Bipolar Disorder and Chronic Pain

The Bipolar-Pain Connection

According to recent research, about 14% of people with bipolar disorder experience migraines and another 24% experience some other form of chronic pain. That’s almost a third of people with bipolar disorder who are in some sort of serious pain!

In particular, migraines affect 1 in 7 persons with bipolar disorder, which is 3 times more likely than the general population. I’ve been living with chronic migraine for ten years now. Some days I feel like it’s a death sentence. Some days I wish that sentence was carried out. My doctors are still trying to figure out a way to decrease the frequency of my 8 to 12 migraines per month. Apparently, “bipolar disorder and migraines are multifactorial in etiology—there appear to be vascular, cellular, molecular, neurochemical (serotonergic and noradrenergic), and genetic (KIAA0564) components in common between bipolar disorder and migraine conditions.”

Pain and Mental Illness’s Affect on One Another

In general, people with mental illness who experience chronic pain tend to have worsening symptoms of their illness. Often doctors do not take seriously the complaints of physical pain from those individuals who have mental illness. A lot of times people with mental illness have increased sensitivity to pain because they are experiencing depression. Also, because they are experiencing symptoms of mental illness, many times people with mental conditions do not seek the medical care they need to address their physical pain. This leads to greater functional impairments, poorer quality of life, increased disability, and increased risk of suicide compared to those without pain.

Treatments that Address Pain and Mental Illness

Sometimes tricyclic antidepressants or other select antidepressants can be used to help minimize physical pain symptoms as well as address depression symptoms in some patients. Care needs to be taken in patients with bipolar disorder, however, due to the increased risk of triggering a manic episode in those who take antidepressants alone. Often times, a mood stabilizer will be used in conjunction with the antidepressant in these patients.

This is exactly the treatment I am currently receiving under the care of my physician. I am excited to see if it will decrease the frequency of my migraines while addressing my depression and anxiety symptoms at the same time.

Non-pharmaceutical treatments for physical pain and some mental illness symptoms can include things such as meditation, yoga, exercise, prayer, talk therapy, and diet modifications.

Work with your doctor to figure out what may be the best course of action for you. The most important thing is to not give up hope and to never give up trying to find a way out.

Unexpected Moments- A Meditation

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So many things in life come to us unexpected – sickness, heartache, disappointments. Many good things come as well like surprises, laughter, and joy. In each unexpected moment lies the essence of life. These are the moments that cannot be planned or constructed in any way. These moments are gifted to us by the sheer forward propulsion of living, of being alive.

When entrapped in the snare of mental illness, we are still within an unexpected moment of life – a moment of sickness. We are still in the forward propulsion of living because mental illness is not static. It is a dynamic phenomenon that must be ridden out like a surfer on an ocean wave. With treatment and time, a solution may be but a moment away.

In those unanticipated moments of darkness and despair, I will keep an open mind so that I may hear an unexpected message of hope and I will know peace.

Borderline Personality Disorder and Motherhood

I bee lined down the hall into the bathroom, and shut and locked the door behind me before falling to my knees. Covering my face with my hands, I sobbed. Outside, my two and six year old girls banged on the door. “Moooommy! Moooommmyyy!” I thought, “Oh, my God! Why can’t they just leave me alone?”…

Read more of my guest post today at Healing from BPD’s website.

An Open Letter to Those Contemplating Suicide

TRIGGER WARNING: Suicide

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An open letter to those contemplating suicide:

I have been where you are, and I know how you feel. Do not shake your head, please. I really do know…the gut-wrenching emptiness, the suffocating weight, the terrifying loneliness, the absolute certainty that you will never feel any better than this moment.

I know the maddening thoughts which peck away at your mind like a vulture picking and pulling rotting meat from a carcass. I know the horrifying realization that you have no control over your feelings; that no one can know the depths of your despair and worse, that no one can save you from the black hole swallowing your mind and soul.

