The Vicious Cycle of Chronic Pain and Depression

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There once was a chicken. And also an egg. And nobody seemed to know which arrived first.

Today, the mystery has yet to be solved.

For many folks with chronic pain, including myself, it seems we are trapped inside our own chicken and egg enigma with real-life consequences. Those consequences are the devastating, debilitating and derailing forces of depression.

Roughly 50 percent of people with chronic pain also have depression, according to Robert D. Kerns, National Program Director for Pain Management for the Veterans Health Administration. Many symptoms include the feeling of loss, isolation from friends and family and fatigue.

To further complicate things, these same experiences can also be results of the chronic pain itself that have caused the depression.

Unrelenting pain can take away so many of the things and activities you used to enjoy or even rely on, making you feel you are no longer yourself. For example, my life used to revolve around yoga. I was in the studio at least four times a week getting in touch with myself as well as getting in shape. I could not remember feeling any better than I did at that period in my life.

Then I got the ground pulled right from under my feet when I was hit with chronic migraines, neck and shoulder pain seemingly out of nowhere over two and a half years ago. I haven’t done yoga since.

The practice of yoga staved off my depression that I had experienced off and on since high school, so losing it was, and still is, something I had to grieve. That grief can become long-term and turn into depression as time goes on, and  you no longer recognize the person you’ve become. So not only are you missing the things that once gave you life, you’re also missing yourself.

You also now have two conditions to treat  —  pain and depression  — that are separate in one way but completely intertwined in another.

This creates a snowball effect. Actually, no, it creates a blizzard.

Pretty soon, you don’t know where you are, who you are or what’s ahead. This feeling can make your physical pain feel so much worse. This pain then makes you even more depressed than you were before, and the cycle continues.

And when I look back, I can’t see a damn thing.

The person I used to be and the life I used to live is something completely foreign to me now. This experience and this pain is all I know. At 28 years old, I’ve involuntarily taken on the role of a shut-in aside from going to work, which in itself is a challenge. I no longer socialize with my friends because it’s exhausting and painful. I no longer exercise because it’s exhausting and painful. I no longer clean my apartment or go to the store or travel because it’s exhausting and painful. If I have to do those things, I pay the physical and mental price for days. And the cycle continues once more.

Then, of course, you wonder: Would I still have this depression if my chronic pain was treated?

At this point, it is hard to say. It has become so ingrained into my being that I can’t imagine anything else. I can’t imagine not crawling into bed right after work and staring at the ceiling for hours until I eventually fall into a horrible and restless sleep. I can’t imagine picking up my niece and not cringing in agony. I can’t imagine going for a jog and not feeling my collarbone begging to burst out of my chest.

I long to do these things more than I can even describe. And that longing is painful and heartbreaking.

And, once again, the snowball flies down the hillside.

I don’t know what lies ahead or if there is calm after this storm. I’ve been continuously let down by false hopes from doctors and I’ve spent countless minutes in the car crying after a diagnostic test turned up negative.

I obviously still need to believe there will be relief one day. But until then, I tumble in the cold.

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Thinkstock photo via chaoss

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What They Didn't Tell Me About Starting Medication for Depression

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Editor’s note: Please see a doctor before starting or stopping a medication.

What didn’t they tell me? Sorry, but quite a lot actually.

She told me about trembling, dry mouth, weight loss and the lack of energy.

“Lack” should be in capitals spread across the page. Like it’s the main part of the article.

The side effects for the first week are excruciating, sorry to say.

They don’t tell you about the lack of motivation, hopelessness and worthlessness that arises upon you while you’re battling through your first week. In fact, you may feel worse than you were when you started.

As a young, depressed 17-year-old, awaiting the freedom of leaving the dreaded school year, this last year is making me feel immense pressure I’m trying to fight through.

When I started the medication, I noticed a plummet in my energy and happiness.

I didn’t want to go to class. I just hid for the day crying until I was numb and throwing up.

I felt empty. I cried myself to sleep pretty much every night.

But you might not go through this, and believe me, that is terrific!

But I don’t want to sugar coat this, you won’t feel better instantly — it might take a few weeks after being on medication for the first time.

Every beautiful body is different and will react differently to medication. There is no wrong or right way as to how you’ll feel, but it’ll be worth the fight once you get through the side effects.

You’ve already overcome the hardest step and I’m proud. Proud for the courage you’ve had to confess that you’re struggling. The strength to say you need “extra” help to get through this pain.

You may feel hopeless in the first few weeks. And thats OK.

The side effects shall pass, it takes time to get the right medication that is right for you, just please don’t lose hope.

Please know good things will take time, promise.

Reach out to those that love you. You’re not alone in this fight, never.

You’re important, you matter and you’ll get through this, stronger than ever.

I promise.

