- A 74.5% incidence of psychiatric disorders was present in the patient sample
- The rate of depressive and anxiety disorders was 29.4% and 23.5%, respectively
- Comorbid anxiety scores (P = 0.019) and SSAS scores (P = 0.046) were significantly higher in chronic pain patients with a somatoform disorder
- HAM-A scores were found to be significantly higher in patients with depression (P = 0.004)
- A positive and linear relationship was determined between the SSAS score and depression, anxiety, and the severity of mental symptom
“Although the mechanisms of the relationship between chronic pain and psychiatric disorders are not fully understood, effective management of both pain intensity and comorbid psychiatric conditions is necessary for the quality of life of patients,” they concluded.
I am flabbergasted that these studies seem to find this link weird. How long do you think one can have chronic pain without psychological consequences?
However, the conclusion is vital I find to effective treatment of chronic pain. Vital for mine anyway. One must treat both pain and mental illness together to get any progress at all, I find, in my case. I never had any progress when they didn’t.
We know what chronic pain is hard to treat. So much so it rarely is treated well or effectively and that, well, that has a cost on the person with chronic pain.
Doctors throw a lot of random ineffective medications at us that have more side effects than any benefits. God forbid they actually treat the pain. Or, hey, give us a program that might help us figure out a program that would work for us overall, with complementary treatments. Nope. Just deal with it. And figure it out.
We are often left to figure out how to cope on our own. Randomly trying out whatever to see what may or may not help. And this trial and error takes a lot of time, costs money, and no real help is found any time soon. All out of pocket, of course. Alternative treatments. And supplements. And vitamins. And every other damn thing.
We struggle to hold onto our career and this causes immense stress. So immense this alone can impact our emotional and mental health severely.
Our lives basically crumble around us and often we experience financial insecurity if not complete job loss. And often have relationship issues if not divorce.
I have No idea why we would experience More depression and anxiety. No clue. It’s a mystery.
And then when we do develop a comorbid mental illness we are ‘catastrophizing’ … well, you try on unmanaged, untreated chronic pain for a decade and see how positive your outlook is. Because this is what Happens. Dude, really. I’m not saying it’s a good thing… I’m saying it’s a bloody obvious development.
I get depression. I get why I have depression, I get all the thoughts I have with depression. I had a therapist once said to me ‘you’re too intelligent to argue with’. And really was I? Or was my argument Right? Was the reasons why I felt the way I did… pretty bloody obvious. And my argument for why I logically felt the way I did make a crapton of sense. Clearly, she should have looked at distorted thinking rather than my actual points. My actual points were accurate for the life of someone with chronic pain and could not have been argued with. That she was right about. She could have, on the other hand, said I was focusing on the negative, or catastrophizing, or black and white thinking or blah blah blah. And that would have also been true. And I have had psychologists change the way I think but it Does Not change the fact that what I thought about Pain was Right. And I would have to be a lunatic to enjoy the experience of pain every damn day. Depression seemed like a natural consequence of that chronic pain over time. And I don’t just mean thought-wise… I mean neurologically, psychologically… on every level of reality we live on, depression is a natural progression of chronic pain. On some level. For many of us. And maybe there is a reason why it hits some of us and not others. Maybe we get nailed more in the neurotransmitters. Who knows.
So, what the hell do they expect? Chronic pain isn’t sunshine and rainbows. If you avoid mental illness it is only because you avoid the level of it that triggers the label. But I bet you get down. I bet you get anxious. I bet you are stressed. I bet you struggle with your mood. We react to pain emotionally. It is pain. We have a reaction to it. Everyone does- the only difference is our pain never ends so our reaction is all the time and coping is trying to manage the pain and manage the reaction to pain and somehow be functional in a world that won’t compromise for us. And then sometimes after a few decades, we do not cope so well with the reaction to pain and the suffering. And we have ‘comorbid’ mental illness.
Well. What a shocker.
And obviously, it needs to be effectively treated along with the pain. Hell, if the pain had been effectively treated in the first place maybe most of us could have avoided the comorbid mental illness. But generally, pain isn’t effectively managed for a very, very long time. If at all. And consequences happen. Lots of complicated consequences.
(And end rant)
Let’s dig in a wee bit via another interesting article I found about pain research. Very cool read, by the way. Check it out.
The structure of the brain’s corticolimbic network, involved in memory and emotion, was different in people who developed chronic pain — before that pain developed. Further, people with a smaller hippocampus and amygdala, two parts of the brain related to stress, anxiety, and emotional learning, were also at greater risk of developing chronic pain. The results suggested “some intrinsic, genetically encoded brain property — and not the pain itself — led to chronic pain,” wrote Dr. Daniel Barron, a psychiatrist and neuroscientist at Yale University who was not involved in the research.
