Tuesday, December 13, 2011

The effects of pain...

Now, I have fibromyalgia. It means that I'm in pain almost constantly, and some times more than others. Now is "more than" time.

I have been saying that this is "just pain", just my brain misinterpreting the signals, not a sign of that I'm losing the ability to use my hands or so. So, basically nothing to bother about.
Then I remembered the "side effects" of pain...

- I can't function when in pain.  This will cause all kinds of things, like stress for work undone, feeling of being worthless, useless, a burden, feelings of jealousy and envy towards people who still can function "normally", anger, helplessness, loss of control, the feeling of being vulnerable and exposed...  and this will cause enorm stress on relationships. People can feel distance from their friends, loved ones and relatives, deliberately isolate themselves, become hostile. Also, the balance changes. I am forced to take, accept, receive more than I can give, I'm forced into a dept of gratitude with no means to pay it back.

- of course pain will make me tired, AND it will make it harder for me to sleep... so I will be suffering from all the effects of sleep deprivation
"This chronic sleep deprivation results in daytime sleepiness, slow reflexes, poor concentration, and an increased risk of accidents. Sleep apnea can also lead to serious health problems over time, including diabetes, high blood pressure, heart disease, stroke, and weight gain."

"...depression, irritability, sexual dysfunction and learning and memory problems..."

"...worsening of ADHD or symptoms similar to ADHD; hypertension"
(ADHD is a problem with inattentiveness, over-activity, impulsivity, or a combination.)
- pain makes me tense - and having tense neck and shoulders give me headache... which makes me tense more.

- pain CAUSES anxiety/panic disorders and depression/affective disorders, which cause more pain... an evil circle...

- people with pain try to self-medicate - I use sugar and comfort food - so I get fatter the more pain I have, and I have more pain the fatter I am...

-also, people with pain gain weight because they are unable to adapt their lifestyle to the new existence with pain - they eat what they are used to eat but exercise less.

- "Conversion disorders"

Conversion disorder (formerly known as "hysteria") is a condition in which patients present with neurological symptoms such as numbness, blindness, paralysis, or fits without a neurological cause. The term "conversion" has its origins in Freud's doctrine that anxiety is "converted" into physical symptoms.

(Women considered to be suffering from hysteria exhibited a wide array of symptoms including faintness, nervousness, insomnia, fluid retention, heaviness in abdomen, muscle spasm, shortness of breath, irritability, loss of appetite for food or sex, and "a tendency to cause trouble")

- Somatization is currently defined as "a tendency to experience and communicate somatic distress in response to psychosocial stress and to seek medical help for it".

- schizophrenic / bipolar / DID  behavior
Schizophrenia is a complex mental disorder that makes it difficult to:
- Tell the difference between real and unreal experiences
- Think logically
- Have normal emotional responses,
- Behave normally in social situations

Bipolar disorder is a condition in which people go back and forth between periods of a very good or irritable mood and depression. The "mood swings" between mania and depression can be very quick.

The manic phase may last from days to months. It can include the following symptoms:
- Easily distracted
- Little need for sleep
- Poor judgment
- Poor temper control
- Reckless behavior and lack of self control (Binge eating, drinking, and/or drug use; Poor judgment; Sex with many partners (promiscuity); Spending sprees)
- Very elevated mood (Excess activity (hyperactivity); Increased energy; Racing thoughts; Talking a lot; Very high self-esteem (false beliefs about self or abilities); Very involved in activities; Very upset (agitated or irritated))

The depressed phase includes the following symptoms:
- Daily low mood or sadness
- Difficulty concentrating, remembering, or making decisions
- Eating problems (Loss of appetite and weight loss; Overeating and weight gain)
- Fatigue or lack of energy
- Feeling worthless, hopeless, or guilty
- Loss of pleasure in activities once enjoyed
- Loss of self-esteem
- Thoughts of death and suicide
- Trouble getting to sleep or sleeping too much
- Pulling away from friends or activities that were once enjoyed

Dissociative identity disorder (DID) (multiple personality disorder) describes a condition in which a person displays multiple distinct identities, each with its own pattern of perceiving and interacting with the environment.

Symptoms can include:
- Multiple mannerisms, attitudes and beliefs which are not similar to each other
- Unexplainable headaches and other body pains
- Distortion or loss of subjective time ( a long time)
- Depersonalization (a feeling of watching oneself act, while having no control over a situation.)
- Derealization (an alteration in the perception or experience of the external world so that it seems unreal. Other symptoms include feeling as though one's environment is lacking in spontaneity, emotional coloring and depth.)
- Severe memory loss
- Depression
- Flashbacks of abuse/trauma
- Sudden anger without a justified cause
- Frequent panic/anxiety attacks
- Unexplainable phobias

Patients may experience an extremely broad array of other symptoms such as pseudoseizures that may appear to resemble epilepsy, schizophrenia, anxiety disorders, mood disorders, post traumatic stress disorder, personality disorders, and eating disorders.
- sexual dysfunctions and problems... not only because of the pain itself, bad self-confidence and social problems. No-one told me "that vulvar vestibulitis/vulvodynia is clearly associated with fibromyalgia".

- changes in personality, mood, appearance, self-image and -worth
  - pain haze - "zombie shut down mode" - all the functions except the basic survival ones are shut down.
  - one becomes more aggressive, irritable, impatient, hostile
  - one becomes uninterested, unable to focus on anything but pain, sad, hopeless, apathic, unable to enjoy of anything, or find anything beautiful or fun, one becomes fearful and suspicious, even paranoid; introverted, isolated
  - one becomes tense, stressed, worried
  - one is not only defined by what one thinks of oneself, but what others think of one... so when I'm getting irritable, depressed and tired of pain, people start avoiding me because I'm irritable, depressed and tired, not fun to be with, and then I start defining me as irritable, depressed and tired, and focus on being all that...
"The researchers found that there was a decrease in gray matter volume in the prefrontal cortex, the amygdala, and the anterior cingulate cortex (ACC) of fibromyalgia patients."

The prefrontal cortex ... has been implicated in planning complex cognitive behaviors, personality expression, decision making and moderating correct social behavior. The basic activity of this brain region is considered to be orchestration of thoughts and actions in accordance with internal goals. The most typical psychological term for functions carried out by the prefrontal cortex area is executive function. Executive function relates to abilities to differentiate among conflicting thoughts, determine good and bad, better and best, same and different, future consequences of current activities, working toward a defined goal, prediction of outcomes, expectation based on actions, and social "control" (the ability to suppress urges that, if not suppressed, could lead to socially unacceptable outcomes).

The amygdalae ... perform a primary role in the processing and memory of emotional reactions...

The anterior cingulate cortex... ...appears to play a role in a wide variety of autonomic functions, such as regulating blood pressure and heart rate, as well as rational cognitive functions, such as reward anticipation, decision-making, empathy and emotion.
- pain makes you more sensitive to pain, not the other way around: the more pain you experience, the more pain you will experience...


I recognize myself in much of what Nikki Albert says in "Chronic Pain: Personality".

I'm finding it very hard to cope with having fibromyalgia, even though it becomes more and more obvious that I have it. (Yes, even after the diagnosis by an expert I have my doubts... I suppose I don't want it. I want to think it's all in my head, just a fragment of my imagination, just hypochondriac attention seeking or something. Not real.)

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