‘Crippling Anxiety or Persistent Pain: Don’t Know What Came First’

‘Crippling Anxiety or Persistent Pain: Don’t Know What Came First’

7 min read
Mental and physical health are more intricately related than you think.

Binaries are deceptive, and the ‘mental versus physical’ division lends itself to that very concern. Everyday discussions on health tend to fit illnesses strictly into either of the two groups: Arthritis? Physical. Depression? Mental.

Such a simplified understanding of health issues is more often than not, dangerous.

The body and the mind work together. They experience pain together. Therefore, physical and mental symptoms are overlapping aspects of a bigger problem.

Michelle George and Divya Gulati* are two women diagnosed with chronic pain illnesses. Their experiences tell us just this: Break the Binary.

Mental & Physical Symptoms: Does One Follow the Other?

Their stories share some commonalities — they’ve both spent major parts of their lives in pain; it took them years to finally know what the problem was; and physical pain had always coincided with stress, anxiety and depression for both of them.

‘Crippling Anxiety or Persistent Pain: Don’t Know What Came First’
“It is too frustrating to be in pain all the time."

Divya was diagnosed with fibromyalgia after six years of experiencing unexplained pain. She consulted multiple doctors and went through numerous tests. The diagnosis was only concluded when all alternative explanations had been discarded.

When I ask her if she felt any mental repercussions of her ‘physical’ ailment, she almost instinctively says, “It is too frustrating to be in pain all the time. It’s mentally overbearing.”

Her pain is her constant companion. It’s there in everything she does. “I fail to do everyday activities when people my age are so active. Even washing my clothes in the washing machine is hard. The difficulties of the daily routine keep getting worse. You don’t know what to do, you cannot have painkillers everyday. After a period of time, when the pain refuses to go, it becomes a big load for your mind to handle.”

And this is only made worse because of the lack of empathy from people around.

She didn’t just have to deal with pain — but also with the stigma and unawareness surrounding it. Her anxiety and depression, in these terms, followed her physical ordeal.

For Michelle, her mental symptoms are a tell that her pain is about to aggravate. She has an autoimmune condition with symptoms similar to Celiac disease. For this reason, she tries following a strictly gluten-free diet. “My relationship with pain comes from joint pain, muscle pain, headache, and even symptoms of depression. Every time I get contaminated by gluten, all these symptoms come back together.”

She believes that her pain has diminished her cognitive abilities, including her memory. Whenever she is overworked and burdened, the aches kick in within two hours. In fact, she takes a painkiller as a precautionary measure before an important event or meeting, because it’s highly probable that the stress would bring back her pain.

Confusion, Stigma and Unawareness

‘Crippling Anxiety or Persistent Pain: Don’t Know What Came First’
“Something that doesn’t come up in a test is treated as a pseudo-disease.”

“The fact that I didn’t know what was going on had an impact on my mental well-being.”

It was only when she finally consulted a neurologist that she knew what had been happening to her. Imagine going through so much pain and not knowing what was causing it? How can it not affect a person’s mental health?

Divya went through a similar phase. The stigma surrounding her condition made her even hide it from others. “I even tried to cover it up. People don’t handle it well.”

There is so much that still needs to be done and understood. She puts it rather beautifully, “Pain itself is restricting. The stigma and judgement only make it more restricting.”

‘I Could Only Deal with It When I Handled the Mental Aspect Too’

Counseling and cognitive behavior therapy is what really helped Divya, in combination with other things. She is currently on homeopathic treatment, along with physical therapy, exercises, acupuncture, floatation therapy, and a mild and customized form of Yoga. “Regular Yoga classes tend to be too vigorous for me.”

She explains that her counselor visits helped her change her perspective towards pain.

On the other hand, Michelle hasn’t had a very pleasant experience with psychologists. “In my experience, the psychologists were never in tune with the other doctor or the neurologist I was seeing.”

She adds that if she does find a psychologist who understands her and is in tune with other doctors, she might not be able to get a wholesome treatment. Until then, she will just be focusing on her diet.

‘Crippling Anxiety or Persistent Pain: Don’t Know What Came First’
Painkillers are not a long-term solution.

Dr Natasha Khullar is a neuropsychologist at Medanta, Gurgaon. In conversation with FIT, she brings out the importance of acknowledging both the mental and physical symptoms of chronic pain. “There is a lot of evidence to show that even with lower back pain, cognitive behavior therapy is equally effective as painkillers and physiotherapy.”

She explains that it works in a loop — with no definite first. Your stress could cause your physical pain (or it could be the other way round) and then the pain could cause further anxiety. It keeps going on. Painkillers themselves are mood-altering substances, but their effect is short-term and they are addictive. So they’re not a sustainable option in the long-run.

A 2019 Lancet report focused on the way people with mental illnesses have an increased risk of physical disease. It stated, “The high rate of physical comorbidity, which often has poor clinical management, reduces life expectancy for people with mental illness, and increases the personal, social, and economic cost of mental illness across the lifespan.”

This brings us back to where we started: The urgent need to stop isolating mental and physical health. It only denies a person the necessary information to deal with all aspects of his/her problems. And it’s not just chronic pain. Almost all conditions affect mental and physical health significantly, if not equally.

Break the binary. It’s time.

(Chronic Pain India is a support group for chronic illness and chronic pain sufferers in India. If you are a pain sufferer or have a family member or spouse in pain, feel free to reach out.)

(This story was auto-published from a syndicated feed. No part of the story has been edited by The Quint.)

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