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 Thinkstock photo via Makidotvn

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Why My Depression Is Like a Power Outage

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This week, we had a power outage. There are around 20 other houses along our road, all of which had a power outage too. It was a storm that bought it on, however the rest of the village had power. In trying to keep my brain occupied with the lack of light, warmth and things to do in general, I found that maybe I have more in common with power outages than I ever thought.

Although we had no power, everything else carried on. I still had to attend sixth form, still had to get work done and still had to attend planned events. To me, this felt all too similar to my depression. Every day, I wake up despite what was whirling through my head the night before. I may have stayed in bed all day, maybe I only had an hours sleep — I don’t even think I managed to brush my teeth — but still the world goes on. The world doesn’t care about how each and every individual feels. They don’t care what happened to you today, or yesterday or even three weeks ago. Because the world will still go on.

Depression stops people, but depression doesn’t stop the world. Depression is selfish. Depression thinks it’s OK to not let someone out of bed to go to work, even though their employer threatens to fire them if they don’t attend. Depression thinks it’s OK to not give someone the energy to eat a meal, even though their doctor demands they eat three substantial meals a day. Depression thinks it’s OK to not let someone complete their assignment, even though their teacher will pull them out of their course if they don’t hand it in.

I really related to Thursday’s power outage. Each and every day, the weather in my head is different. Occasionally there are amazing bouts of sunshine, most of the time it is constant rain with a slight wind and then every so often, there’s a storm. The rain isn’t enjoyable, but it’s bearable. But whenever there’s a storm, it wipes me out. I can’t function. My whole body stops. I can’t move — my God, it’s even hard to breathe. But that doesn’t matter, does it? Because still I’m expected to carry on with my life as if nothing is the matter.

It’s just like a power outage, really. The world doesn’t stop for a power outage and the world doesn’t stop for depression.

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Unsplash photo via Chris Lawton

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4 Songs in My Depression Recovery Playlist

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A couple of months ago, I wrote an article about songs that help me through depression. While I still love these songs, I’m tired of wallowing in the fact I’m depressed.

Subconsciously I changed my playlist to more inspirational upbeat songs.

Since I shared my previous songs with you all, I wanted to share the songs that push me to get better. Recovery will never come if you don’t separate yourself from the label. You are so much more than depression and anxiety, and here are some songs that might help you:

1) “At My Best” by Hailee Steinfeld and Machine Gun Kelly


If you can’t take me at my worst / you don’t deserve me at my best.

The best thing you can do for yourself during hard times is to weed out the people who don’t care about you. A common name for these people is “fair-weather friends.” These are basically the people who are only down for good times. While those friends are fun to be around, they will never be the ones holding your hand and at the end of the day, they won’t be there for you.

2) “Rise” by Selena Gomez

“You can hold onto the sadness like a souvenir / Or you can close your eyes / and see your life / Like the air / you can trap the strength you never knew you had … You can rise from the rubble.”

To me, this song just proves recovery is out there. It may seem like it doesn’t exist, but it does. You can get better. You will get better. The world is never as bad as it seems because you have so much strength in your heart.

3) “Temporary Home” by Carrie Underwood

“This is my temporary home / It’s not where I belong.”

This world is so temporary. In the moment pain seems like it will last forever, but it won’t. We are guests here. I believe the real life is up in Heaven. No matter what you believe, pain will just be a memory someday. You won’t care what people said — who liked you, or who didn’t. It doesn’t define you.

4) “Girl on Fire” by Alicia Keys

“She’s just a girl, and she’s on fire.”

You are a fighter. Look how far you have come, how much pain you have endured. I’m so proud of you.

You can get through anything. You are unbreakable and there is nothing you can’t handle. Depression has nothing on you.

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Unsplash photo via Siddharth Bhogra

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The First Step to Being OK Is Admitting When You're Not

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Everything around me was buzzing. There was lively chatter. There were people everywhere. But I felt nothing. I felt numb and alone, and as the lump in my throat formed I knew what was coming. I was going to cry and as someone who doesn’t cry often it was a foreign feeling.

I knew my depression and anxiety were giving me shit. I could feel it when I woke up in the morning and I was starting to forget the reason I was even here anymore. Then the affixation of whether I made the right decision sets in. I focus on it and tear it apart as I try to ease my mind and give me some temporary relief. But it wasn’t going to come as easy this time.

I hate when people say you’re fine or you’ll be fine. I know I’m fine, but I don’t want to be just fine. I want to feel happy. Even as I sat in one of the most beautiful cities in the world with amazing people I had just met, I wondered if this was it. If this is what my life was going to be for the rest of my days. If I was going to have to keep moving, keep meeting new people to feel the momentary high that makes everything worth it.

I was always good at faking my smile. I think it’s because it’s the only thing that came naturally. Even in the saddest, most uncomfortable moments there is always a smile plastered on my face. And maybe that’s what confuses people. Maybe I’m not able to open up and tell people that right now I’m struggling so hard to just stay afloat. To continue to look at myself in the mirror and not hate the reflection and fake smile looking back at me.

