Do you ever wonder with chronic pain where your motivation goes? Why accomplishments just seem… meaningless? One does tend to blame the pain itself. Like it sucks the life out of everything but there was a study done that suggests otherwise.

That motivation thing, lack of, and what to do about it

A series of experiments in mice by Malenka and his colleagues, described in a study published Aug. 1 inScience, showed that persistent pain causes changes in a set of nerve cells in a deep-brain structure known to be important in reward-seeking behavior: the pursuit of goals likely to yield pleasurable results. Malenka’s lab has been studying this brain structure, the nucleus accumbens, for two decades.“We showed that those brain changes don’t go away when you transiently relieve the mice’s pain,” Malenka said. The experiments also indicated that the mice’s diminished motivation to perform reward-generating tasks didn’t stem from their pain’s rendering them incapable of experiencing pleasure or from any accompanying physical impairment, he said. Your Medical Guide

 Fields, who did not participate in the Malenka group’s study but wrote an accompanying perspective piece published simultaneously in Science, described the psychological effect of chronic pain as “the clouding of the future. There’s no escape from it. You want it to end, but it doesn’t.” As a result, people become pessimistic and irritable, he said. “People come to expect the next day is going to wind up being painful. It just takes the edge off of life

little pleasures — and big pleasures, for that matter.”Your Medical Guide

The study was interesting in that they had mice who would nose a spot to get a reward and then they increased the amount of nosing they had to do to get that reward. And the chronic pain mice lost the motivation to do so. Physically they were able to. Their pain was treated. And still, they had no motivation to get that treat. 

Because with chronic pain effort seems like a momentous amount of energy being lost. And all our energy is on tolerating this pain, combating this fatigue and getting what needs to be done done. We have nothing left for motivation. We really force ourselves to do things. Force and force and force, but the motivation isn’t there. We fake motivation.

So that sensation that you have no motivation to get through the day, to attain the goals you need to or even attain the goals that are seriously meaningful to you could have little to do with the pain aspect of the chronic pain… but is part of the persistence of the chronic pain itself. We no longer have the sense of their being a reward for our behaviour. We no longer have a sense of pleasure from our accomplishments. It has been dulled.

So what do we do about it..

I found this video on helping with motivation.

I have chronic pain and depression so motivation is a massive mountain to climb… and I am at the bottom curled up in a ball not motivated to climb it.

What I have done to tackle my motivation is a started a journal. It is partly my gratitude journal and partly my motivational journal. For motivation I set one goal for tomorrow, one exercise goal and I list one thing I accomplished that day.

My goals are all simple things I can do that day. I have long-term goals, but I choose what I do that day. Like exercise is a long-term goal but I will say ‘exercise for 10min’ because that is my current limit. Then my goal will be exercise for 11 min.

I always note an accomplishment because we have to note what we have succeeded in doing.

And I do something to award myself at the end of the week for achieving my goals and progressing either toward long-term goals and achieving my small goals. Small goals are things like ‘do light housework’ because my main goal is to keep the house cleaner. I need to pace myself so I keep an idea of energy and what I am doing that day and what I can therefore handle.

So like she says make a list of things we want to improve on and small goals that get you there.

Takes a month to make a habit, so you need to consistently be doing these things before they become a habit.

Some days on flare days I may not achieve all the things I listed, but I will accomplish some. I want to achieve at the very least 1 thing every day no matter what.

See also:

Self-care: When you are in a funk
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