If there is anything that my readers struggle with most, it is the effects of their chronic pain on their mental health. This is something that is unavoidable unfortunately when you have Rheumatoid Arthritis. This disease, as you all well know, is just debilitating on all fronts. Even those who have always seen the glass as half full and have the mental toughness of war veterans will mentally struggle with unrelenting chronic pain. I liken the emotional roller-coaster of RA to the 5 stages of grief. I do this because we do grieve. We grieve every day for the bodies we once had that was pain-free and could freely move. The 5 stages of grief are:
But it’s not really stages for those battling chronic illness. It’s not finishing one step, moving onto the next and then graduating at the end. It’s more like a cycle or bouncing a ping-pong ball. Yes, it’s the thing we call pain that determines where in the 5 point cycle the ball lands. Do you agree?
Before I go through the stages, let me first reiterate that you are not alone in your struggle. We all feel this, ALL Rheumatoid Arthritis warriors feel this, some days more than others, some deal with it better than others. You are certainly not alone. And yes, we battle the effects of chronic pain on mental health every.single.day.
I want to stress the importance of reaching out and getting support if you ever feel that the stress of it all is getting beyond your control. This can be from a support group or from a mental health professional. If you need a support group, there are many on Facebook and online. They are all fantastic. You can join The Rheuma Mill community on Facebook here. Now, onto chronic pain and the brain…
You can’t handle the truth!
When I was first told that I had rheumatoid arthritis, I actually didn’t experience denial. Admittedly, this was mainly due to the fact that I didn’t actually know what Rheumatoid Arthritis was. Mind you, it didn’t take me long to get to know it! But I must say, I was quite happy initially to finally get a diagnosis because my unexplained symptoms was really impacting my life. You can read more about that here.
It wasn’t really until those symptoms put me in the pits of hell did I start thinking ‘this can’t be happening to me!’ When your life and health take such a dramatic turn, it is really hard to wrap your head around it. This is particularly so if you’re like me and have lived a very healthy and active lifestyle. Why me? I did everything right! There are also how many people in the world? 7.5 billion? and 1% have RA and I have to be one of the 1 percent? I’m not even in a high-risk category! So it’s true, bad things happen to good people.
But denial actually serves a valuable purpose and that is protection. In not facing the realities, we are trying to protect ourselves from the painful truth and from the memories of a happier time, a time without pain.
There is no magic pill for this stage, it is something that with time, will become easier.
Anger is probably my most frequented stage. The ping-pong-pain lands here often I must admit. Although probably more frustrated than angry or I get angry out of frustration. There are so many things to be frustrated at:
- Being tired – I am tired of being tired. I get ANGRY that all I want to do is rest when once upon a time, I couldn’t sit still! AAARRRGGGHHHH
- My stupid hands – why can’t they do what they’re suppose to do? Pick stuff up, pull up pants or maybe just, you know, bend! AARRRGGGHHH
- People not caring – I am trying can’t you see that? I’m in pain remember? Everyone’s life has continued on as normal but mine. Well actually, they’ve continued on without me. AARRRGGGHHHH
- My meds actually make me sicker – How does this even make sense? Is there not an end to this misery?? AAARRRGGGHHH
I could go on but as you can see, there’s a lot of anger there. So if you feel angry, it’s perfectly normal.
But here are some things to help you (and those around you) deal with it:
- Recognise that you’re not you when you’re angry. An abnormal reaction to an abnormal situation is actually perfectly normal.
- Express the emotion in a constructive way, not a destructive way.
Constructively dealing with anger is screaming into a pillow, ranting to yourself and/or punching/kicking something. Kickboxing is my outlet, a great form of exercise and really helps me.
Destructive anger is when you lash out at those trying to help you. When you feel that you’re about to lash out, take a moment to cool off. But the most destructive thing you can do is suppress your anger. This will only prelong the emotion.
Grab a bargain!
This is what I call the ‘if’ or ‘If only’ stage.
‘God, if you release me from this misery, I will start going back to church every sunday’ or
‘If only I had been healthier, I wouldn’t be in this mess.’
There are four psychological reasons why our brain takes us to the bargaining stage:
- Trying to regain control – If I prioritize my health, I will no longer have RA
- Guilt – If only I had eaten better, this wouldn’t have happened.
- Seek explanations – I have RA because I wasn’t being physical enough.
- Hanging onto hope – If I eat better, I will no longer have RA.
As unproductive as this way of thinking sounds, this process is crucial to move out of the anger stage and step closer to acceptance. The fact is, a majority of us never saw it coming because there is no conclusive reason why Rheumatoid Arthritis occurs.
Down, Down, Down we go….
The most common misconception about depressive disorder is that it is an unnatural way to be when in actual fact, it is. Our circumstances absolutely qualifies us to be overwhelmingly and persistently sad. The persistent pain affects our daily functions so how could we not feel depressed? Many pain patients, more specifically, chronic pain patients, experience depressive disorders. Chronic pain statistics absolutely backs the notion that depression and chronic pain are extrinsically linked.
