I feel this study that came out of Australia has some important lessons for us to think about for our coping with chronic pain and that is why I felt the need to mention it. As well as some previous research I remember coming across.
It was a small study, as scan studies tend to be, where they looked at the brain scans of 19 individuals with nerve pain and jaw disorders compared to the scans of 19 healthy individual control subjects.
The main finding is that those with chronic pain had lower levels of glutamate which is an important chemical messenger between brain cells that helps regulate our emotions.
What this means for us is pretty important:
“[It] means their brain cells can no longer communicate properly and therefore their ability to process positive emotion is jeopardised,” Associate Professor Gustin said.
As a result, people in chronic pain can have personality changes where they are “prone to feeling tired, unmotivated and constantly worrying on a daily basis”, she said.
You can see how these results are pretty important to our coping with pain when we already have to deal with being tired, unmotivated and worried. Unmotivated is the one in particular that concerns me. We need motivation for many of the daily things we need to do to cope and it is extremely hard to muster that up. And one does wonder why that is.
The researchers found that the greater the decrease in glutamate the more chronic pain people showed pessimism, fatigue, fear, and sensitivity to criticism.
And I know fatigue can be something that is immensely difficult to deal with. As is fear when it comes to fear of activity or fear of the future. And we do tend to constantly fight a pessimistic attitude and we are very aware of that.
Clearly, they want to see these results replicated in a larger trial.
“We know that almost half of people with chronic pain have mental health conditions such as depression and anxiety and these findings may well be an explanation,” she said.
“The research could help change the way we understand and respond to chronic pain.”
There has been previous research on motivation
That motivation thing and what to do about it and it references a study done on mice that showed a disruption on the reward system of the brain. The mice with chronic pain, even treated, had no motivation to seek the reward they knew was there. And maybe there is a connection. The chronic pain was causing more than just lack of motivation but also fatigue, fear, and pessimism… they just gave up on that reward.
When you think of chronic pain and motivation with these issues:
It makes sense and it explains a lot. Chronic pain makes living life and doing things a Momentous effort. And it does seem that our own brains are constantly sabotaging us. And one way is the motivation problems we can have… like we have to Force ourselves to Do things and hope that will eventually give us our motivation back… but it never does. Instead, we are constantly exhausted… just all the time and everything seems like so much damn effort.
And that compromises our capacity to cope and manage chronic pain. We may have a routine of things that help us cope… but it never becomes a routine because motivation lacks so much or fatigue is just so intense. It is a struggle to do the things we know make us feel a little bit better, even though we Know those things help. And that makes our mood suffer. Why can’t we just Do the things we need to Do that help us feel better and cope better? Well, don’t knock yourself… our brains, apparently, are just not helping us in this.
So I do believe the research is onto something. We know already that chronic pain isn’t just pain. It comes with symptoms as well.
So consider all that when you are trying to cope and set up routines and habits to help you cope. It is a challenge. We will falter from time to time. It is going to happen and we shouldn’t feel guilty about that, just try again the next day. It takes a lot to fight our brains on this and deal with the chronic pain at the same time.
What it essentially boils down to is that chronic pain is complex and difficult to manage. Difficult to treat as well. And one of the reasons why is that these other symptoms do not help us with struggling to engage in our own treatment but rather compromise it. And it can be a real struggle for us to stay on the track we want. Or feel like we are getting any results at all. That pessimism we can have can make us halt any treatment believing nothing works or will ever work. I have been there. However, that was because I had that pessimism, the fatigue and depression rolled into one. And yeah it felt futile. And at those times it does seem like a break from ALL that is the best I can even do. But eventually, I get some motivation back to find the energy to work at different coping strategies and develop new habits and routines to help me cope. Hoping I will not compromise my own coping again, knowing it is very possible I will. Sometimes the best we can do is just cope the best we can when we can.