The thing about chronic daily migraines is the suffering. Can’t escape the suffering. Chronic pain research is in its infancy but one thing they know is when we feel pain that pain information in the brain also goes to emotion centers. So we have the sensation of pain and we have an emotional response. We have suffering. They go hand in hand.
That means with chronic pain we have to find ways to manage our suffering. Personally I suck at this. I suck balls at it. I am not a overly negative person. More a realist but when it comes to pain I am negative. I find a life with pain to be a limited existence. On my dark days I wonder if it is just an unlived life.
So for people like me who develop depression associated with pain. Well, we have to look at the thoughts that come up when we are in pain and suffering to see if they are rational and reasonable thoughts. Because pain and depression both distort thoughts. I will be in pain FOREVER. I will NEVER feel better.
Here are some examples:
- Ignoring the positive: We tend to notice the negatives in our lives and remember them. We then fail to notice the overall positives to an experience, even if it outnumbers the negatives by far. This leads to such things as assuming the worst is bound to happen, since your negative history suggests that. For example, someone may know from experience treatments have failed and make the assumption all treatments will fail in the future.
- Minimizing the positive: When we manage to achieve something, despite the obstacles of our health, we make little of the achievement because clearly if we were in perfect health it would have been easier or not such a great achievement. I do this one a lot. My psychologist said why are you always minimizing your accomplishments? And your impact on others? And I have no idea. He said it was because I have low self-worth.
- Skills: We can make a long list of things we are not good at, or character flaws without acknowledging the fundamental power we have to alter them, and therefore we acknowledge our failures as par the course. Yet cannot name anything we are actually good at. We make compromises for our health and sometimes people see them as failures or they see the things they can no longer to as well, or as effectively as failures. We fail to acknowledge anything that we can actually do well, despite our disability. I saw not being able to work full-time as a failure, missing a day of work… failure. But I never saw working part-time and making it to work as a success.
- Overgeneralizing: Just because a situation went down badly once, does not mean it will always go down the same way. While this seems self-explanatory think of all the times you say ‘this is always the case’. Sometimes we believe after trying many treatments that we never will find a treatment. Or if we are in a bad work situation we feel it must always be this way that we must suffer this way forever. I overgeneralize sometimes. I say my past pain was this way therefore my future pain is going to be this way… but I cannot know that.
- Self-talk: This is crippling to a depressed person because negative self-talk sets you up for failure, so that when said failure occurs, you expect it… in an attempt to save yourself from disappointment. When confronted with a problem instead of saying ‘This is going to be a challenge. I better get right on it.’, someone might say ‘There is no way I can do this.’ For someone with chronic pain it might be, ‘I cannot do this, it will hurt too much’. Or for migraines it could be ‘it will trigger a migraine’ or ‘I already have a migraine and it will make it worse.’. Immediately it shuts down the possibility without even thinking of ways around the problem. I give myself no slack with self-talk it is brutally negative. I have no consciously say I am human, today is a bad day and I can have bad days.
- Self-evaluation: The depressed mind it an overly critical one. We don’t give ourselves any slack. We make any sort of error and automatically we think ‘I’m worthless’, ‘I shouldn’t have tried’, ‘I’m useless’, and ‘it’s hopeless’. As such we blame ourselves for everything wrong and credit others when things go well. We have to avoid black and white thinking. With a chronic health condition we tend to blame ourselves for our illness. No matter what happened or any other factors or people involved, we blame ourselves because we are not 100% healthy and therefore not as effective as we could have been. I play the blame game all the time, and the blame falls on me… no matter what it was. And it lowered my self worth. So we really have to be realistic with this. Comfort it. Why am I useless? What makes it so?
- Automatic thoughts: We have more than enough time to have programmed ourselves to think and react a certain way. So when something happens in a situation we have a knee jerk response that is often negative. Anything that involves statements with should, must, always, never. Often we have rigid standards we hold ourselves to, impossible to hold to… like: ‘I have to succeed or I am worthless‘.Mine was I have to work or I am worthless. And I felt pretty worthless when i wasn’t working as a result. We have to catch these thoughts as they come and turn them into something more reasonable. I changed it to I have intrinsic value outside of my work and worth more than my work.
- All or nothing thinking: Thinking in black or while. ‘I used to have a social life but now I am a complete hermit and never go out.’ ‘I used to want to have a career but now I know it is impossible to achieve.’ It is never all or nothing. There are always shades of grey and many options in the middle. We know we are capable of social events with preparation, proper environment, and recovery time and with the understanding we are willing to take an increase in pain in the short term for some events. With compromise and acclamation we can achieve some work goals as well.
It helps to see a psychologist about this. They give you homework to work on your thinking and little graphs to write one. You feel a thought about your pain, write it down, pick which distortion you are using and then phrase it in a more reasonable way. It really does help out a lot to do it. I think everyone could use clearing out all the mental negative clutter once in a while to be honest. It helps us then look at suffering differently. Takes away the distortions and changes our perspective. This can reduce suffering.
Other ways to combat suffering are to ensure you are living the lived life… not the unlived life. Things that help with suffering management:
- Some socialization in a month. Nothing extreme. Go for coffee with a friend. Lunch with a family member. Book shopping with your significant other. Keep it simple.
- For isolation: the first step is to get outside the house. So they recommend just going for short walks.
- Do things you are passionate about. We need to do things that are for us, not necessary, just for us. Helps sustain mood as well. So hobbies (Reading, writing, video games, knitting, coloring, painting…)
- Don’t fear an impending migraine. Be prepared instead. And go to events, the movie theater, a show, a concert. Maybe you’ll have to leave early, maybe not… but you gave it a go!
- Write in a gratitude journal: Three things you are grateful for that day. You can expand it like I did and added one small thing I accomplished that day. One goal I had for the next day.
- Exercising: Some exercising, just walking, or moderate aerobic exercise will help with mood. It is also supposed to help with migraines, so there is that. Make it gentle to start and take it easy. If you can’t do any of it, then stick to short walks, they still count.