Depression is not just all related to the pain itself but also to pain management and pain medicine. That is, having to seek medical care, dealing with health services, the anxiety of harsh medicinal treatment. All this will have psychological effects.
It’s not just the pain
Rheumatoid Arthritis not only affects our joints but also our nervous system causing extreme fatigue. The stress of not being able to actively engage with life when we want to also links chronic pain and depression.
How long we stay in the depressive stage really depends on our level of physical pain and mental health. It is natural to wonder if there is happiness in sight when you’re dealing with depression and pain. Everyone handles the psychological effects of pain differently. Our support network plays a major part on how quickly we move through this phase. Individuals who chose isolation or feel disconnected from others are those that are at risk of clinical depression which requires professional guidance. If you are finding it difficult to talk to your friends about your chronic illness, I provide great tips here.
In saying that, depression will help us detach emotionally from our situation and move us to the next stage which is acceptance. I had to really think about his one. How does being depressed detach us emotionally from our situation? Well, when I was in a depressive state, I felt nothing. I was completely empty and forgot everything. Nothing existed. This is why the support network comes in because you’re reminded of what you do have. I remembered that I had children to care for, a job I enjoyed and things I enjoyed doing. Once I remembered these things, I picked myself up and accepted the new norm. But it wasn’t all me, it was mainly the meds. Yes, the meds kicked in and that helped.
Even though I have found medication and treatments that have helped me, that doesn’t mean I am pain free, chronic illness free and have a perfect bill of mental health. I still have those things but to a lesser degree. But what I have more of is anxiety. I want to talk a little about anxiety and pain because it’s related to the effects of chronic pain on mental health.
I was not an anxious person pre-rheumatoid arthritis. Now, with RA, I am constantly anxious because I fear more pain. I am anxious to let people touch me, I am anxious to even touch things myself because anything small thing can trigger the intense pain that I know so well. Now with Covid-19, my chronic pain and anxiety is at it’s worse. I don’t even want to leave my house and when I do, I am riddled with anxiety. I am just so anxious of pain and illness. Despite this, I don’t let it interfere with my daily life so I continue because the show must go on.
I ungraciously accept
Acceptance is not saying ‘thank you’ and ‘it’s okay that I have chronic illness’. What you’re actually saying is ‘F*&% you, I’m going to be okay.’ So what you’ve essentially done is re-entered life again but with a new reality. It’s not great but you can work out a way around it. You acknowledge that you are going to have good days and bad days and soon the good days will out-number the bad days. It’s hard to see when you’re in the other stages but you do move on and grow with your new norm. As crazy as it may sound, you will also reach a stage where you appreciate what your chronic illness has done for you.
Stand up straight and realise who you are, that you tower over your circumstances.Maya Angelou
The effects of chronic pain on mental health is something we should all be consciously aware of. This is because our physical pain can cause depression and our depression can cause physical pain.
10 ways to stop the ping-pong-pain
Here are 10 things we can do to better control our comorbidity of chronic pain and mental health disorders.
- Be kind to yourself – You need to be your biggest supporter. Avoid self-criticism and give yourself one compliment every day.
- Take care of yourself – Prioritise your needs. Focus on nutrition, exercise, rest and drink lots of water.
- Engage with a support group – Being able to help others will help you.
- Switch off – Do something completely mindless or mindful to allow your mind to also rest.
- Connect – Spending time with loved ones or even pets
- Gratitude – Name one thing to be grateful for each day and keep a journal of it.
- Ask for help – It is okay to ask for help when you need it even though you feel that you are asking all the time. Don’t suffer in silence.
- Just live – Continue to do the things you would normally do. If something is too difficult, find another way or replace it with something else.
- Start today – Don’t wait for a better time. The best time is right now.
- Do your thing – Do what makes you happy. We all have multiple things that make us happy, just pick one thing to lift your spirits. There are some things that make me happy that I can’t do anymore but I have other things that make me happy. I have also found other things I can do that make me happy. You can too!
If you are really struggling with ways to manage your mental health, look at my extra resources.
The Rheuma Room
I am acutely aware of the effects of chronic pain on mental health so I do those 10 things every day. My life is now very different but I have not only accepted the new norm but I’ve come to quite enjoy it. I have also found new activities, communities and places that I can enjoy. One of those things is writing. Writing has really helped me accept my condition and is a great outlet. Support groups, even though they are fantastic, have limitations. There are only so many words you feel like punching into your phone. Sometimes you don’t want to continually burden friends and family with your rants. But my laptop always listens and I can write whatever the hell I want and it doesn’t judge me. I highly recommend you try it yourself. Do it in The Rheuma Room!
The Rheuma Mall
The effects of chronic pain on mental health can impact your life but it can be a positive impact. That is why I created the ‘I Roar‘ range. It is such a powerful message and I want all those who wear it to feel empowered. All profits from The Rheuma Mill is donated for arthritis research. Raise awareness and ROAR back at Rheumatoid Arthritis today. Check out The Rheuma Mall now and contribute to arthritis research.