functioning and physical,social, emotional, or spiritual well-being.

Types of Mental Health Problems 

People can experience different types of mental health problems. Some can occur for a short time, and some occur over an on-going time period. Just as other health conditions, these are real and diagnosable health conditions that affect and are affected by functioning of the brain, an organ of the body just like the kidney, liver, or heart. Mental health problems can affect your thinking, mood, and behavior. 

Common types can include: 

Anxiety Disorders 

People with anxiety disorders respond to certain objects or situations with fear and dread. Anxiety disorders can include obsessive-compulsive disorder, panic disorders, phobias, and Post-Traumatic Stress Disorder (PTSD).

Attention Deficit Hyperactivity Disorder 

Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders and can continue through adolescence and adulthood. Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity (overactivity).

Eating Disorders 

Eating disorders involve extreme emotions, attitudes, and behaviors involving weight and food. Eating disorders can include anorexia, bulimia, and binge eating.

Co-Occurring Mental and Substance Use Disorders 

Mental illnesses and substance use disorders often occur together. Sometimes one disorder can be a contributing factor to or can exacerbate the other. Sometimes they simply occur at the same time.

Mood Disorders 

These disorders involve persistent feelings of sadness or periods of feeling overly happy, or fluctuating between extreme happiness and extreme sadness. Mood disorders can include depression, bipolar disorder, Seasonal Affective Disorder (SAD), and compulsion to self-harm.

Personality Disorders 

People with personality disorders have extreme and inflexible personality traits that are distressing to the person and/or cause problems in work, school, or social relationships. Personality disorders can include antisocial personality disorder and borderline personality disorder.

Psychotic Disorders 

People with psychotic disorders hear,see, and believe things that aren’t real or true. An example of a psychotic disorder is schizophrenia.

Substance Use Disorders 

Substance use disorders involve the dependence on or abuse of alcohol and/or drugs, including the non-medical use of prescription drugs.

Suicidal Behavior 

Suicide is a serious problem that causes immeasurable pain,suffering, and loss to individuals, families and communities nationwide. Millions of people consider, plan, or attempt suicide each year; many die as a result.

Treatment for Mental Health Problems 

Most people who experience mental illnesses will improve if they receive appropriate supports, services, and treatment. The first step to getting the right treatment is to see a health care professional and review your symptoms and life circumstances.

Treatment options are tailored to each specific person and condition; however, the most common forms of treatment include:

Psychotherapy, or “talk therapy” (sometimes called counseling)—teaches people strategies and gives them tools to deal with stress and uncomfortable thoughts and behaviors. Psychotherapy helps people manage their symptoms better and function at their best in everyday life. Cognitive behavioral therapy (CBT)—helps people learn how to identify unhelpful thinking patterns, recognize and change inaccurate beliefs, relate to others in more positive ways, and change behaviors accordingly. CBT can be applied and adapted to treat many specific mental disorders.

Medications—used to treat the symptoms of many mental disorders such as schizophrenia, depression, bipolar disorder (sometimes called manic-depressive illness), anxiety disorders, and attention deficit-hyperactivity disorder (ADHD). Medications can also be used to manage the cravings and relapse associated with certain kinds of addictions. Sometimes medications are used with other treatments such as psychotherapy or counseling.

Rehabilitative services—include recovery-focused activities or treatment/therapeutic interventions such as assistance in improving or restoring daily living skills,social and leisure skills, grooming and personal hygiene skills, and meal preparation skills; other support resources; and/or medication education.

Sources:

Substance Abuse and Mental Health Services Administration (SAMHSA). Community Conversations About Mental Health.  (2013).  Public Domain.

When the Air Leaves the Room

I'll admit it.  Today was not a success.  I went to my daughter's livestock show this morning.  It was supposed to start at 9:15a.m.  Two-and-a-half hours later, her group still had not shown.  I was okay for that first hour or so.  After all, I had prepared by taking my Klonopin before we left the house. But then it started happening.  Everything started getting unbearably loud and stuffy.  I felt like I was suffocating.  My chest started to hurt, all the way through to my back, and down my left arm.  I felt like I was going to throw up, pass out, and/or die.  I have went through this enough to know that it's not a heart attack; no need to call an ambulance.  But I would not wish a panic attack on my worst enemy.  Needless to say, we had to get out of there.  Once we got to the car I took another Klonopin, closed my eyes and tried to imagine I was far, far away.  My chest hurt all the way home but by the time we got there I was feeling calmer, slurring my speech like a drunk (thanks, Klonopin) and ready for a nap.  Luckily, my son was wiped out from getting up early so we slept for a few hours.

 I still don't feel great.  Panic attacks wipe me out much like migraines do.  After all that intensity, the body just doesn't have anything left to exert.  I feel terrible for not being able to stay long enough to see my daughter show her goat.  These shows are not my cup of tea, but I make myself go when I can because I love her. But I have to wonder, what is worse:  showing up and "embarrassing" my kids with these panic attacks, or not showing up at all.  Because a lot of times I don't risk it.  This is why I rarely make it to school functions (I went to both my daughters' open houses last week but I had to leave early from the middle school because I felt an attack coming on).  I hate being this way.  I hate how other people (won't mention names, but you can imagine) think I just make excuses not to be there for my kids.  Like I would actually miss part of their lives on purpose!  Bull----!!!  But that's how it looks to someone who has never experienced this type of thing.

 I don't really care what others think of me, but I ache for my kids.  My daughters are 13 and 11, and they seem to be more understanding than most adults.  They have (unfortunately) seen firsthand what the anxiety does to me.  They have even told me to stay home sometimes.  I don't want to be an absent parent.  There are so many things I miss from their lives as it is.  I don't get to be a full time parent to them like I do my son.  I'm more like a fun (though neurotic) aunt.  I would like to kick and pout and scream that it's not fair (and sometimes I do when no one is around) but that doesn't change anything.

I feel like a failure today, but that's not true.  I did try.  I tried and, though things didn't turn out the way I wanted them to, I faced my fear for as long as I could without having to be carried out on a gurney.  I love my children.  They love me.  I won't always be present at livestock shows or other school functions, but I hope they do realize that they mean more to me than anything else in the world.  I hope they never have to experience what it's like to have a panic attack.  I am proud of them, and they make me try a lot harder than I would without them.  It doesn't paint the perfect portrait of a family, the way things are.  But it's close enough.

"A Mother's Prayer" By Tina Fey