I know the physical aches and pains, the dead-weight of every extremity as you try to simply move from one position to another; the grayness of the world, day in and day out; the tears, the endless stream of tears; the absolute void of anything positive; the loss of all things which use to bring you peace and joy. These things I know.

I have also been where they are, and I know how they feel. Please do not doubt me. I really do know… the feel of the hard floor hitting their knees after hearing the news of your death; the anguishing pit in their stomach as bile rises in response to the action you took; the constant and nagging nightmares of what your last thoughts were before you swallowed the pills, pulled the trigger, fell from the chair, jumped, or cut through your vein.

I know their flashes of imagery at how you must have looked while you died and right after; their regrets of things said or things not said, and never having the opportunity to tell you that you don’t have to do this; that you don’t have to choose a path that will cause so much horrific pain and devastation to those you leave behind.

I know the clutching of their hearts and their screams of “No, no, no!” I know how they’ll have to live the rest of their days wishing they could see you smile one more time; give you one more hug; share one more laugh, cry, argument or anything with you. I know that they will never stop thinking of you, or truly be able to fill the spot you tore from their being.

I know depression is a disease of perception, and it wants nothing more than to kill you. It is a disease of the body, attacking mercilessly. But it is also a disease that can be treated. No matter how many times treatment has failed, if there is breath then there is still hope.

Please do not take away the ever-present possibility of help. Breathe for one more day. Tell someone you are thinking of suicide, and then breathe again for another day. Tell someone else you are thinking of suicide, and breathe yet for one more day. Keep breathing and keep telling someone how you feel.

Be honest with those who can and will help you – family, friends, and professionals. If you don’t have those options, find another professional and another until someone can help you. Call a stranger, a hotline, go to a support group and ask for help; keep reaching out to someone; keep asking for help. Find people who will care. They are out there; keep searching and don’t stop until you find them.

And most importantly, keep breathing. As long as there is breath, there is hope.

Mental Illness and the Power of Now

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I’ve been reading the book, The Power of Now by Eckhart Tolle, for about ten months. I can only read a few pages at a time before it becomes too intense in its truths and suggestions for my brain to handle. It’s a fascinating book that gives me a lot to think about and meditate on.

Today, I wanted to share a quote from the book that particularly related to my mental illness symptoms, and maybe to yours as well. It has to do with surrender, which Tolle explains is an inside job, meaning that while you can take action to try to change the overall situation if you want to, you still need to accept the tiny segment of Now that is occurring.

If I equate this with my mental health symptoms, I may need to accept, for example, that I am feeling sad and agitated at the present moment. Overall, I have been feeling this way for the past week, which I can work towards changing by reporting these symptoms to my doctor, praying, writing, and focusing on what tasks I have in front of me – in the Now.

It is when I do not accept or surrender to my current feelings that I become even more depressed and agitated to the point of wanted to harm myself in some way. (Some people may cut, abuse drugs or alcohol, overeat, engage in risky behavior, or attempt suicide.)

So, here is the quote:

“Non-surrender hardens your psychological form, the shell of the ego, and so creates a strong sense of separateness. The world around you and people in particular come to be perceived as threatening. The unconscious compulsion to destroy others through judgment arises, as does the need to compete and dominate. Even nature becomes your enemy and your perceptions and interpretations are governed by fear. The mental disease that we call paranoia is only a slightly more acute form of this normal but dysfunctional state of consciousness.

Not only your psychological form but also your physical form – your body – becomes hard and rigid through resistance. Tension arises in different parts of the body, and the body as a whole contracts. The free flow of life energy through the body, which is essential for its healthy functioning, is greatly restricted. Bodywork and certain forms of physical therapy can be helpful in restoring this flow, but unless you practice surrender in your every day life, those things can only give temporary symptom relief since the cause – the resistance pattern – has not been dissolved.”

Aren’t these ideas amazing to ponder? I can relate to all of them. I have a fear of people hurting me; feel like I am in competition with everyone; filled with fear of natural disasters, or some harm coming to one of my children. Fear rules my life, and I don’t want it to.

