How to Manage Chronic Pain and Depression when Everything Else isn’t Cutting it.
Pain mitigation is always the goal of treating pain conditions; however, there are cases in which chronic pain can only be managed. Western medicine’s approach to pain management is through medications, i.e., opioids, steroids, anti-inflammatories, muscle relaxers, and last but not least—antidepressants. But what non-pharmaceutical approaches are there to manage pain, and more specifically, to manage the depression associated with chronic pain?
Herbs & Nutritional Supplements
There are many natural supplements used to help with chronic pain and depression, such as turmeric, white willow bark, frankincense, cat’s claw, ginger, St. John’s wort, omega-3 fatty acids, SAM-e, kava kava…and the list goes on. In my over two decades of clinical experience in complementary medicine, I have not found these to be potent enough to handle severe pain or depression. Why? Because either the condition is too advanced or a person’s system is not sensitive enough to respond to the gentle approach of natural supplements.
If a person is accustomed to taking pharmaceutical drugs or potent over-the-counter medications (NSAIDs and Acetaminophen), it is unlikely that a supplement’s milder effect will be able to provide anything close to the same level of relief as a prescription or over-the-counter drug. It is possible to step-down one’s tolerances where natural substances would have a more noticeable effect on the body, but this would require an extended period of abstaining from strong pharmaceuticals as well as refraining from chemicals and stimulants commonly consumed in the diet. For severe chronic pain and depression, abstaining from prescription pharmaceuticals is not a viable (or wise) option for most patients.
Here are a few unorthodox things to consider to manage pain and depression:
Sleeping Beauty probably died young.
Sleeping 6.5-7.5 hours is considered a moderate, and moderation is the key to health. Sleeping too little or too much increases mortality risk. The most significant mortality risk comes with sleeping too long. Cases involving depression often list poor sleep as one of their symptoms, yet what is a more accurate portrayal is fragmented sleep, where they wake not long after the onset of sleep, then a while later they fall asleep again (at any time of day). People with chronic pain and depression, even though they have sleep disturbance at night, generally sleep too much and it poses a risk for increased pain, a worsening of depression, and a higher mortality rate.
“I hurt, I’m tired, and right now I just need to rest. Tomorrow I’ll go for a walk or go to the gym.” Yep, we tell ourselves that a lot. Tomorrow becomes another yesterday. Movement is different than exercise. With exercise you move at a higher intensity and take days off, with movement you get to sleep and rest—that’s it. Set a routine for movement—go places, piddle around the house and yard, get out the bicycle, or take a stroll with your pet. Here’s the rule: you have to move your legs, and you can’t sit nor lay down. With chronic pain and depression, rest less and move more, especially when you do not want to.
Take off the sunglasses and ditch the sunscreen.
Exposure to sunlight creates a feeling of well-being. Ultraviolet A (UVA) and ultraviolet B (UVB) increases the number of beta-endorphins that make you feel better by reducing pain, increased relaxation, and producing the “runner’s high” during exercise. Sunlight deprivation is connected to depression. Also, insufficient sunlight exposure can result in too much melatonin that causes tiredness, listlessness, and depression. If you are in pain or depressed, stop covering up and shielding out the light—soak it in. But remember, moderation is the key to health. Do not let your skin to get red and avoid sunburns. A wide brim from a hat beats a pair of “looking cool” sunglasses any day and still lets in the full spectrum of light.
Take time to breathe.
Meditation is not a ritual requiring a rigid pretzel posture with incense in the air while repeating a mantra of some foreign language gibberish or flowery positive affirmations. Meditation is about taking a break to breathe. Just check out for a few minutes, sit, and take several mindful breaths. While you are doing this the world around you, and within you, can reset. When meditating, do not try and figure out complex issues or empty your mind of all its many thoughts, just enjoy the breath—in through the nose, down into your belly, up into your lungs, and out your mouth. Meditation is a better alternative to taking a nap and is more rejuvenating. Also, you don’t require a snack after deep breathing like you do a nap, which helps eliminate those unwanted calories.
Choose the right support network.
Do not hang out with depressed people and don’t bring upbeat people down. Support groups may have their place and offer real empathy and compassion, but they can also be a dismal vacuum of commiseration and competition for pity. We all have to paint on a smile now and then, and people with depression have to do it a lot. The upside is that pretending to be happy creates a sense of happiness. A person should not feel fake or their feelings contrived, yet trying to become a better you may require a little “fake it until you make it” attitude. Find a support group of people that support you and not your condition.
Oh, do not forget…
Acupuncture by Troy Sammons works hard to mitigate pain so that you can enjoy the fleeting moments of life without pain and depression. (Obligatory plug. ?)