Pain and Depression - Are You Overwhelmed or Proactive?

Chronic pain affects every aspect of your life. [It affects your quality of life as it limits your physical functioning, your ability to perform activities of daily living, and your ability to work. It has social consequences for your marital and family relationships, it may limit intimacy with your partner, and it may prevent interaction with friends. Given the pervasiveness of pain, it's no wonder that chronic pain affects your psychological well-being as well.

Why do pain and depression co-exist so often? Scientists have been studying this relationship through neurosciences and epidemiology and have made important discoveries. First of all, both depression and the suffering of pain are located in the same area of the brain. Second, the same chemical messengers are involved in regulating pain and mood.What are the mechanisms that affect these parts of the brain and these chemical systems? We find that depression runs in families, so that the stress of having pain may trigger the chemical changes in the brain leading to depression in persons who may be vulnerable because of a family tendency (genetic) to depressive illness. More commonly, however, a person has no family vulnerability to depression, but may get "worn down" by all the stress, losses and problems encountered by having pain over many months. Either way, this "wearing down" is biochemical, such that certain important chemicals (similar to vitamins) that are responsible for regulating both pain and mood appear to be functionally depleted. This is why the same medications that are helpful in depression may also effectively treat pain, because they enhance the pain and mood regulating effects of these chemical systems in your brain.

Seeking help and advocating for yourself are the first steps to treating your pain. Your physician's goals in treating you are to reduce your pain, improve your physical functioning, reduce your psychological distress and improve your overall quality of life. There are many different ways to treat depression and anxiety related to pain. Your physician may suggest one or more of the following therapies to reduce your psychological distress:

• Medication
• Cognitive-behavioral therapy
• Stress management (e.g., relaxation techniques, hypnosis, biofeedback)
• Supportive counseling
• Family counseling

It's important to remember that being depressed is not a sign of personal weakness – depression and anxiety are related to chemical imbalances in your brain. Depressive and anxiety disorders are illnesses that can be treated. Taking medication and going to therapy to treat your depression is the same as taking antibiotics to treat an infection – the necessary steps you take to get better.

• Keep a diary and record changes in your pain and emotions. Bring it with you to your doctors' appointments to remind yourself of how you were feeling and when you were feeling better or worse.

• Identify a support network. Support persons could include family members, friends, support groups. 

• Educate yourself through books, reputable web sites, and organizations.

• Set realistic treatment goals.

• Stay active – with your doctor's advice and approval, begin an exercise program.

• Try stress management techniques and use them regularly. Guided imagery, hypnosis, biofeedback, and relaxation techniques really can work if you work at using them. ]

This information is from the National Pain Foundation website:   http://www.nationalpainfoundation.org/articles/98/pain-and-depression

I have had chronic pain for 35 years (from an auto accident) and I struggle with feeling overwhelmed at times. I have found I cannot handle the stress of pain and depression along with other health complications alone. Sometimes I need someone from my support network to help me get back on track. Whether it's taking more time to pace myself because I'm doing too much - or  I may need to get out of the house and get out of myself. My friends and family help me immensely when I'm willing to listen to them and let them help. I will never forget there was a time when I had no support system and that was a very dark time in my life but I did make it through. I encourage all of you who deal with pain (or chronic illnesses) and depression to get the help you deserve. No one should have to deal with these symptoms alone.  Feel free to leave your comments here if this is something that concerns you. 

Addressing Emotional Eating Habits

I've been researching anti-inflammatory foods for the last several months. I've learned a lot about the nutritional value of eating a variety of vegetables and fruits, along with whole grains and lean meats to aid in healing my body. I know to avoid inflammatory nightshade vegetables. I understand the difference and benefits between Omega 3 and 6 fats. And I know how to adjust my food choices to compensate for my digestive disorders. There are links to all of the posts I've blogged about. But to be perfectly honest with myself, I'm having trouble with emotional eating, especially at night.

I've identified one source of this type of eating (for me) as a result of taking multiple medications late in the evening. I take 10 tablets between dinner and bedtime. My thinking has been that all this medicine upsets my stomach, so I have a little (too much) to eat. Now that I've learned I have Gastroesophogeal Reflux Disease (GERD) and Gastroparesis (paralyzed stomach), I realize I'm only adding more stress to my already compromised digestive system. So why do I do continue to eat at night? There's more to this than just what I thought was a physical feeling.

