Friday, December 12, 2008

New Research on Pain

A recent study in General Hospital Psychiatry demonstrates that people with chronic pain are more likely than others to have suicidal thoughts and to attempt suicide. In addition, those with chronic head pain are more than twice as likely to have suicidal thoughts than those with other kinds of chronic pain. Of course, the large majority of people with chronic pain are not suicidal. Here's a link to a summary of the research.

My headaches have been chronic for the last three years, but I have never been suicidal. I have had lots of depression issues since the headaches got bad, so I am on an anti-depressant, with no intention of going off anytime soon. (I tried to go off the anti-depressant a year and a half ago - it wasn't pretty - I sat on the sofa and stared.) Even though I haven't thought about suicide, I can understand how someone's thoughts would go that direction.

Pain itself causes changes in the brain that make a person more likely to be depressed. Doctors who treat chronic pain patients should pay close attention to depression symptoms. Chronic pain can also negatively affect a person's productivity, social life, occupation, and family life. I find that my mood tends to go downhill when I have several days of headache because I don't like not being able to keep up with housework. I also get more depressed when I have to miss social events or, worse, family activities because of headaches.

The main reason, I imagine, though, that people in chronic pain get suicidal is hopelessness. It is hard to look at the future not knowing if I will ever be pain-free. My life for three years has revolved around pain, pain medications, catching up after headaches, planning around headaches, etc. When my head doesn't hurt severely, I'm often exhausted from just having the headaches. Having been a planner all my life, I find it difficult to look ahead a week, a month, a year, or five years, and not have a clear plan of what I'm going to be doing. When life becomes wrapped around pain, I can understand not wanting to go on anymore.

So, why have I never made it to being suicidal? Part of it may be that I've been a naturally optimistic person. When I get depressed, I get sad, blue, unmotivated, and melancholy, but not ready to completely give up. The main reason, though, is that I have hope. I have hope in Jesus. He said that He came that we may have abundant life here on earth as well as eternal life (John 10:10). He didn't promise that life would be without pain, but rather that He would see me through (John 16:33). Even when I am in a lot of pain, I can go back to God's promises (it helps that I have a good bit of Scripture memorized since I don't like to read when I'm having a severe migraine). I also work with a counselor who has helped me change my thinking so that I don't get so far down in depression when I'm in pain. Specifically, I have messages that I can tell myself when I feel my emotions going off the deep end (for example, "the migraine won't last forever - they always end", "the worst that will happen is going to the ER for medication", "the house can be cleaned later", etc.). I have learned not to "catastrophize" (how's that for a word?) my pain, allowing me to function better.

If you're reading this and you're wanting to hurt yourself, please get help. Call 911 or a friend. The fact is, chronic pain and depression can and should be properly treated. It's not easy, but we can live productive lives without feeling hopeless. While I've never been suicidal, I can say that my life is better than it was two years ago, even though my pain level isn't much different. And, remember, Jesus came to give us abundant life and joy, even in the midst of pain.

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