Fear of pain is normal and natural but I think an acute fear of depression’s pain actually makes depression worse; and of course, this is something that none of us want. But how does fear make pain worse? Can you get over fearing depression’s pain?
We Fear Depression’s Pain
I fear depression’s pain. I fear my next depression. I fear the worsening of a current depression. I fear how painful tomorrow might be because of depression. I fear what might happen because of depression (My Suicide Attempt Story).
If you’ve never suffered from severe depression you likely won’t understand this fear and this pain but the pain of depression is real and really life-threatening (Healing After a Suicide Attempt) because it can be so severe. It’s like any other kind of pain. It’s like severe pain due to an illness or after an injury – it’s horrific. But the difference is, depression pain often pops out of nowhere. If you had the risk of breaking your femur and experiencing that pain at any time, you would be scared of it too.
Depression Pain Gets Worse When You Fear Pain
The thing that I’ve learned is that fear increases pain. Let’s say you have a pain level of 6 (where the pain is measured between 1 and 10, 10 being the most pain you can possibly imagine). A pain level of 6 is nothing to kid about. It’s awful and it’s going to make it very difficult to accomplish the things you need to do (I Can’t Do Anything Because of Depression, or Can I?).
And it would be completely normal to fear your pain getting to a 7, 8 or more. You might ruminate on the fact that you’re in pain and marinate in the fear of it continuing or worsening. You’re` focused completely on the pain in the future. And when you focus on bad things happening in the future, that produces anxiety (it’s pretty much the definition of anxiety) and that anxiety about the pain increases the pain you actually feel. So suddenly you’re not living with a level 6 pain, you’re terrified of a level 7 and that makes the pain even worse.
It’s a trick of the brain.
The Brain’s Fear of Pain Is Usually a Good Thing
Under other circumstances, fear of pain is helpful – when, for example, you can control whether you experience future pain. Fear of pain allows you to modify your behavior so the same pain doesn’t occur again.
But in the case of depression, you typically experience a loss of control. You don’t control whether the pain of depression gets worse in an hour, or a day, or a week. You don’t control if it goes away. You can use coping skills and treatment to try to make the depression do what you want, but in the end, you just don’t control your brain. This increases fear. And I might suggest, it increases mostly useless fear.
Dealing with Fear of the Pain of Depression
I think it’s clear that fearing pain makes sense in most human circumstances, but it doesn’t make sense when you’re talking about a brain illness – something you can’t control.
So when you feel depression pain getting worse, check in with yourself: are you terrified of what comes next? Are you feeling extreme anxiety? If so, you need to deal with that (Dealing with Fear and Anxiety in Bipolar Disorder).
First, admit that you’re scared and/or anxious (Being Incapacitated by Anxiety in Bipolar Disorder). Say hello to the fear and/or anxiety. Shake its hand. Acknowledge that these are feelings that exist to protect you. The fear and/or anxiety is doing its job. It’s trying to be helpful.
But because in this case, these feelings aren’t helpful, we need to work to get rid of them.
I suggest tuning into your pain and really feeling it. Feel where you are right in the here and now. Realize that your pain is at a 6 and not a 7 or 8. Acknowledge that pain. Acknowledge that it hurts and acknowledge that it sucks. Be real with yourself.
And then realize you can’t predict the future. Take deep breaths. Then take a few more (Mindfulness Coping Skill 1: Deep Breathing). Feel the cool air fill your lungs. Realize that you are living now and not tomorrow. Tomorrow – and its pain or healing – aren’t guaranteed to anyone. Dealing with the now and not the later will help beat that fear and anxiety back. (Yes, this is part of mindfulness.)
And beating those feelings back can help how you experience your depression pain.
I know it’s really hard to talk your depressed brain (A Depressed Brain and a Mind Trying to Deal with It) into anything, let alone convincing it to give up fear and/or anxiety. I get that. But it’s important. Because after all, having to live with a level 6 pain is bad enough without adding fear and/or anxiety on top of it.
Image: The original uploader was Harrygouvas at Greek Wikipedia [CC BY-SA 3.0 or GFDL], from Wikimedia Commons.
Depression affects the body in peculiar ways. There are medications that can ease the pain and bring up mood levels, but the person has to take it regularly without fail. I am happy to see more individuals like you coming forward to share your awareness. Hopefully this will get rid of the stigma attached to such issues.
Hi Natasha,
Thank you so much for this post, and also for writing the post Bipolar Is about Physical Pain Too. My former therapist didn’t believe the muscle pain I have during my depression is real. She said in her 20 plus years of being a therapist, she’d never heard of anyone experiencing painful depression before. However, she hadn’t had very many bipolar clients in her career either.
The pain I have reminds me of the muscle aches of a very bad flu. I don’t know exactly what causes the pain, but the pain is real! What bothers me most is that I let this therapist make me doubt my own experience, and I felt ashamed of who I am. So, thank you for being brave enough to face this disorder, take the pieces apart, and then lay them out where we all can see them.
Carol – Bipolar II Rapid Cycling (and it ain’t pretty)
I agree with you, Natasha. Fearing the depression just creates a vicious cycle of depression, anxiety, fear, increased depression and pain, more anxiety and so on. Fear and anxiety were the keys to my increasing depression. Once I realized that, I was able to do something about it. I started learning to accept my feelings of depression instead of fighting against (which made it worse). That was a major step to heading off a major depressive nosedive. Also, my psychiatrist gave me a medication that helps to relieve anxiety — not a benzo. The combination of these two items in addition to my regular meds really helped to level me out.
Hi Natasha, thanks for writing your blog! I’m writing a novel for ages 10-15 about a girl and her bi-polar Aunt. who goes off her medications. I’m a bit stuck on how to get the Aunt down from her manic phase. She has stopped taking medication, and is very manic. How would her mania end without medication? Could she wake up one day and be depressed? Or is it more likely she would fall off gradually over a period of days, or weeks? I know it’s different for everyone, I have bi-polar relatives and have also worked in residential mental health facilities and I’ve read SO MUCH! But I can’t seem to find answers to this question and accuracy is really important. Any suggestions would be great, or suggestions for further research. Thanks!
Hi Meredith,
I’m going to post your question on Facebook and see if we can get you some answers.
– Natasha Tracy
Hi Meredith, interesting question, given that all the literature is from people working in medical settings, who for obvious reasons don’t tend to see a lot of untreated episodes anymore (or at least don’t leave them untreated). And with use of lithium and other agents going back ~70 years, there’s not a lot of modern info. Got me curious. ?
One short writeup https://onlinelibrary.wiley.com/doi/epdf/10.1002/pnp.283 reported a “background risk” of 10-20% of people switching from mania to depression. Length of untreated episodes vary, but it says typical is 3-6 months, which I’ve seen elsewhere. I haven’t chased down the references but it might be a good starting point.
For a historical perspective, this article looks at admissions to a UK asylum from 1870-1875. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC539549/pdf/0960361.pdf
Hi Meredith, there are quite a few responses to your query on Facebook. You can see them here: https://www.facebook.com/natasha.tracy.writer/posts/10216229774076410
– Natasha Tracy
I always love your material, here and at Healthy Place. Thank you and sending wishes for joy and peace.
Sue
Hi Susan,
Thank you very much :)
– Natasha Tracy