Depression and Chronic Illness, Aha!

Depression. It's an ugly word. The word itself makes you think of cloudy skies and sad commercials. You just thought of one didn't you?

Depression and anxiety can sneak up behind you and lurk in your shadow. You don't even notice the Big D standing behind you slowly cloaking you with a film over your heart.

Therein lies the problem.You are already in pain, you are already fighting fatigue, you are already feeling down, so how can you possibly know that you're depressed?  Am I feeling down because I'm in pain or in pain because I'm feeling down? When pain levels are high so are anxiety levels. You might as well not expect me to concentrate or carry a conversation because as much as I truly want to talk...my brain is busy doing things that are out of my control.
Many (not all) physicians are quick to pass out antidepressants at the first sneeze. I denied them for years. Then when I finally went in open minded I said proudly "only because it's for pain". Still denial. But I tried them, because I was assured they also help with pain and also I can't take narcotics and function at work. Then I gained 20 pounds which didn't help my joints, felt loopy all the time and more tired than before I started them. So, in my further clouded moment I told the Doc he must be wrong. I'm doing this without these meds. And I did, I went gluten free (for a short period of time) finally got biologics, took my vitamins and started feeling better-well at least manageable. I requested vitamin level blood work. I was extremely B & D deficient and completely convinced that would solve the problem. And it did help, for awhile. Then after 2 years when the first biologic stopped working, Big D camped outside my front door with the boogeyman and the werewolf and all other scary nightmare creatures. I ignored them. I knew they were coming to talk to me. To put that warm blanket of deceit over me. And without any treatment or even admitting to myself there was an issue. I opened the door myself. 
You see, depression has several stigmas and I was prideful. I believed those stigmas or at least worried about people that did and I felt shame.  Shame about having this illness, shame about things I wasn't doing at home, shame about taking things away from my husband and son. Shame that I might be depressed and someone might know.

I.
Was.
Wrong.

Now, I know that there are many types of depression and anxiety. There's even more treatment options. I'm not a licensed medical practitioner, but I can put it here for you in layman's terms when it comes to pain and depression working with eachother.
Depression hurts. Yup, we've all heard that commercial and I am not advertising for them. It's unfortunately the truth. Especially for those already in pain. For those that didn't get the instruction manual...its lovingly referred to as painbrain.
Painbrain is caused by your body and your mind fighting eachother (or maybe a strongly worded discussion). Your body is already sending signals to your brain about pain. Because your pain doesn't go away, your body is starting to send stronger messages via your hormones (adrenaline). Your brain has to listen now. But its getting so many signals and warnings that sometimes the circuits overload and you lose some concentration as well. The body fatigues as it would naturally after fighting an illness.
This also leads to painsomnia. When you can't sleep due to pain and the fight or flight signals your mind is receiving from those warning signals.
I didn't recognize it as the Big D. I was losing interest in everything.  I didn't want to leave the house. My pain levels were off the charts and if I made it through a work day all I wanted to do was sleep. Denial even then.

So there in the middle of my denial, I had an AHA! moment. Recognizing depression and anxiety as a separate yet connected issue with pain is important.  I went to talk to my doctor. Who also asked alot of questions and spent a great deal of time helping me understand the link. Getting over the stigma was the hardest but once I found the tools I needed to connect the dots, I was able to resign myself for treatment options.

Depression, part Duh! To be posted later this week.

Touch is healing and scary

My father taught me early on the importance of a good hand shake. A handshake should be firm and definitely not a limp fish. That's ingrained in my mind. Now from an arthritis perspective, meeting someone for the first time is nerve racking for me. Not wanting to come across rude, I often grin and bear it. Truth be told, I try to duck hand shakes all together anymore. 

Sadly in avoidance, I have been known to dig for an imaginary emergency in my purse. The ol' keep your hands in your pockets comes to mind. And there's the always popular politely keep your hands behind your back. Probably not the best options, but depending on the day and pain level sometimes you just can help it. 
Germs are my other reason for not shaking hands. Most noteworthy medications used for autoimmune disorders drastically compromise the immune system. Shaking hands is just not always possible. I think a nice respectful head bob should quietly replace the germ transferring painful motion of shaking hands! 

There are buttons and stickers and magnets available that simply state " I'm sorry, I don't shake hands". I suppose that's fine as well, but seems a bit forward to me. So the question is, TO SHAKE OR NOT TO SHAKE?

Touch is comfort? 

It can be when pain is not severe. A hug, a snuggle, and sometimes just a hand on the shoulder. Some believe that healing energy is passed through touch. Others believe that another heart beat is soothing. I believe anything is possible and truly just knowing that someone else wants to care for me is often comfort itself. 

Not necessarily human contact, pets can even be a source of comforting touch and good snuggle buddies. My pups definitely sense when I am in pain. They stay right by my side when a flare occurs ( a blessing and a curse). 

And then there's pain brain (many factors to pain brain will be eexplained this blog) 

I could quote some technological medically correct factoids here but to keep things in my terms. 

PAIN FRENZY- when pain receptors in your brain are firing in so many different directions that your mind overloads. It hurts to have on clothes. Sharp sounds hurt. It hurts to think. It just hurts. 

**For those of you visiting because you love someone with chronic pain, please take note. 

We do not want to be cranky, or testy, or rude. Pain frenzy is out of our control. It does not give us the right to be nasty so a gentle reminder that said crankiness has ensued will do. However, when you see the signs of pain frenzy, you may want to proactively disperse endorphin producing chocolate and back away. 

Actually, some soft relaxing music or the hum of a fan can be soothing. By eliminating other background noises that seem magnified during pain frenzy you are removing a trigger and helping to calm the mind. Everyone has different tastes in music but particularly, I use instrumental cello music or yoga inspired relaxation music. 

Short of voodoo, any method that is legal and helps subside pain frenzy is worth try to me. 

What helps this time may not the next. Don't cut yourself short by only using medications to ease pain. Explore new options.