From Both Sides of the Couch

A therapist reflects on her time with patients, and her time as a patient.

When Emotional and Physical Pain Hit Simultaneously

How do we cope when our minds and our bodies are both hurting?

At the time of this writing today, I’ve been dealing with a continuous migraine for thirty-nine days. I’ve had severe migraines for seventeen years but this is the worst one and by far the longest one has ever lasted. My usual go-to abortive migraine medication of Imitrex has stopped working.

I’ve been to the emergency room several times, I was hospitalized for two nights and received a powerful vascular constrictor by IV (which I had to be on a heart monitor for) — which helped — until I got home and the migraines returned. I was desperate and tried everything and anything to alleiviate the severe pain. I got trigger point injections, took narcotics, got massage and Reiki and nothing has helped.

I’m holding out hope though for this past Thursday I received Botox injections — about 30 of them — in my head, neck and scalp. Botox was approved to treat migraines in 2010. The neurologist said the medication could take anywhere from 24 hours to a week to take effect.

Find a Therapist

Search for a mental health professional near you.

I became less productive at work and had to cut my day short more times than I would have liked. My social life dwindled because I couldn’t stand being out. I lost my appetite and had to literally force myself to eat so my anorexia wouldn’t be triggered, but I lost some weight regardless. I wasn’t sleeping well because I would wake up from the pain.

My depression returned and my psychiatrist added Lithium to my medication regime. I don’t know whether it’s helping. I felt helpless and frustrated and I frequently burst into tears when the pain pulses through my head because there is no way to alleviate it.

When I was being admitted to the hospital, I lay on the stretcher in tears, waiting and waiting for pain medication. I waited over three hours for a nurse to come administer the meds. While I lay there, my thoughts started to get irrational and I began to ruminate about cutting my temple — where the pain was most intense — and letting the “bad stuff” ooze out so I would then be pain-free and could just go home. Once I got the medication, my thought process became more rational.

I haven’t cut myself for seven years, but when I used to engage in that behavior, I did it to distract myself from the emotional pain that I was feeling from the combination of my depression and my starving myself and the remainder of the jumble of feelings that I was unable to tolerate.

During this ongoing migraine I’ve resisted that urge to distract myself with that behavior — this time it would be inflicting physical pain on one part of my body to distract myself from physical and emotional pain that's occurring in another part of my anatomy. But I have enough scars and I've learned that cutting doesn’t work. And it just leaves feelings of regret.

 

 

Several of my patients have been diagnosed with conditions that cause chronic pain, others say they are constantly fatigued from dealing with depression and the demands of their lives and still others have serious medical problems which makes it difficult to attend sessions regularly and keep up with every day obligations.

Any one of the above situations can cause a patient to become depressed or aggravate an existing depression. As their therapist, I can listen empathetically, suggest that they see their medical physicians and encourage them to follow their directions. I can teach relaxation techniques and coping skills but in the face of severe physical and emotional pain, a patient may not have the motivation or the wherewithal to try them.

When you have a psychiatric history and have to reveal the cocktail of medications that you’re on to a physician that in itself is often the first step in creating a prejudice. The New York Times recently ran an article titled “When Doctors Discriminate.” http://www.nytimes.com/2013/08/11/opinion/sunday/when-doctors-dis...

The article details the author’s experience of being discriminated against by the medical community because of her psychiatric diagnosis.

 

I don’t know what the solution to the problem is for right now; this issue is widespread and obviously the medical community needs education. We as individuals who suffer from psychiatric illness need to stay strong, listen to what our bodies are telling us and be persistent in obtaining the medical care that we need to stay physically healthy and strong. For we need our physical strength to overcome our emotional obstacles.

We all have goals and dreams for our futures. Neither emotional nor physical pain is welcome there. Let’s find a way to continue to work hard for ourselves so we can emerge from the darkness.

 

Gerri Luce is a licensed clinical social worker who publishes under a pseudonym.

more...

Subscribe to From Both Sides of the Couch

Current Issue

Love & Lust

Who says marriage is where desire goes to die?