Pain; something we are all trying to avoid in one way or the other. Some of us are running away from physical pain and some of us from emotional one. We work to make sure that pain never comes and if it does, that it goes away soon. What happens when the pain doesn’t go away?
What happens when the pain is there to stay?
Chronic Pain & Mental Health
There are many physical illnesses that have chronic pain as a symptom. This includes rheumatoid arthritis, interstitial cystitis, multiple sclerosis and fibromyalgia among others. It makes sense to think that being in pain causes stress and may lead to anxiety or depression but we don’t really understand the whole depth of it. Let me paint you a picture to help you understand.
“You wake up one morning with excruciating pain in your lower back. You have to urinate 30 times a day and every step you take hurts. Your doctors tell you that the pain is in your head and it is a simple UTI but you know the pain is real. The pain is constant. It is there for every second of every day. You wake up in pain and you sleep in pain. When you seek treatment you are told that it is just in your head. Slowly, you learn to tone out the pain but you cannot do it forever. Sometimes the pain is high and sometimes it is low, but it is always there. No one believes that you are in pain since all your reports are normal.”
This is the story of a friend of mine who had to suffer for months due to the non-diagnosis of Interstitial Cystitis. You can read more of her work here http://interstitialcystitis-india.blogspot.com/2016/03/Interstitial-Cystitis-India.html?m=1
It wasn’t even thought that this disease existed in India before 2011. It was then that a doctor pointed out that the disease exists but is not diagnosed due to lack of knowledge. (Remind you of something else?)
Physical Pain Has Emotional Consequences
Pain has emotional and mental consequences. Chronic pain makes it even worse as people tend to be traumatised by the persistence and intensity of the pain. Pain killers help but only to a certain extent and the mind unavoidably goes to dark corners in search for an end to the pain.
People who have suffered from chronic pain have admitted to having thoughts about suicide or self harm. Those who indulged in self harm reported an ease in pain, but only temporarily. The relief was fleeting and lasted for a few minutes at best. Mutilation ultimately ended up becoming a destructive addiction for them.
A study also pointed out that chronic pain and how we deal with it affects our feelings of depression. The correlation between chronic physical pain and presence of depressive symptoms is explained by other features which are not related to pain. Chronic pain itself does not necessarily predict psychological distress, rather, other mediating factors such as self-efficacy, catastrophizing and coping strategies might play important role in affecting psychological well-being of chronic pain patients.
Health practitioners handling chronic pain patients need to evaluate patients’ psychological aspects so that treatment can be provided effectively, for example, conducting treatments with the aims of maximizing self-efficacy and minimizing catastrophizing. Consequently, this may help chronic patients to improve their psychological well-being.
It is important that they stress on how we cope with the pain and how to maintain maximum efficiency despite the pain. It is hard not to catastrophize chronic pain since it comes with large emotional and physical costs but if we manage to keep it to a minimum, we might be able to protect our psychological well being.
Z, Farezadi & Normah, Che Din & J, Zubaidah & C, Maria. (2008). Chronic pain and psychological well-being.