I was tired of being nice. I just wanted to be mean, to be angry. But I wasn’t ever allowed to be angry. As soon as my personality changed from bubbly to even slightly upset, people treated me as if I had a disease and they would actively avoid me or bombard me with questions. I hated feeling like I could never be anything but happy because it would burden the rest of the world.

So I hide it. I don’t tell people the shit that hurts or confront the assholes who’ve taken advantage. I bury it down deep until it explodes out in self-hatred. How could I be so stupid to let people come into my life, take what they need and go again? How could I think my life would fix itself if I don’t ever want to confront the issues?

That’s the thing about reflection. Sometimes the deeper you dig, the more things you see that you don’t like, things you desperately want to change. Memories you didn’t want to ever think of again. Or the people who hurt you but you still don’t hate and probably won’t ever, because hating them would take away from hating yourself.

I hate giving people advice anymore. It felt so cheesy and hypocritical to tell people how to be happy when I couldn’t even do it for myself. I don’t mind listening to people who are upset but I feel like I have nothing to offer them but tired old clichés and sympathetic nods. I didn’t even know who I wanted to be anymore, let alone be able to give someone what they need right now.

So what happens when you get so deep down the tunnel that digging yourself out seems like an impossible task?

I think you give yourself a fucking break.

That’s it. Give yourself a break. Worry about nothing but yourself. The people who love you will always be there if they are truly meant to be. Self-care is never selfish. It’s also OK to just not be always happy. Know you’re resilient and that in time you’ll get back to yourself.

This is the time when I need to take my own advice and give myself a break, even though right now all I want to do is tear myself down. Eventually, bit by bit, I’ll get back to me. But it takes time and I’m starting to be OK with that.

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Unsplash photo by Mike Wilson

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When I Was Reminded of the 'Growing Pains' of Therapy

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I’ve been to therapy before. OK, that’s an understatement. I’m what I like to call an “advocate of therapy.” I’ve used it. I believe in it. I basically tell everyone I know they should find a therapist. For me, therapy has always been a positive. Something I would do for me. To help me. I would almost go as far as to say it’s my “me” time. How many parents out there hear what I’m saying? Where else can we go and have peace and quiet and almost one whole hour of uninterrupted time to talk about us? Then add the topping of leaving therapy feeling as though there’s been some kind of weight lifted off our shoulders. Just writing about it makes me want to call my therapist and squeeze in a mid-week session!

But then it came time for my husband to see a therapist. In my heart of hearts, I knew it was a good thing. I was looking forward to it. Hopeful. He had struggled with depression for as long as I had known him, and it was only masked by his use of alcohol in our younger days. Given my love of therapy, you can imagine my enthusiasm when he finally agreed to start counseling! Looking back on the beginning of this journey, I’ll always hear the words of my therapist, “Janae, your struggle is going to be remembering that he is becoming something entirely new.” I shrugged it off happily. Of course he was! He was going to therapy. He was going to be changed. Transformed. It was going to be amazing! Butterflies. Rainbows. The whole happy nine yards!

What I forgot in my enthusiasm was how painful change can be.

I forgot that in between the old and the new, was growth. And growth can only come with an abundance of growing pains.

I had forgotten from my own therapy from years ago — the therapy that probably saved my life and allowed me to become someone who can see butterflies and rainbows — the word I had to memorize was perseverance.

So the day came when my husband came home from counseling, and I was short with him. I didn’t understand why he wasn’t happy. He’d just gotten an hour of “him” time. What was his problem? And in that moment, in my nicest “I’m over being home alone with the kids, why aren’t you completely revived after seeing the therapist” voice, I called him out on his attitude.

One of the first things he was working on was communicating, and I was blown away in that moment at how he conveyed the emotion of being hurt. Up until this time, and throughout his depression, the only clear emotion he could convey was anger. He simply looked at me and explained how not everyone has the same experience with therapy that I had. For him, in order to get to the good, in order to see through the journey to the other side, he has to go through some muck! He was delving into areas he had avoiding his entire life. And this strong as steel man was breaking. He was feeling emotions he hadn’t allowed himself to feel in years. And all the while, he was trying to be what he couldn’t be for us in those times of battling depression. He was trying to be more present. To be more joyful. To be more kind. And to have hope.

In what some would see as a moment of weakness, I saw a moment of strength. I saw my husband fighting a battle that most won’t ever know the pain of fighting. And in that moment, I was humbled by his choice to be honest with me, to be transparent in what he was going through.

As the spouse of someone beginning this journey of therapy, I am learning what my role is. I will be hopeful. I will offer grace. I will listen. I won’t forget that perseverance matters. He will get there. I will continue to be his safe place to land, and I will remind myself my love is so needed.

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Thinkstock photo via shironosov.

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