Physically I am usually in pain – tension headaches, muscle cramps, migraines, neck stiffness, clenched jaw, exhaustion, etc. I exercise, go to the chiropractor, and get massages to try to relieve my physical pain. The results are always temporary, lasting a day or two at the most.

I must work on surrendering to what is in the Now. I must work on dissolving the “resistance pattern.” But, how? I will keep reading and let you know what I find.

What are your thoughts on this? How do you work on surrendering in your daily life?

The Stigma of Mental Illness

“The challenge we all face is how to integrate after loss or conflict and return to a greater wholeness of self. This is accomplished through social supports, coping, and other resources. This we call the process of emotional healing…” – from People Can Recover From Mental Illness, an article by Daniel Fisher, M.D., Ph.D. and Laurie Ahern

When it comes to mental illness what can I say that has not already been said? Not that it matters. Maybe it does. I don’t know. All I know is that I have it and so do others – others like me, who are stigmatized by the ignorance of those who don’t have it; by those who have it but don’t know it; by those who have it but act like they don’t.

How can one understand an experience if they can’t experience it first hand? I don’t believe they can. Intellectually they may be able to comprehend the phenomenon, but bodily, mentally, emotionally, and spiritually, they cannot.

In my experience, except for three people in my life (one being my therapist), others do not even want to understand. It is so far beyond their comprehension that they don’t even ask questions, research, or read about mental illness. Only one other in addition to the above three shows sincere concern for my symptoms and experiences with mental illness. I am grateful that I at least have four people who care. I probably have more but they either don’t know how to show it or don’t know enough to know they should show it.

I don’t think the stigma of mental illness will ever go away outside of those who actually have it. If people could only open their minds and their hearts to see beyond the craziness, the depression, the manic behaviors, the anger, the insecurities, the social anxiety, and the dissociation – all of which most people have to some degree or another, though they’d never admit it – then maybe they would see a soul; souls who just like them are doing the best they can within the physical limitations of their bodies and minds. Maybe then they would learn how to validate rather than ignore or worse, shun or even worse, judge. Maybe then they could become allies to our healing journeys rather than obstacles.

Writing Moment by Moment #23 and #24

#23 – A beautiful person gave me permission to accept help without feeling guilty and to take extra-special care of myself because I am “going through a healing period” which I need not minimize.  A weight lifted from me in that moment.

 

#24 – I think that I finally get what “mindfulness” means versus distraction.  Here’s a fun fact:

“Mindfulness practice leads to increases in regional brain gray matter density…in brain regions involved in learning and memory processes, emotion regulation, self-referential processing, and perspective taking.”  ~Psychiatry Res. 2011 Jan 30;191(1):36-43. Epub  2010 Nov 10

Now, to practice it…

What moment are you grateful for today?  I had three wonderful “in the moment” moments today – the above two and a third which I posted here.

For more on “Writing Moment by Moment” click here.

Writing Moment by Moment #1

Each day for the month of January, I am going to write about one small moment for which I am grateful. If possible, I will also include photos. I am calling these posts, “Writing Moment by Moment.”

The objectives for this exercise are to increase my attention to the little things in life that I normally take for granted or might not notice otherwise. Some examples include, a small bird chirping outside of my window, my dog’s lazy yawn-and-stretch routine, the way my daughter’s hair sticks up in the morning, the smells from the kitchen when my husband is cooking a yummy dinner, and the list could go on ad infintum.

Would you like to join me and record one moment that you are grateful for each day? If a daily committment seems too overwhelming, how about once a week or month? I’ll be honest with you…I will probably miss a day here and there but I am going to do the best I can. Each day I write for a moment is better than not doing it at all.

Leave a comment and let me know what moment you are grateful for today or if you prefer, post it on your blog and then come back and leave the link to your post in the comment section so I can stop by and witness you “Writing Moment by Moment.”

 

Today, I spotted my journal (see photos above and below) on top of my bedside table and in that moment, I felt extremely grateful for the role writing has played in my healing process over the years.

 

What moment are you grateful for today?