I don't have all the answers yet. But I have been researching emotional eating on several websites, including WebMD and NIMH. The Mayo Clinic defines emotional eating as [a way to suppress or soothe negative emotions, such as stress (physical and mental), anger, fear, boredom, sadness (depression) and loneliness. Major life events and the hassles of daily life can trigger negative emotions that lead to emotional eating and disrupt your healthy eating efforts. Sometimes the strongest cravings happen when you're at your weakest point emotionally.] Well I certainly fall into the category of daily life triggers. Besides the health issues listed above, I also manage chronic pain from Fibromyalgia, Arthritis and Neuropathy, Irritable Bowel Syndrome, Chronic Fatigue Syndrome, Hypercholesterolemia, Diabetes and Liver Disease. My body is under a lot of stress every moment of every day and has been for 30+ years.

On Women's Health (about.com) there's an article that addresses the mindset of "dieting" or limiting food selections. For those of us with Diabetes, we must keep track of the type and amount of  carbohydrates we eat, in order to stabilize our blood sugars. Having the mindset of tracking foods, keeps us in control - or so we think. However, mentally we are always thinking about food and making a judgement of whether we're staying within our boundaries. If we eat too much, or eat a restricted food (not within our food list), we tend to beat ourselves up. This negative thinking can cause depression or a sense of failure, and we give into the notion of that we have no control after all. Our negative thinking patterns can have a destructive influence on our eating behaviors.

So I went on to research the psychology of eating disorders (about.com), night eating syndrome (wikipedia.com), and the role of caloric intake on sleep disorders (nature.com). All very interesting stuff. What I discerned from these various articles was that treatment for eating disorders usually involves anti-depressants, possibly an appetite suppressant, and cognitive behavioral therapy (CBT).  The underlying concept behind CBT is that our thoughts and feelings play a fundamental role in our behaviors. Since negative feelings or thoughts reinforce faulty beliefs about ourselves, we can change those thoughts by first identifying them. The next step focuses on learning and practicing new skills to cope with the eating disorder (night eating).  CBT is a gradual process which makes incremental steps towards changing a destructive behavior into a positive healthy behavior. CBT entails multiple strategies and is well-suited as a short term treatment option.

This is definitely something I will think more about and talk with my doctor about. I hope this has been helpful information for you personally or to think about the effects it may have on your co-workers, friends or loved ones. Maintaining a healthy weight and lifestyle is critical to helping our bodies heal, but it may require we take an in-depth look at our eating habits.

Depression and How It Effects Your Well-Being

Depression is a very common illness effecting up to 25% of the world's population (roughly 340 million people*). Depression is thought to be a brain disorder, caused by abnormalities in the levels of neurochemicals in the brain.  Chronic depression is a long term disease which can effect a person's basic ability to function on a daily basis.

The cause of depression may include factors such as genetic vulnerability, physical or mental trauma, loss of a close family member or friend, chronic illnesses, multiple surgeries, or high levels of stress. Often there are multiple things which combine over time and effect the chemical composition of the brain. Treatment usually involves medication and psychotherapy. Many symptoms improve with careful monitoring of your health care.

One of the most difficult problems for a person with depression is reaching out and seeking medical assistance. The person tends to withdraw and pull away from others. Feelings of hopelessness, despair, lack of self esteem, the stigma of having a mental illness, the threat to job security or family relationships, changes in sleep patterns, appetite, concentration, loss of interest and irritability are all very real. Untreated depression can lead to personal and marital troubles, financial difficulties, and a terribly high (up to 15%) suicide rate.

I have suffered from depression most of my life but have been on medication over the last 15 years. It's been helpful understanding how my young life experiences contributed to my illness along with a traumatic auto accident, recurring surgeries and the now the resulting diseases I have.

I remember going to a seminar on Fibromyalgia and the guest speaker, a world renown specialist in the field, was asked a question from the audience. The question was, what does a person with Fibromyalgia (all over chronic pain) tend to die from? The specialist hesitated to answer and then very frankly said, suicide.

Chronic pain, whether it is physical or mental, is excruciatingly difficult to live with. When the pain is both physical and mental, it is unbelievably overwhelming and can even be paralyzing. All I can say is be kind to yourself or your loved ones suffering with depression. Your love and hope matter on a daily basis.

Try to eat a healthy diet and exercise every day, as these are equally important to obtaining optimal health. I find when I do these two things, life seems much better. Releasing endorphines through exercise is very healing for the body and mind.

Keep checking back for more tidbits of info and support.


(* figures provided by the World Health Organization, http://www.depressioncenter.org/ Depression as an Illness)