The mental struggle of chronic pain

This post has been circling in my head for several years now and I've hesitated putting it into words because dealing chronic pain can be a very personal experience, and certainly my experiences may not be anything like someone else's.

WebMD defines chronic pain as a pain that lasts longer than six months. Chronic pain can be mild or excruciating, episodic or continuous, merely inconvenient or totally incapacitating.

It goes on to say: The emotional toll of chronic pain also can make pain worse. Anxiety, stress, depression, anger, and fatigue interact in complex ways with chronic pain and may decrease the body's production of natural painkillers; moreover, such negative feelings may increase the level of substances that amplify sensations of pain, causing a vicious cycle of pain for the person. Even the body's most basic defenses may be compromised: There is considerable evidence that unrelenting pain can suppress the immune system.

Because of the mind-body links associated with chronic pain, effective treatment requires addressing psychological as well as physical aspects of the condition.

It's simplistic to think that chronic pain affects mental state in an "pain = sad" equation, though I have a sense that someone who has never experienced chronic pain might think of it that way.  In fact, I would say that it's not the act of being in pain itself that directly causes depression in any way, but rather what the chronic pain indirectly affects in someone's life.

Chronic pain is different than acute pain in that there is no clear end.    If you cut your arm, you have a good idea that once the bandage is off that your arm is likely going to be fine, even if you are in pain for a few days.   With chronic pain, you have no real idea of when the end will come, if at all.  There's a sense of being put in a situation that you can't quite control for some unknown amount of time, which causes significant anxiety.

Chronic pain also makes you constantly think about it.  Even when you aren't thinking about it, you are.  People in chronic pain make a million decisions every day that are based solely on managing or mitigating their pain.   It starts to consume your thought processes for almost everything in life until it is just second nature.    At times, it feels you are living a parallel life, with an entirely different decision process from those that are around you.  Even little things, like, I recently gave away a lot of my scrapbooking crafts and when asked why, I explained that it bothered my neck too much to look down for any period of time.  Based on their response, I could tell that the answer was not what they were expecting, even though I've had chronic neck pain now for years.

Chronic pain keeps you from doing the things that you really love.   Not doing what you love takes a such a toll on you mentally.  Especially if those close to you are able to continue on without you.  You might be jealous of them in some way, or wish that they understood how hard it is for you to miss out.   The feeling of being left behind as people go on and enjoy their life without restriction hurts.

Chronic pain is incredibly isolating. Unlike an acute injury, people are not always terribly sympathetic to chronic pain.  You aren't in a cast, you don't have stitches, you likely look just like you always have.  But you could be having a really, really bad day.  After a while, you stop talking about it with others because you worry that either people are tired of hearing the same complaints from you or they just don't believe you.  Then it becomes part of your inner monologue only.

I think despite all this, is it possible to deal with ongoing pain and have a positive outlook.  A large part of it is acceptance... acceptance that your life will be different than others, but that it is ok.  It can be a very hard thing to accept and it takes some time to get there, particularly if the chronic pain was the result of an accident or decisions made.  In the end, we each have our individual struggles and you can only walk your path.   You could spend your time wishing for something different, or you can walk the path you have in front of you and enjoy it as best you can.