Coping with Pain and Depression… | Counseling | Therapy

Coping with Pain and Depression during a Chronic Illness Episode

Jonah Taylor , MSW, LSW — Associate therapist

Coping with pain and depression during a chronic illness episode in Philadelphia, Santa Fe, Mechanicsville image

Coping with pain and depression during a chronic illness episode:

Maybe you’ve recently gotten a chronic illness diagnosis. Or maybe you’re struggling to find a name for your symptoms. Or you may be years into your chronic illness. No matter where you are in your journey, chances are you’ve probably felt sad, angry, numb, or demotivated at times as you’ve struggled to navigate the medical system, deal with uncertainty, pay for costly testing and treatment, and cope with losses in your life as a result of your condition.

These emotions may feel particularly acute during a flare up, when your symptoms, like pain, seriously limit your life. If these emotions have been persistent over time rather than passing visitors, you may be feeling depressed as a response to the high levels of stress that often come with managing chronic symptoms. This is a common response to illness, but due to stigma and lack of training for medical professionals, too often people don’t receive the mental health support they deserve to effectively cope with the social and emotional costs of illness.

During a flare up, when your chronic illness, pain, and depression have you in a really dark spot, it can feel impossible to find a sense of control over anything in your life. You may be dealing with, among other issues, job loss, changes to your appearance, and relationship changes. This accumulation of losses may make you feel like you don’t even recognize the person looking back at you in the mirror, and this can be a haunting, disorienting experience that leaves you feeling hopeless and depressed.

The first thing to know about this experience of coping with pain and depression during a chronic illness flare up is that it’s common; it’s normal to feel scared about the future when you’re sick and it seems like your body can’t be trusted to keep you safe. The second thing to keep in mind during a chronic pain flare up is that while your emotional experience is real and valid, you don’t necessarily know what the future will bring. When you’re feeling depressed about your illness, focusing so far on the future often isn’t always useful. In fact, it can often keep you stuck in a spiral of hopelessness, making it hard to function and potentially even worsening your chronic symptoms. (See the mind-body connection.)

Coping with Pain and Depression during a Chronic Illness Episode Exercise

During your next chronic pain flare up when you would normally be coping with pain and depression, try taking a break from thinking about the future. See if you can find a greater sense of control in your life by taking things one day at a time. Here’s one way you might do that: Each morning, write down three goals you have for yourself. Keep it mind that it’s important these goals are realistic and very short-term. Don’t beat yourself up if the goals don’t seem big enough. When you’re experiencing a flare up or acute distress, your body and mind are operating from a place of complete overwhelm. Big, future-oriented goals simply are not feasible. In these moments, it’s crucial that you right-size expectations to match the moment. Your goals need to be manageable bites. Sometimes, simply setting a goal to get out of bed in the morning is enough. Another goal might be to call someone you care about to ask them how they’re doing. Taking care of others can often be a healing experience. Going to a therapy session is another goal you might set for yourself when you’re feeling beaten down and overwhelmed.

Then, at the end of the day, just take a few moments to reflect on your goals, crossing out the ones that you accomplished, and saving the others for the next day. Allow yourself to feel some satisfaction, however small, for making these steps to take control in your life. You may find that you didn't get 100% toward a goal, but don't discount having made it 40% or 60% of the way there. Write down that accomplishment even if it feels partial. Goals shift when you have a chronic illness. If you can learn to dance with the shifts rather than being rigid about your original goals, that is a worthy accomplishment itself.

Coping with Pain and Depression during a Chronic Illness Episode Exercise Part 2

If you still find a part of you thinking that your goals aren’t big enough, or that you didn’t do enough to reach your goals, just label those thoughts as skepticism, harshness, or judgment. Without fighting the thoughts, take a breath and let them go, giving yourself permission to feel some accomplishment just for making it through the day. Truly, sometimes that’s enough!

When you’re dealing with a chronic illness flare up and depression, you deserve support for managing the emotional impact that your condition has had on your life. Consider reaching out to one of our skilled chronic pain therapists to help.

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