I was teaching health profession students this week about mental health and pain. The Circle of Self was a good visual way to capture a current phenomenon. One of the very important things we talked about was the LIMITS of MEDICATION! The students were very insightful about the reasons so many people are struggling with depression, anxiety, and pain. And, the more we talked, the more it made sense that this is a common pattern.
STRESS
We made a list of reasons why the incidence of depression, pain, and anxiety are so common. I would love to hear what you would add to this list. Current themes in our society that contribute are:
- Stress
- Anxiety
- Decreased coping skills
- Social media – most posts are either deceptively positive to look good or very negative
- News, especially so much bad news
- Poor sleep hygiene
- Expectation of instant gratification
- Reliance of medications or techniques to ‘just fix it’
THE CIRCLE OF SELF
When someone experiences depression, anxiety, and/or pain, several things tend to happen:
- Less movement – more sitting or lying around
- Decreased social activities – stay home more, reject offers to get out
- Nod off or purposefully take a nap during the day
- Have interrupted sleep at night
- Experience pain – either pain when there was none or worsening pain
These changes lead to more and more focus on self. How do I feel? What is happening to me? Why me? Why do I feel this way? Why can’t I sleep? Why can’t I get motivated? Woe is me…
This common pattern of self can also impact heart disease, diabetes, obesity, and more.
The role of SLEEP
Most adults need 7-9 hours of sleep per night. As we age, more and more things seem to interrupt this sleep. You might need to go to the bathroom more often during the night. Pain can wake you up or keep you awake. Napping during the day can mess with your nighttime sleep.
Too little sleep can increase your risk of depression. It can also make your recovery from depression most difficulty.
Too little sleep can limit your ability to manage with pain. Pain can feel worse, be more frustrating, and limit your activities more when you’re extra tired. Also, the more you hurt, the hard it is to sleep, and a vicious cycle is started.
The role of MEDICATION
Low amounts of key neurotransmitters in the brain can lead to depression and/or anxiety. There are medications that can help increase the amounts of those neurotransmitters. Note, this process takes about 8 weeks, so starting medicine doesn’t make you feel better right away. Usually your energy gets better before your depressed or anxious thoughts.
In the studies that showed that these medications can help, counseling was also a key part of therapy. The medications by themselves don’t help as much as they do when you also have counseling. It is the counseling that can help you find some different ways to think, stop the negative thoughts, and help you focus on more positive aspects of your life.
For pain, some medications block some of the pain signals going between the site of the pain and your brain. Others decrease the intensity of those signals. The pain medication should match the type and intensity of the pain. This means the same pain medication is not the best option for all types of pain. There have been huge issues in our society of overuse of pain medicine, especially opiate medications. These have a role in some types of pain. Once the pain starts to decline, the medication should be decreased and stopped. In another blog, I’ll review all of the many types of pain medications and when/how to use each.
Breaking the Cycle
Medications are part of breaking the cycle for many people. Note, medication is often helpful to start the process. It might not be needed long term. Ask you doctor about how long it will be helpful for you.
Counseling is part of breaking the cycle. Learning to change your thinking patterns is key. Having support is also key.
Then, I want to share something that has repeatedly been shown to effectively break this cycle. Do something for someone else! Focus on self leads into the negative circle that gets tighter and tighter, isolating you from others. To purposefully think about others can help you out of this dark place. Call to check on a friend. Help someone with a project. Visit an older relative or friend. Take a meal to a new parent or someone who is sick. Make a donation. Write a letter to a soldier. Plan a special outing with a friend. Join a club that works on a social issue.
There are many options! The point is to find someone else you can think about and help. Distraction is helpful for pain tolerance, anxiety reduction, and depression treatment. Thinking about someone else helps you out of the dark focus on self.
For more information about breaking the cycle of self, contact us at www.medsmash.com/contact or 410-472-5078.
For further application, check out my personal blog.