Chronic Pain and Suicide


Chronic Pain and Suicide

The Relationship Between Chronic Pain and Suicide

The human body has an amazing talent for adaptation.  If you jump into a cold swimming pool, the chill will last only momentarily while your body adjusts.  If you smell a terrible odor, your nose will get used to the scent and it will be less offensive in no time.  If you have to lift heavy weights, your muscles strengthen over time making the weight seem less of a burden.  The human body can adapt sensory perceptions and physical abilities depending on the needs of the situation.

Some adaptations cannot be made, though.  Unlike the previous examples, people with chronic pain cannot “get used to,” “deal with” or “adjust” to the pain.  For them, the pain never lessens, alleviates or feels less intense.  In fact, many people with chronic pain experience increased pain and negatives associated with pain over time. Chronic pain is an anomaly in terms of adaptation.

Chronic pain leads to many negative repercussions.  Without relief, pain triggers feelings of irritability, frustration, changing moods, hopelessness and desperation.  Left untreated or unresolved, these symptoms can morph into depression, and with enough time, will likely lead to thoughts of suicide as hopelessness becomes too much to manage.

People with chronic pain are at greater risk of attempting or completing suicide for several reasons including:

  • Chronic pain increases the risk of depression. Depression increases the risk of suicide.
  • Pain medications have a strong impact on mood and impulse control. This leads to opportunities for poor decision-making.
  • People attempt suicide to find relief from physical pain that seems to be worsening.
  • Pain medications lend themselves to being abused and overused. This might lead to accidental overdoses resulting in death.

The best treatment for avoiding suicide and depression in people with chronic pain is two-pronged.  Treating only the pain or only the depression will end with poor outcomes.  Consider a holistic approach when dealing with chronic pain.  If your body is not healthy, your mind will struggle.  If your mind is not healthy, your body will struggle.  Because of this, targeting the pain and depression separately as well as with an integrative approach will yield the best possible results.

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Treat the Pain

Unsurprisingly, treatment for chronic pain begins with looking at the pain directly.  If the physical symptoms can be reduced, there is less of a need to focus on the psychological.  Less pain means less depression.  Here’s how:

  • Be preventative. The best way to address chronic pain is to not experience it in the first place.  Surely this sounds elementary, but too many people take poor care of themselves.  Taking precautions to avoid injury will exclude you from having to suffer the consequences.  Wearing a seatbelt or a bike helmet will help limit significant repercussions from accidents.  Keeping your body agile and strong will increase your resiliency if injured.  If you only think about chronic pain after the pain begins, you might be too late.
  • Act early. Since prevention is not always possible, act early.  Treating the pain early gives you a better chance for a full recovery.  Have you found yourself thinking that the pain will go away on its own with time?  Have you avoided going to doctors’ appointments?  This approach only ends with increased pain.  Men tend to evade treatment more than women as they perceive treatment as admittance of weakness.  Seeking treatment is the strong thing to do.
  • Follow treatment recommendations. Once you attend treatment, be sure to follow the full recommendation of the doctor.  Many people smile and nod when in the office and choose only pieces of the treatment plan to follow when home.  Your doctor is acting in your best interests with the treatment prescribed.  If you are not comfortable with the plan, discuss your views in the office.  If you are not comfortable with your doctor, seek a second opinion.  Advocating for yourself will give you a better chance for improved treatment.
  • Improve diet and exercise. Being strong and resilient help avoid pain, and they can also help improve pain.  Experiment to find the types of exercise that work with your pain.  Always consult your doctor before beginning a new exercise program.  Find new ways to push yourself while being safe as fear of further injury may be too restricting. In addition to exercise, finding ways to improve your diet will be helpful.  Certain foods are linked to healing.  Research ones that seem useful based on your injury or level of pain.
  • Seek alternatives. Great outcomes can be achieved from alternative treatments.  Massage, chiropractic, acupuncture, acupressure and others are options to lessen your pain.  Depending on your location, there may be a shortage of alternative treatments.  Find ones in your area that fit in with your budget.  The best aspect about alternative treatments is their risk.  The risk is typically low and side effects are not common.

Treat the Depression

Even when you follow the above recommendations precisely, some pain cannot be reduced or managed.  That leaves you in the position of needing to protect your mood, you frustrations and your well-being since depression can prove more frightening than the worst pain.  Here’s how:

  • Know yourself. Having the ability to accurately self-monitor your thoughts, feelings and behaviors leaves you better able to understand your triggers, reactions to those triggers and possible solutions.  People with chronic pain tend to ignore what their body is telling them because it is often negative.  Go against this instinct and work to actively pay attention to yourself.  What makes the pain worse?  What makes your depression worse?  Pain has a way of affecting your memory so make lists, charts and journal to make sense of the information you collect.  Any data collected will prove useful at some point.
  • Know your expectations. The opening of this article discussed someone’s ability to adapt to change.  Since pain makes it difficult to physically adapt, it is your challenge to psychologically adapt.  You accomplish this through changing your expectations.  Your expectations are the lenses through which you see the world.  If you expectation is that you will miraculously recover and have no pain, you will likely be disappointed.  If you expect to be in excruciating pain for the rest of your life, you will become more depressed and hopeless.  Instead, consider expecting to be in some level of pain but that it will not consume your entire life.  This expectation will prove realistic and encouraging.
  • Distract and divert. Paying more attention to yourself in the name of self-monitoring is fantastic.  Equally important, though, is finding time to find distraction from your life.  Accomplish this by finding time to engage in pleasurable activities.  Play video games, meet with friends or watch a favorite movie.  Having too much focus on the negative will increase depression.  Find moderation, though.  Too much distraction and diversion will leave you stuck in the quagmire of pain.
  • Know your services. Make yourself aware of the services available in your area for mental health treatment and suicide prevention.  Are you already in therapy?  Ask your therapist for contact information and the appropriate services you can access.  When depression is high, you will be less likely to seek out services so learning about them when symptoms are low is a better strategy.  Suicide hotlines, intensive therapy programs, mobile crisis workers and inpatient psychiatric services are all available to improve your depression.
  • Play it safe. Safety should always be your primary focus.  If you are not safe, your symptoms cannot improve.  Establish a level of distress that you are willing to tolerate and a plan of action if that threshold is crossed.  There is no shame in admitting that you need help, only in not seeking the help you need.  Work with your mental health professionals, physical health professionals, friends and family to plan for intense symptoms.  Do you think about taking more pain pills than prescribed?  Do you think about wanting to sleep for a few days?  Do you think that the pain is too much to handle?  These are warning signs of suicide that should be taken seriously.  Waiting only makes things worse.

Conclusion

Pain and depression are a package.  Where one goes, the other is sure to follow.  Work to minimize their impact by treating the physical pain and the emotional pain concurrently.  Realize that they are intimately connected to each other.  Along the way, always play it safe.  Suicide and accidental overdose are real problems for people with chronic pain.  Find solutions to avoid being another statistic.  You are worth it.

Eric PattersonEric Patterson

Eric Patterson, LPC is a professional counselor in western Pennsylvania working for the last 10 years to help children, teens and adults achieve their goals and live happier lives. Read more about Eric and his writing at www.ericlpattersonwriting.com.

Jan 6, 2015
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