Pain in the brain is in the structures of the brain. And there has been research to suggest certain brains develop chronic pain while others do not. Not that you will have this specific chronic pain… but you will have a predisposition to developing A form of chronic pain. And maybe that is why some of end up with more than one form of chronic pain. We have the brain structure for it and then with chronic pain already it makes us more prone to, well, pain. The setup is already wired in there.
“In a way, you become a catastrophizer if you have more pain,” he says. And all these factors are highly interrelated. “The more pain you have, the more anxiety you have, the more pain you have, the more depression, the more catastrophizing, the more fear. All of those things sort of cluster together.”
And here it is mentioned that we do catastrophize with pain, as I said, it is a thing that tends to happen the more you live in pain. The more pain the more anxiety about pain, the more depression… the more catastrophizing… and on and on we go down the hill.
And basically, we know this and deal with it on many levels. He says they cluster together. I call it a clusterf*ck. Same difference. They muck about with our coping is what they do. As I said, not a surprise. It is something we have to cope with and wrap our heads around.
“For the first time, the study shows that the chronic-pain patient not only is suffering from chronic pain, but to compensate for that and cope with it, they actually develop lots of positive emotional and cognitive properties,” Apkarian says. “Their personality changes, in a positive direction. If only consumed with their pain, they would all commit suicide or not be able to survive. Instead, these people live. Yes they’re suffering, but they’re fighting the suffering.”
This part of the article is the best part because we do develop ways to cope with suffering in a lot of fundamentally powerful ways. We fight suffering in many different ways that work for us and survive. Yeah, sometimes the suffering overwhelms us but other times we are ahead of the game and we are coping well. We Can cope. That is the message here. And the methods we develop are skills we never had in the beginning of this journey and have helped us endure and persevere and live. That is pretty powerful.
I find this the most enlightened part of the article. We do change in profound ways. Yes, we are prone to mental illness. Yes, prone to catastrophizing. But, man, do we develop some hardcore coping mechanisms that in many ways are quite positive and are developed to help us survive, persevere, and cope long-term. It is amazeballs really. To think of the You Now compared to the You in the beginning of your journey… you have learned a crapton of how to cope and live with chronic pain and illness in ways people cannot even fathom. Many ways are extremely positive coping strategies. So not all doom and gloom, man. The strength, man, is amazing. If we just think about it for a bit.
“Pain is like a memory,” Tan says. “You’re locking in this information, long-term, hard-wired in. There’s lots of literature suggesting pain and memory are related, biologically speaking.” In fact, he and colleagues actually call the phenomenon “neuropathic pain memory,” and he believes these memories are stored in both the brain and spinal cord. “We don’t know as much in the spinal cord, but evidence from our work and others in more recent years show that the spinal cord is also important in abnormal pain processing.”
I posted this quote to remark on the fact pain is like a memory. Remember with chronic pain there is no injury left for the pain to be there usually. It is the brain memory of the injury on repeat. Basically out brains felt the injury and the pain, and got stuck on repeat from the trauma of that, and it never ever forgot it. With other conditions, the brain just became more sensitive to pain stimulus or all stimulus… until it causes pain and then pain begets pain. Chronicfication of pain is a bizarre thing and why it goes chronic instead of… not is dependant on a lot of factors including the brain itself. It is like an echo that just keeps on going and going. The brain is a broken record on this… playing a song long past its due. Turning if off seems to be impossible, at this point, turning down the volume we can sometimes do with some treatments. But sometimes, man, our control only lies in the emotional and mental suffering that comes from the physical pain. Sometimes that is where our actual control lies and where we can dampen it a little and change our perspective a little and cope a bit better. Not in the pain itself that seems to just play on and on.
But we fight our brains along with way. Chronic pain comes with it symptoms, it can trigger mental illness, it can have certain beliefs and thoughts, and ways of thinking, and lack of motivation and fatigue… and we have to wade through this swamp on a daily basis while trying to cope and make any sort of progress and this is insanely difficult to maintain.
**Someone called this a wee bit of a rant post. lmao. Well, I can have a wee bit of a rant post now and again. Not Entirely the point. Perhaps they missed that part but such is life. But, yes, a wee bit of a rant in there as well. I do like a good rant now and again. I guess I should tag it under my rant category, eh? 😉 Nevertheless, we do deal with mental illness and it isn’t exactly a shocker to Me, anyway. But we also develop quite amazing coping strategies and that also isn’t a shocker to Me.