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Depression from Chronic Pain: Should You Try Physical Therapy?

Robin Kahler is a patient who was diagnosed with affective bipolar disorder in 1988. She works from her home in Tucson, Arizona, as an ...Read More

I have Affective Bipolar Disorder. It was diagnosed in the 80’s and so I’ve had a few years to learn how to cope with it. But now I have to learn how to deal with the depression caused by chronic pain. For me there is a huge difference between the two.

With my bipolar, on a day of depression, I know that I need to drink more water and take a nap, and soon my meds will help. (Of course that may work for me, I know that other people have more difficulty. The hardest part about bipolar is finding the right meds, but once you find them, things run fairly smooth.)

But, I have discovered that chronic pain depression is another ball game. I personally find the depression from daily, unrelenting pain to be a hundred times worse to deal with. It is truly the worst depression I have ever felt. Some days it becomes painful to even try to smile. With bipolar, I tend to laugh and try to hide it and fool people. I can’t do that with pain. Oh I could at first, but it’s been over a decade now and smiling has become more difficult.

I have learned that chronic pain is something that I need to deal with on almost an hourly basis. One hour may be excruciating and thoughts of true darkness descend. The next hour, it’s not so bad and I’m feeling more hopeful. If you have chronic pain, you know what I’m talking about. And you know the hopeful moments are many times, too few to appreciate.

So what’s the deal about physical therapy? I did mention that, didn’t I? If you have never gone and wondered about it, I thought I’d share my experience.

I was first given a prescription to go to physical therapy back in 1999 for a torn rotator cuff. I didn’t go because someone told me therapy was painful, VERY painful. A few years later another doctor gave me another prescription for physical therapy for bursitis. Again I didn’t go because someone else told me it “hurt like hell” to go to physical therapy. Then I was given another script for spinal stenosis. Again I didn’t go. Finally I was given a script for massage for fibromyalgia and I thought, a massage didn’t sound painful, so maybe I’ll try.

But again, I put it off. I pictured entering a room filled with strange high-end exercise machines and overly buff therapists dressed in skin-tight lyrica (shiny). I live in a college town and so I thought all of the patients would be twenty-year old football players with six-pack abs and sore elbows. I really didn’t want to be the only overweight, slightly hunched over, old lady in a room filled with hyper-healthy and happy young people who would scorn my sagging skin.

Finally I couldn’t stand the pain and depression another moment, and so I made my first appointment. I tossed and turned a few nights as I pictured walking into that room full of six-packs. I wished I were young and slim again. Finally I got up the courage and I went. Because of what I’d been told, I expected a great deal of pain and I was surprised when the first thing I heard was, “the old no-pain, no-gain thing is really out-dated.”

The therapist was a nice young man named Jacob, who was dressed in cotton scrubs. (I’d pictured a comic book tough looking, “Nick”.) Jacob spent an hour telling me about things I could do to help decrease my pain. (Over the weeks I learned that he was right.) He gave me a few mild stretches to do and I got to use one of the fancy machines. He told me if I felt any pain to stop. The myofascial release massage did hurt at first, but it really does help the fibromyalgia.

I’ve been going twice a week for nearly three months and it isn’t the chamber of horrors I’d pictured. Most of the people there are my age, or older. There is a young boy who exercises for a curve in his spine that he was born with, it’s nice to see that. In my day we were just told to “sit up straight”. He’s learning some life-long lessons and it’s comforting to see how times have changed.

Clearly, it wasn’t what I’d imagined it to be. I still have pain, but I have more days that it’s less. I can certainly move better now, and it’s becoming a lot easier to smile. Of course, it helps emotionally to have someone who understands to talk to as well, but for this blog, I’m referring to my dealings with the physical pain.

Most insurance plans pick up much of the bill. I had worried about the cost, but mine turned out to be (for my personal cost) the price of two packs of cigarettes a week. I don’t smoke, but it seems more than a fair trade to me.

The best part about physical therapy is that my therapist takes the time to try to explore different things to help with my pain. For example, for many years I have applied the heating pad to my achy arms, back, and legs. I mentioned to my therapist that while the heat feels good, afterwards my body is very stiff and I can barely move for a while. He suggested that we try an ice pad. It’s a pad filled with moving cold water. I hesitated at first, but after I tried it, I found it relieved my pains for hours longer than heat ever did.

I’ve come to the conclusion that heat, for me was more comforting than helpful, it was like curling up by the fire with a good book, it felt nice and emotionally comforting, but it really didn’t help the muscle pain once the heat was removed. So with my therapist I’m learning to look at more alternatives and I’m hoping for a better, less pain filled future. I have kidney disease and so I cannot take NSAIDS or many of the drugs on the market for these conditions. I need to find other routes to explore. I’m glad I looked into physical therapy, it seems to be a route in the right direction. You may want to ask your doctor if it might be a road for you to try.

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