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Monday, 23 September 2013

The Emotional, Psychological and Social Cost of Pain

When you first start to feel pain, sure you're miserable about it. Still, most of us would assume that it's temporary, and that a couple of pills will take it away if we want to resort to chemical assistance - especially if there's no obvious cause like an injury. One day turns into two and then three. After a week goes by, with no relief no matter how many pain relievers you take, you're in nothing but a blur of pain-filled days. You've booked a doctor's appointment that you don't even feel well enough to go to. You want to curl up in bed with the blinds closed and the lights out, vowing not to get up until the pain retreats. Still, you know you need help, so you go to your appointment, your body tense with pain and anxiety. Whatever is wrong with you, it can't be good.

Stock Photo

Your doctor won't know what's wrong with you at first, so there's going to be a delay in the diagnosis. The length of that delay will depend on how unusual your condition is, and your personal doctor's level of knowledge in that particular area. If you're lucky the problem is pinpointed quickly, and some form of treatment can start. If you're not so lucky, a year or two can go by while they mess around with various tests. That was my personal experience, and I don't wish it on anyone. However, there's a lot more involved with being in pain than what the doctors will ever bother telling you.

To start with, you're going to become a different person, and it's damn shame your doctor won't see fit to warn you about that. It would be nice to be able to tell the people around you that they're going to see some changes in you. You won't necessarily see it happening at first. We all get a little cranky when we're in pain, and that isn't a surprise to anyone. Constant pain, however, takes a huge toll on our emotional state. When the pain doesn't lift, quite often our mood keeps sinking along with our feeling of well-being. Then, when you're no longer as happy as you used to be, and it never lets up, the people around you are going to react to that. They're going to lose patience, no matter how saintly they are when things start out.

Now, here you are, in agonizing pain. Suddenly your understanding partner is no longer so understanding and they're ready to rumble. They don't like being snapped at and ignored. Who does? But then, who enjoys being in pain and feeling like they're being picked on? You're in the weak position at this point. You don't feel strong enough to fight back, but then you certainly get angry enough and you snap. This is where the rage monster, the one you never knew hid inside you, suddenly reveals itself. Quite frankly, the strain on your relationship is more than most people can ever imagine.

Many years ago I went for some counseling to understand certain aspects of a difficult childhood, and I mentioned to the therapist that I'd experience headaches my whole life. They were literally non-stop, 24/7 headaches. I was always on pain relievers for them. Thankfully a year or two later the headaches stopped for no discernible reason. Believe me, it was a weird sensation to stop suddenly one day and realize, "Wait a minute. Where's the pain?" However, when I mentioned this to the therapist she explained something to me about how pain changes who we are. This was in addition to the strain on our personal emotions, and the anger and irritation we're bound to feel. Let me explain.

Pain causes social withdrawal. Imagine you've got plans to go out with Bob and Fred, the couple across the street, for a night of fun and frivolity. Do you really feel up to dancing your butt off to the latest Miley Cyrus twerk-fest? Not so much. Besides, the hammer-licking schtick isn't really up your alley these days. No, what you really want to do is the same thing you wanted to do the day you had your doctor's appointment, and you're pretty darn sure that shaking your body around isn't going to give you any hope of feeling better. So, you cancel. Maybe your partner goes out anyway, which you resent. Or maybe they stay home and give you dirty looks because you're just not a whole lot of fun these days.

You cancel your plans over and over, until one day there are none to cancel because you're just not making plans now. Now you just want everyone to leave you alone with your misery. Misery of that kind does not love company, let me tell you. That misery wants to crawl around in cold dark holes, hissing at every living thing that passes by. It doesn't matter if those living things happen to be your offspring either. Your relationship with your partner and your children can deteriorate very rapidly, and hearing your little ones ask why "mommy is always so mad at me," will break your heart, make you feel shame and guilt, and then piss you off, because, really, why the hell doesn't anyone understand that you're in pain?

You've alienated your friends, your partner and your children, and probably any extended family as well. People get sick of hearing about your days anyway. They don't want to hear the constant litany of complaints that's your only well of conversational topics. What do you do all day besides suffer? You can't talk about the football game you never watched, or the latest movie you haven't seen. There's no point in talking about the lives of your friends, because they could be dead at this point for all you know. You might be able to entertain them with the story of how you watched the dog humping your leg because you just couldn't bring yourself to care.

Situational depression has set in, taking up permanent residence it seems. Now you're not angry. Now you're nothing inside. Your doctor wants to put you on pills. You'll probably take them in the hopes that you'll actually be able to care about something, or maybe you hope they'll numb you further and help you sleep. Either is possible with anti-depressants. The problem of course is that you're not experiencing a chemical imbalance. You're in pain! It sucks! Who wouldn't be depressed by that? The only cure for that depression is to get rid of the pain, which is often easier said than done.

So many people are condemned to pain for the rest of their natural lives. There are medical conditions that there is very little treatment for, and even the strongest narcotic pain relievers aren't enough to relieve all of the symptoms. I can think of several examples. I have a friend who contracted a very rare sort of flesh eating condition. She's in constant pain and there's no cure. I know someone else with ankylosing spondylitis, a form of arthritis that fuses your spine together, among other nasty things. One of the treatments that partially works to slow the condition and relieve the pain can come in at a cost of $72,000 per year. Take a look at Mick Mars' page (lead guitarist for Mötley Crüe) on Wikipedia. He suffers from the same condition, and is three inches shorter than he was in high school. With all the money in the world, he was unable to do anything to help himself.

Mick Mars - Wikipedia
Pain traps you, caging you in misery. Whether or not escape is possible obviously depends on what's causing it, but the long-term effects of living with pain are excruciating beyond the pain itself. If you can't find a way to live with the pain, your former life is over. That's what the doctors won't tell you. Instead they let the knowledge sneak up on you, and then it's too late to prepare yourself or your family. You don't smile at the jokes that made you fall in love, you don't tickle your kids until they're squealing, and your dog never learned to shake a paw or stop humping your leg. Your old friends ask, "Whatever happened to what's-his-face?" But they don't really care what the answer is anymore.

Suicide can happen, particularly with people that have been diagnosed with something incurable. Or they opt for procedures with high mortality rates, because they feel it's worth the risk. In the case of ankylosing spondylitis, patients have the option of a stem cell transfer, which is extremely dangerous. Your immune system has to be completely killed for a short time and then clean stem cells are re-introduced into your body. The risk is that your immune system might not start up again, or that you might catch something while it's completely turned off, so you die. Still, when living with that kind of pain it's something that people seriously consider. It's preferable to suicide at least, since there's a pretty good chance you'll live through it and then quite possibly be cured because your old, diseased stem cells have been killed, and healthy ones begin to spread through your body. If you're curious about the procedure, you can read about it here.

In future posts I'm going to talk about ways to handle your pain, including medications, mental and physical techniques. You may have options you're unaware of, that can take the edge off the pain and make your life more bearable. Be as patient as you can be. The answers will come.