Body

Chronic pain and mental health

My chronic back pain has a long history. I have come from uncomfortable sensation in my shoulders during the day to constant stiffness, pain and fatigue starting just when I wake up. I am a strong believer that everything that we struggle with within our bodies, by that I mean any chronic illness, has its initial cause. By not knowing that cause (etymology) we can't cure any disease (at least with intention to do so). So, trying to find out the original cause of my chronic pain has become my passion for the last few years. Not because I like to constantly think about my pain, but because I love learning about my body and mind: how it functions, what causes the disease, etc. And of course, I hope to find a "magical cure" or solution to help myself one day.

The reason why I am talking about self-help so much is not because I never go to doctors, in fact I highly encourage you to go see a doctor if something is bothering you instead of reading information online. Not only it can be very overwhelming and stressful, but it is also very misleading (next thing you find out is that you might have cancer). It is almost impossible to self-diagnose simply based on the symptoms, so it is important to seek medical help first and to do all needed tests in order to make sure you there is no further damage. 

However, many of us do regularly see our doctors but are told that pain is "normal", it's "in our head", "there is nothing serious", etc. Although it is extremely helpful to know there's nothing serious with me, it doesn't help with my pain, neither does thinking that it's in my head. That's when my own research comes into place. Perhaps this additional knowledge can help guide a busy doctor to look in the right direction, or maybe further life-style changes that we might find about educating ourselves, can help us cope. No matter what the result is, knowledge is power, how we are going to use it depends on us

Interestingly enough, not long ago I found myself in love with learning about connection between our mental health and chronic pain. Of course, if you think about it logically, then this connection will make a complete sense. For example, anxiety causes our muscles to tense, and prolonged tension causes pain. If this pain lasts more than six months, it becomes chronicIn my case I used to be constantly anxious for many years. I think there are more factors to it, of course, including unhealthy lifestyle and more. Our bodies are so complex, that it would be quite silly of me to think that only one factor has contributed to my chronic pain, in fact something had to contribute to my response to stress which led to anxiety disorder. But I'll try to keep it more or less simple and just talk about things that are connected to mental health in this post. 

Pain-depression connection

The neurotransmitters in our body, serotonin and norepinephrine, influence both pain and mood. Their dysregulation is linked to (surprise!) depression and pain. Studies show that the more physical symptoms a person has the more chances are that he or she has a mood disorder.

If I am having many seemingly unrelatable physical symptoms (which does happen quite often), I focus on my mental health more (if I think it's something serious, I go to a doctor, but I am learning to recognize when it is an actual physical problem and when my mind is trying to tell me something through body sensations). 

However a treatment does not bring complete remission from depression if it doesn't address physical symptoms[1]. So, it is a double-edged sword. It is still not fully understood what comes first, and for different people it will probably be different, as many factors come into play. For example, patients with preexisting depression were found to be more likely to develop chest pain and headaches within 3 years.

Pain-anxiety connection

Research shows that chronic pain and anxiety-related disorders are very much connected. It makes sense, as both signal possible danger and the necessity for action. It is a survival mechanism that our body has learnt. 

Increased expression of PACAP - a peptide neurotransmitter the body releases in response to stress - is also increased in response to neuropathic pain and contributes to the symptoms of pain[2]Knowing that it is easier to respect and understand our body, that was perfectly designed for the environment we used to live in. It is not very well equipped for our today's reality, though.

Catastrophizing, hypervigilance and fear avoidance tend to make pain worse[3]

Also elevated hormone cortisol that our body releases in response to stress has been well documented and linked to pain somatization disorders, such as fibromyalgia, chronic fatigue syndrome, chronic pelvic pain, and more[4]

Of course, there might be more to it, but you get the picture. When I was younger, I experienced many traumatic events that in turn led to inability to cope with constant stress. Now I am here struggling with not only mental but physical pain, which can be very debilitating. However now when I know my "weak spots" and when I know how important it is to recognize when I am stressed, I can prevent my body from getting even worse. 

Painful emotions

It is very interesting how our emotions can translate into pain in the specific areas. Here you can find what emotions cause pain in certain parts of our body. Emotions that we don't listen to (as they try to tell us something) can cause inflammation and then chronic pain, so it is important to recognize what our body and heart are trying to tell us. For instance, shoulder pain (that I suffer from) can mean that I carry too many responsibilities (at least I feel that it's a lot, and it feels like weight on my shoulders). Learn to listen to your body and mind, which means paying attention to your feelings and body sensations that may come as a result. 

Taking care of both: mental and physical

There are a few ways how we can address both issues at the same time. It's important not to ignore any of our symptoms and pay attention to what we are feeling now. Do I feel any emotional pain that can translate into any physical sensations? Am I stressed and therefore tensed? 

Avoiding stress and anxiety 100% is impossible, but there are certain lifestyle changes that help coping with them a little bit better.

The truth is that for everyone it is going to be different. Maybe regular exercise makes you feel worse, or there is a certain type of movement that works for you. Perhaps there are certain things that trigger your anxiety and therefore chronic pain. Try to find what works best for you. It is very important, because many people don't realize what sounds good to them may not feel good to others at all and vice versa. I would like to encourage you to spend more time learning about your body and its needs.

One of the reasons why I wrote this blogpost was also to encourage you to seek help if you need it. Since your physical pain can be a result of your mental pain, you might need to talk to a therapist and perhaps even try medication. I know that many people can be terrified from having an idea of mental illness medications, but mental illness is just as real as a physical one, it can and should be treated

I would like to mention that self-love is incredibly important in my journey to recovery. I felt the worst when I hated myself, I used to self-sabotage and ignore what my body was trying to tell me. According to science[5], "the cells of our body are merely following instructions given by the nervous system, by the brain", so it is no surprise that at some point I found myself feeling incredibly unwell. I was stuck in my victimhood mentality, focusing only on my mental pain, sending messages to my body that I didn't care about it. It was a dark place to be in. 

So, if you feel like you are suffering, have compassion to yourself, pay attention and take care of yourself. Dealing with chronic pain isn't easy, and nobody has all the answers, but try not to give up and look for the solution that will work best for you.


References

[1] Madhukar H. Trivedi, M.D., The Link Between Depression and Physical Symptoms, article, 2004,<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC486942/>

[2] University of Vermont, Connection between chronic pain, anxiety disorders found by researchers, article, August 31, 2016 <https://www.sciencedaily.com/releases/2016/08/160831133421.htm>

[3] Kara E. Hannibal, Mark D. Bishop, Chronic Stress, Cortisol Dysfunction, and Pain: A Psychoneuroendocrine Rationale for Stress Management in Pain Rehabilitation, article, December 2014, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4263906/>

[4] Adam KM Woo, MB BS FRCA, Depression and Anxiety in Pain, article, March 2010, <https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4263906/>

[5] Bruce H. Lipton, How to Heal Your Body With Your Mind, blogpost, March 2017, <https://www.brucelipton.com/blog/how-heal-your-body-your-mind>