Do you ever contemplate suicide?” No, I don’t think I could kill myself but, I think that I’m dying and wouldn’t care if I did die. “Would you consider your self sad or hopeless?  This disease is lifelong and it affects all kinds of things that make me sad, and is there really any hope of not being this way? so, Yeah I’m pretty sad and hopeless.

This was a conversation I had with a disability assessor regarding my chronic fibro pain and depression associated with it. That was maybe three or so years ago.  I don’t think or feel that way now.  Some of the things I have learned in my pain class has helped with that.

Unfortunately, I have seen some of these same words echoed on the Fibromyalgia Support Group Facebook page and in posts from other chronic pain bloggers.  The fact is many people feel varying stages of chronic depression when chronic pain is a diagnosis.  Is it because we hurt that we are depressed?  Or is it that we are depressed so we hurt?  Studies have been going back and forth for a while.   Because our bodies go chemically haywire in both situations they are actually linked in the brain.

Comparison of brains. These images show the brain from the left side, demonstrating striking differences between chronic pain patients and healthy subjects. They illustrate with colors how much activation (red-yellow) or deactivation (dark/light blue) was found at each location. (Credit: Image courtesy of Northwestern University)

According to studies done by Dr. Chantal Berma (1) depressed mood leads to maladaptive changes in brain function associated with pain.   In Dr. Berma’s studies as well as studies done by Northwestern University’s Feinberg School of Medicine, researchers found that in a healthy brain all the regions exist in a state of equilibrium. When one region is active, the others quiet down. But in people with chronic pain, a front region of the brain that is  mostly associated with emotion “never shuts up,”  These areas that are affected fail to deactivate when they should. They are stuck on full throttle, wearing out neurons and altering their connections to each other.  That permanent perception of pain in your brain makes these areas in your brain continuously active. This continuous dysfunction in the equilibrium of the brain can change the wiring and could hurt the brain.   It could be that pain produces depression and the other reported abnormalities because it disturbs the balance of the brain as a whole.(2)

So basically, no matter which came first, they both become intertwining signals that can change the brain, causing a seemingly endless loop. This statement in itself could be even more depressing.  However, there are things that have been found to work managing both chronic pain and chronic depression that can in fact bring back the separation of the connections and lowering the affects of both on an individual.

Researchers have found through controlled studies, that these things are effective for managing both chronic pain and chronic depression.

Progressive muscle relaxation through gentle stretching 

  • Progressive muscle relaxation and gentle stretching, such as meditation and yoga,   allows oxygen to get to not only the muscles so they can function properly, but also to the brain allowing the nerve connections to have the power to bring proper functioning to all of the systems in the body.(3)

Meditation or hypnosis

  • Meditation strengthens the brain by reinforcing the connections between brain cells. Much of the research is showing, meditation causes the brain to undergo physical changes, many of which are beneficial. Other studies, for example, have shown that meditation is linked to cortical thickness, which can result in alleviation of depression.(4) 

Using cognitive behavioral therapy to reduce harmful fear and anticipation of painthats stinkin thinkin

  • Our thoughts drive us in many ways.  If we allow ourselves to continually be fearful and anxious of perceived pain levels and use the “why me”, or the “I’m such a bad person, I deserve this” mentality is getting in the way of our real situation, STOP YOUR STINKIN’ THINKIN’. (This book is one helpful resource on how to retrain your thinking )

Sunshine

  • when you’re exposed to sun, your brain increases serotonin (a hormone connected with feelings of happiness and wakefulness) production. And when the ultraviolet rays from sunshine touch your skin, your body produces vitamin D, which helps you maintain serotonin levels.  Being out in the sun isn’t enough by itself, though. We have to soak in the sun’s rays. But we’ve been taught to put on sunscreen whenever we go outside, and there are downsides to the use of sun-blocking chemicals. Our bodies need to be exposed to some full-spectrum sunshine – at least 15 minutes of undiluted sun three times a week.  The ultraviolet rays of the sun make our bodies produce vitamin D, which is thought to help protect us from various types of cancer and helps us build a store of the vitamin to last through the dark winter months. In addition, vitamin D helps our brains make more serotonin. If we slather our skin with sunblock every time we step out the door, we’re cutting down on vitamin D and its benefits.(5) If getting enough sun is not possible for your situation,  Taking vitamin D3 is a viable option to help produce melatonin in the brain.

 

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