It’s all in your head

Over these last few months, there have been a number of news and medical publications making the claim that past trauma is the cause of difficult and uncontrollable physical pain. This isn’t a new idea nor is it a conclusive proclamation of why all pain manifests. Of course, it is catchier for journalists to summarize the story using biased language instead of explaining the actual study breakdown in full. 

There is no definitive proof that historical trauma causes intractable pain and pain disorders. There is no way to accurately measure pain. This makes studying pain and its root causes very difficult. While approaching chronic pain and rare diseases through a multisystem lens is important, qualifying all difficult pain as trauma-based is dangerous. 

Most of us who have chronic conditions have already been told, “It’s all in your head” or “ The tests are inconclusive” too many times. Some doctors will only imply that your pain is psychological, others will say it bluntly. However, there is a major psychological component to having a chronic disease or symptom. That component usually exists in tandem with the condition, not as a precursor. Being dismissed by medical professionals, finding no cure for your condition, trying a multitude of treatments, self managing and detecting physiological changes, losing family and friends, a lack of autonomy, deteriorating body function, and having no one who understands your conditions all take a very serious toll on your mental health. 

The side effects list on most prescription drugs include anxiety, depression, suicidal thoughts, impulse control issues, lethargy, and even an overall feeling of unease. When trying to control a rare or difficult disease, you are trying a bunch of different prescriptions, sometimes multiple drugs that have these side effects. Everyday we have to choose, take the pill with the side effects or take the symptoms on their own.

Although I think the story has been blown out of proportion, I don’t want to discount the reality of past trauma. Everyone has drama and trauma in their past. For some people it absolutely does present as a serious physical issue. There is a scientific reason that cognitive behavioral therapy and all forms of prayer and meditation are recommended as part of a wellness journey. Stress has been proven to have a negative impact on our bodies. Dealing with our psychological pain can help lower stress and that is a very good thing. 

If we are looking at psychology as a part of treating chronic conditions, the larger problems still remain… Who is going to pay for it?  When am I going to find the time and energy to go through a major emotional upheaval on top of trying to survive every day? Will they ignore treating my physical pain and only work on my mental health? Who is going to believe me when I say that my chronic symptoms are still present? Will future doctors automatically presume my invisible symptoms and pain are purely psychological manifestations? Who decides which symptoms are trauma related? Am I excluded from any trials or possible treatments if psychological methods don’t yield results? How is my mental health supported throughout the years? 

If a doctor asks you (or if it is a question on one of the many forms you fill out) if you are feeling depressed, anxious, lackadaisical, or are having troubled sleeping and you answer honestly, you get labeled as that feeling. Instead of asking (and understanding) if the negative feelings are in relation to your disease and/or medication, you will automatically fall into their “mental abnormalities” category and be dealt with as such. This cold knee-jerk reaction leaves patients feeling like they can’t discuss their ever changing mental health with their doctors for fear of reprisal by insurance companies and medical professionals.

Like most issues around patients with chronic and rare conditions, our mental health isn’t a quick and clean conversation. Some of us had psychological troubles before getting sick. Others only have mental issues when using medications. Even more have a fluctuating level of happiness based on their flares and physical symptoms. There is a saying in Psych classes that everyone is diagnosable. Most doctors only complete a few hours of mental health training during their schooling. If they aren’t expected to deeply understand psychology, how can patients with complicated conditions be expected to express their honest emotions?

If you are suffering from dangerous, scary, or unwanted thoughts, please seek help from a professional psychologist or psychiatrist. There are many low-cost and even free resources available to you. This applies throughout the industrialized world. There should be absolutely zero shame or embarrassment in asking for help. If you are afraid or nervous to start working on your mental health, remember that professionals practice confidentiality. There are various types of therapy so you can find one that best suits your needs. Getting help for your mental pain does not disqualify you from needing help with your physical pain. Once again, you have to be your own advocate and stand/sit/lay firm in your quest for good health.

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