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The depression and the pain

This image represents the sort of depression I get with intense chronic pain. But not all depression is like this. I get that I am depressed. Don't get me wrong, I admit to it. When I was younger I would not because of the massive stigma. Doctors are likely to then say your pain was all in your head if you admitted to depression. And my depression is distinctly linked to my chronic pain, as it has been noted by my psychologist. Lot of pain, intense depression, especially status migraines that are in fact associated with mood issues as is. Lower pain, mood stabilizes. But I comprehend even at the best of times I have aspects of depression. Go through more severe bouts of it even when the migraines get particularly problematic as they have been.

However, this is the status quo. I find it very hard to imagine it being Otherwise with this sort of chronic pain. With fibromyalgia, chronic migraines, nerve damage and hypermobility syndrome. Not to mention other health issues. I mean this compounds to a lot of crappiness. I am fully capable of good moods. Of happiness. Of joy. Just things are dulled. Sometimes numbed. Sometimes plummet. I don't understand how I am expected to enjoy this really. Am I supposed to be pleased about this? Supposed just tolerate this existence with a smile on my face? I have a smile... yeah, it hides a lot. It is designed to.

So I know that when I add stressful, painful factors like work into the equation it is a lot more difficult to manage my mood because a lot more pain and a lot less sleep. How is this unexpected? How is this not entirely predictable? Understandable? Frankly, it makes a lot of sense to me.

When I am not working I Do a lot of things to consciously manage my mood as part of my coping strategies and even then dips and valleys are part of the pain game.

Pain wears a person down. The lack of sleep does not help with mood. We have to really work at stabilizing our mood. But I just think depression is something I will always deal with to a degree because the pain is something I will always deal with to a degree.

Obviously I have to avoid medications with a side effect of depression since clearly that causes major problems. Major risk factor there I had not considered since my depression always seemed so 'normal'... this constant presence, aside from acute pain, that I didn't think it would be dramatically affected. But it is. Not stable under those situations.

I just can't be indifferent to this pain. There is this component of suffering you simply cannot escape. Suffering is not pleasurable. It is not enjoyable. It does not make you happy. It sucks the happiness from things. You try to distract yourself from the pain, from your thinking, from everything because just pausing makes you focus on this suffering and the pain. On the suckiness of it all.

I do know that serotonin is affected by chronic pain and insomnia. However, I do wonder if antidepressants are a true solution for a depression linked to a chronic pain situation... a situation that is, well, chronic.
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