Pain can increase depression and depression is one of the causes of pain. If you get better control over one, you will have better control over the other. When pain and depression co-occur, negative self-talk has been found to be associated with more depression and greater pain interference. Depression makes chronic pain management even more difficult. The term negative self-talk refers to thoughts, ideas, beliefs, or even images that are overly negative and leave you feeling hopeless. This kind of self-talk takes an already bad situation and makes it worse. Research has found that CBT is highly effective for managing both pain and depression, while other therapies such as behavioral activation and Acceptance and Commitment Therapy show promise. CBT teaches individuals to pay attention to their thought processes, which can maximize or minimize pain. Thoughts like “This pain has ruined my life, and there’s nothing left to be done,” negatively affect your emotions and behaviors, said Thorn, author of Cognitive Therapy for Chronic Pain: A Step-by-Step Guide. They also make you more likely to get depressed and withdraw. “If you feel like there’s nothing you can do, you won’t do anything,” which is “really dangerous for someone with chronic pain and depression. Paying attention to your thoughts is especially helpful when your pain level rises. “As soon as someone has an empowering thought, they start to feel like they have a little bit more control over their life. Thorn suggested asking yourself, “What just went through my mind? What am I saying to myself?” If you become aware of a negative thought that’s emotionally laden for you, “stop, breathe and then consider your options.” This helps to interrupt your reflexive reactions, such as lashing out at yourself or your loved ones. It helps you choose a different path, and reminds you that you have more control than you think you do, she said. In CBT, along with other therapies like behavioral activation, clinicians also help patients discover the kinds of physical activities they can engage in without exacerbating their pain, Thorn said. They also help them make realistic goals and manage defeatist thinking. For instance, a person who used to run 10 miles might be able to walk for a few minutes today. They might easily think that such a minor activity isnt even worth it. However, as Thorn said, walking for a few minutes several days a week adds up. “That kind of gradual increase will build on itself.” Plus, regular physical activity helps to improve mood and energy levels. Obviously for many of us, walking for even a few minutes sounds like a bit of a dream but build from where you are. If you find sitting too painful, start to lie on a bed wedge and gradually increase the time (pacing) and increment of the wedge incline. Strengthening your body is always beneficial but doesnt have to be punishing exercise. Living with constant pain is especially debilitating and naturally can lead to or exacerbate clinical depression. The key is to seek treatment for both, and to remember that a more fulfilling life is absolutely possible. It may not be the one you dreamt of but as Randy Pausch said, “Its not about the cards youre dealt, but how you play the hand.”
Posted on: Mon, 07 Apr 2014 08:23:03 +0000
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