Reprinted with the permission of the PAINS Project
I’m not “just” depressed!
As a person who lives with pain, I am well aware that the last thing any of us want to hear is, “You’re depressed.” In fact, we tend to fear that label and avoid it like the plague, particularly because we translate it to mean – “You’re not really in pain. You’re just depressed.”
In the first year of my pain journey, tears of frustration came quite easily. Frustration with the system and the difficulty in finding help. Frustration with the constant pain with no relief and not one person to tell me why this was happening or what I could do about it. Frustration with not being believed. I sometimes wonder how often my pain was dismissed and those tears were recorded as “depression” in my medical record.
The Pit of Depression
Have I been depressed about the situation I find myself in? Certainly! Wouldn’t anyone? There were times in years past when I felt like I was facing a losing battle and the fear, pain and loneliness had me feeling like I was at the bottom of a deep, dark pit, unable to climb back out.
Human beings are by nature social animals, and I’m no exception. Before my accident, I led a life full of activity. I was working 60-80 hours a week running a community center with programs for seniors and children. When I wasn’t working, I spent time with my family going to movies and attending the children’s sports and school activities.
Living a life with pain means giving up so many of the activities we take for granted. Pain isolates us from our families and friends to the point that they fade into the woodwork and we find ourselves alone much of the time.
I work from home now. I use email to communicate with my clients and my daughter got married and moved away, so it’s just me and the cat. The silence can be deafening, and I have to use all of the tools in my tool belt to keep from falling back into the pit.
I’ve learned that what I experienced is referred to as situational depression. It was during those times that I turned to my online peer support group. Those people living with pain 24/7 who really understood. They helped pull me back out of “the pit” and helped me to see all of the good things around me that I was missing by focusing on what I had lost.
Chronic pain isn’t just about the physical pain. Chronic illnesses devastate finances and families and often result in job loss, divorce, bankruptcy and more.
It’s no wonder that depression plays a part for so many. It’s normal!
Pain, Depression and Stigma
Those who live with chronic pain also live with the stigma that comes with wearing the label of pain patient. We’re called malingerers, drug seekers, lazy and more.
Since depression is a mental health issue, it carries a stigma as well. The National Institute of Mental Health (NIMH) website lists four things that everyone should know about depression:
Depression is a real illness.
Depression affects people in different ways.
Depression is treatable.
If you have depression, you are not alone.
The same could be said for chronic pain:
Chronic pain is a real illness.
Chronic pain affects people in different ways.
Chronic pain is treatable.
If you have chronic pain, you are not alone.
So then, why was I afraid to ask for help with depression? I lost my job, my home, my spouse, my independence, my transportation, my ability to walk unassisted, my ability to do simple things like tie my shoes and fold a load of laundry and so much more. It would only be “normal” to need some help in dealing with all of that.
Thankfully, my former employer paid for a year of counseling for me. I learned some things over that year. There was no shame in going to a professional for some help in working through all of these changes in my life – and – it helped. Going through some therapy gave me the tools that I need to stay out of the pit.
A peer support group is a crucial part of my chronic pain toolkit and, after almost sixteen years living with pain, it remains one of the key things that helps me live this new chapter in my life. However – it cannot be a substitute for professional help when needed.
We don’t try to make major repairs on our car without a mechanic. We call the plumber when the basement is flooded. And we all know the quote from Abraham Lincoln, “He who represents himself has a fool for a client.”
We struggle so much just to be believed about our pain that we can be truly terrified to admit that perhaps we need help with depression as well. Perhaps we are suffering from major or clinical depression and need ongoing treatment. None of this negates our pain. In fact, depression and pain can feed off of each other, making both challenges worse.
If you find yourself “in the pit” of depression, don’t try to fix it on your own. Seek help.
If you are in crisis and need immediate emotional support:
Call your or your loved one’s health professional.
Call 911 for emergency services.
Go to the nearest hospital emergency room.
1-800-273-TALK (1-800-273-8255) National Suicide Prevention Hotline
1-800-442-HOPE (1-800-442-4673) Kristin Brooks Hope Center National Hotline
1-877-Vet2Vet (1-877-838-2838) Veterans peer support line or chat online
1-800-SUICIDA (1-800-784-2432) Spanish speaking suicide hotline
IMALIVE.org (volunteers are trained and certified in crisis intervention)
If you think you or a loved one might be depressed, click here to learn more the signs of depression and where to turn for help.
Suicide and Chronic Pain
I began writing this blog last year thinking that November would be an important time to address depression and suicide as it relates to chronic pain. As a lay person, I’ve read about seasonal affective disorder (SAD), a type of depression linked to the seasons, and I assumed that depression and suicide would be more prevalent during this time of year. I’ve learned recently that suicides are actually more prevalent in the Spring. Of course, one life lost is too many and this topic is valid regardless of the season.
I have never experienced these types of thoughts and feelings. I was fortunate to have discovered the importance of having hope very early in my pain journey and I credit my peer support group for helping me hold on to it. They were positive, upbeat, laughing and joking together – and sharing tips on gardening and other hobbies they were participating in.
I was dumbfounded. How were they able to laugh? How could people with severe back pain do gardening? I had to learn how they were doing it.
Fifteen years later, I still have a brown thumb, but I laugh, I joke and I have a life that is not held hostage by pain. Peer support, professional counseling and lots of teaching from numerous organizations dedicated to helping people living with pain have given me hope and purpose. Without that support, things could have been quite different.
Many people living with pain have lost all hope and feel completely alone as if no one else could understand. Despite the estimated 25 million people who live with severe (known as high-impact) chronic pain in the US, so many have no idea that there are others going through the same thing. I want them to know that they are not alone. There are people who do understand and who are advocating for better pain care. And there is hope.
The most important thing for anyone who is having these thoughts and feelings is to reach out for help.
PAINS will publish an educational brief on chronic pain and suicide in the next few weeks. Watch your email for a notice when it is published for more in depth information on the connection between chronic pain, depression and suicide.
Depression Basics – NIMH
MentalHealth.gov – HHS
Pain and depression: Is there a link? – Mayo Clinic
Seasonal affective disorder (SAD) – Mayo Clinic
Situational depression vs. clinical depression – Medical News Today
Situational Symptoms or Serious Depression: What’s The Difference? – National Alliance on Mental Illness
About the Author: Carolyn Noel serves as webmaster for the PAINS Project website, coordinating content for the website and social media and providing IT support to the team.
Carolyn was severely injured in a rear-end auto collision in 2002 and has suffered with chronic pain ever since. She has been diagnosed with fibromyalgia, degenerative disc disease, six herniated discs, a traumatic brain injury, peripheral neuropathy, basilar artery migraines, sciatica, etc. She spent nearly five years in a wheelchair and is now walking again. She shares her story of the many challenges she has faced along with her successes as a means of inspiration to others in pain.
She served for six years in the Marine, Corps attaining the rank of Sergeant, and is a former Captain with The Salvation Army. She currently serves on the advisory council of her local Salvation Army Corps.