Depression & Pain

Hi all,

As we near the end of September being world Chronic Pain month I have thought long and hard about writing this blog.

My last blog I wrote about the real day in the life for me and what it was like to get out of bed and the effort it took to train for triathlons and the things I do with my daily pain.

I got a really positive reaction to it which surprised me a little being honest and thank you to everyone who read it and reached out to me.

Throughout the month I have spoken with a number of different people, I have taken a keener interest in social media posts and I have decided I would mention the somewhat "Elephant in the room" word "Depression".

Why?

Well it's simple I think when you have a disease such as Arthritis or any other chronic pain related disease depression is a symptom, it has to be.

Yet when you read about whatever disease it is it's very rarely mentioned, there seems to be wanted to distance this symptom from the disease.

Do I have depression; yes I think I do at times. It affects me more when I am having a "Flare" up. I am grumpier, impatient, and hard to live with, tired, short tempered and generally pissed off with the world. I would describe this as Depression, perhaps others will disagree but from my view it's a form of it.

I also think you can say this for the majority of modern society too, I don't think I am much different really.

Everyone has their own battles and hardships such as managing a disease or illness, loss, death, work, children, mortgage, or as I would like to call it "life".

Modern Life is massively hard for everyone, it's an ever changing, constant merry go round, there are so many influences or factors of influence everyone has one common denominator "Stress".

Stress is the one common trigger in all of this. And how you manage and handle stress is the defining factor in what stress causes you in the long term.

Kids these days have it so hard, I read the other day of a 12 year old girl getting legs waxed because she was getting bullied in school, her mam noted she never got waxed, she could not believe she was allowing it to happen, but the pressure and stress on kids to be "normal" is massive.

There are millions of examples I could use. I have three kids and I understand the pressures on them and us as parents it's constant and huge.

So for people with a chronic illness I do think depression and pain go hand in hand.

Also what I see with the medical side the doctors and consultants are only interested in dealing with the pain management side of things so the depression goes on unchecked.

I have never once had a doctor or consultant ask me "how I was" in the sense of my mental health or even how I am coping having my diseases. 

People get diagnosed with awful things every day, but not really told how to manage this news. Again I am generalising here, I am sure there are a lot of brilliant support units out there and I am not calling them out as being bad.

I also don't mean this bad on the doctors and consultants either, if they were to take this level of interest they would probably get to see 2 patients a day and their practices would be more like a wellness centre.

They are only going to deal with the here and now; the pain side of things, that's what medicine is really it's the person that has the warmth and interest in the person.

Arthritis has no cure, it is different for every single person it affects them different in some manner so it's a very very difficult disease to master so how do you go about it as a doctor or consultant, really I don't think you can do more. But the patient can.. Self-help, self-care.

Thankfully I have a strong mind and I do my best to manage my own mental health but for others it's harder and I hope some of these people can get to read this blog and some parts make sense and you realise it's not just you.

I can't' tell you if I am doing a good job as there are days and even weeks where I feel a different person completely (In fact at times it really has got so bad I don't think it will ever improve and this scares me).

For me it starts with the fatigue and I mean proper lethargic feelings like when you wake up knackered from a good night's sleep this continues for a few nights or longer. This then moves into not caring about things like work, people, friends, family and then this quickly moves to the world is against me and at this point it gets scary it's around this point you start questioning your reasons for being here.

This slippy slope can take a few weeks or it can take a few days depending on the person but when you get to the point and start thinking everyone and everything is against you and question your worth you know you're not in a good place.

Let me ask each and every one reading this, never question your worth and if you do, you need to act, speak with people, someone, anyone but YOU need to act.

Every single person is special and is worth a huge amount to people. We are all worth a massive amount, never forget this ever please, even if you feel you're not you're in a dark place and remember this is your mind chattering it's not the normal good you.

However you can control your mind, you are in charge of your mind this is the good news.

I have been doing a lot of research into how I got this disease recently as I feel my medication is not working for me and I have concluded the medication only deals with the pain not the disease.

So the more I got into it the more I questioned what is causing my body to be like this?

What I have found (and it's only early days in my research and understanding) is that the majority of chronic diseases are actually in most cases triggered by one or more stress related incidents.

My arthritis is not necessarily inherited; it's more how my body reacts to stress. This may be very similar to my family's and low and behold we all get Arthritis but it's not necessary something that is passed down in DNA history.

My own stressor or trigger was the passing of my baby daughter Emma at a month old and everything after that with family, concern about my wife, concern about my job, just concern about what lay ahead for us as a family. This was an indescribable time of stress and it lasted for a very very long time.

We lost something of ourselves that day and during that time, we are different people today 16 years later as a result; this I know 100%. Although I would like to think for the better funny enough.

I was fit and healthy (in general) prior this event, we were a young married family with a baby daughter and one on the way. Unfortunately something happened to trigger Emma to arrive early and that's the start of this journey.

It took time to manifest itself as Arthritis but having such a toll of stress on my mind that my mind was in constant fight or flight mode for years after and ultimately it affects my body.

Being in this mode is very very bad for you, a person should only be in this mode in emergencies it's this mode that allows people live and survive in situations of great stress such as a burning building, car crash, etc. but being in this mode all the time for any length of time is very bad for you, basically the body will turn on itself and start fighting with itself, it will look for something to fight.

In my case it found my weaknesses, my ankles, my hands, shoulders, stomach and hip and started attacking them, then my immune system will try to defend this attack and you get inflammatory Arthritis and the vicious cycle of your body being in constant flight or fight mode.

From my recent reading and watching various documentaries this same pattern can be said for many and some believe all chronic pain diseases. I am not claiming this as I am not qualified to do so but I do think there is truth in the research.

I don't want this blog to be all about depression and bad things but I do feel the need to call it out that chronic Pain and depression need or should be in my view treated together.

I also feel modern medicine may also be a contributor to our bodies constant state of stress thus causing our bodies to remain in this state of flight or fight and therefore now ever allowing our bodies to actually heal and maybe actually reduce the pain and symptoms naturally.

So what next, what do I do, how do we "manage" our symptoms and mental health. Unfortunately I don't have that specific answer.

I think if I did I would be a very rich and happy person living the life I want to live. Ironically that's part of the answer. Trying to live the life we want to live, to the best of our abilities.

What do I mean by this, well I go back to the mind for a bit, the mind is an absolute amazing thing so complex we still do not fully understand it.

But it can be controlled, for example we know that in a state of "happiness" the mind triggers the body to release chemicals that contravene and shut out the negative and bad stuff in the body, couple this with exercise the body can give the right conditions effectively heal itself.

A simple act of gratitude triggers the good chemicals, so imagine if we can find a way to trigger these good chemicals all the time. Over time this will help healing.

This is why I find training and setting goals good. The exercise makes me happy and also by default the exercise is releasing the body's own natural painkiller and other endorphins that counter the bad. So does exercise Heal? No I don't think this alone will heal but most certainly it does help.

What type of exercise? well that's personal to everyone I can't tell you that, what I would suggest is once it's hard enough to raise your heartbeat for over 25 mins this will trigger the release of the natural chemicals and I feel there is a knock on effect as when you start it's hard, maybe even sore, then you start noting small improvements, over time you start maybe losing weight, then other people notice and comment then maybe you get brave enough to enter or do something that you taught was beyond you and when you achieve this I can tell you the release of chemicals is insane.

So you can see the knock on and benefit of exercise, couple that with eating healthy, cut out all refined crap and sugary stuff and your mind-set will start changing, no longer will the mind be in the constant Flight or Fight, it will be in the good place and be releasing the good chemicals. At this stage you are giving your body the chance to heal.

So I think I have waffled on long enough I could continue and go on and on as this is a really interesting and wide open topic and also very much open to interpretation and personal choice.

I want to sign off by saying the things I have written are my own views right or wrong, accurate or not. If however you are finding things tough remember you are not alone there are millions out there going through similar, talk to someone, write something, join a group or a club don't feel you are alone you will find your not just reach out please. 

For me I mentioned small goals, this years goals I have 3 - Open water swim a few weeks ago, I did it in 31 mins and finished 70th from 160 and on the 2nd page of 4 of the results pages. Huge achievement for me Goal smashed.

60K Cycle at the end of September - This will be a bit of fun, the Great Dublin Bike Ride.

Get back Jogging and complete a parkrun by the end of the year (no time, just run it).

My big goal for next year is to take on another 70.3 Ironman and complete it in the pack like a normal person and not with 7 mins to spare. I have not yet signed up to one as I'd like to do it abroad I just am yet to pick one.

Thanks as always for reading.

Ken.