Double Trouble: Physical Pain & Bipolar’s “Psychic Pain”

Last Updated: 1 Jul 2019
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Dealing with the physical pain PLUS the “psychic pain” of bipolar can be difficult to do. But that doesn’t mean that you have to stop living your life as you want to.

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A few years ago, I started long distance walking. I found that hitting the two- and three-hour mark was the only way my “bipolar brain” experienced the benefits of exercise. The shorter stuff, the 20-minute walk that supposedly raises serotonin? Never did anything for me. But the long distance? Wow! In order to train harder, I decided to start biking. I even contemplated giving up my car—where I am, in Portland, Oregon, it’s possible to bike and walk everywhere (as long as you don’t mind rain).

Unfortunately, the second time I rode a bike marked the end of my biking dreams. Due to a mechanical problem with my brakes, I hit a curb and my body flipped over the front of the bike at the perfect angle for the handle bars to twist and poke me in the pelvis, then I slammed onto the concrete. I was pretty stunned by the fall, but I actually laughed because it was exactly like the movies: the entire thing felt like it was in super slow-mo—including the way my body bounced when I hit the ground. After taking a minute to clear my head, I stood up. Wow, that was crazy! I thought to myself. I started to walk away and realized I was limping a bit, but I figured I’d be fine.

The reality? Hitting the handle bars had dislocated my pelvis. Landing on the concrete on my right hip had popped my pelvis back in … sort of. The limp I noticed was from my semi-dislocated pelvis, which I unknowingly walked around with until one day my wonderful osteopath said, “Julie, your hip is riding up on the right. Let me fix that.” Pull! Crack! Ouch, but pelvis back in place. I started physical therapy to rehab the damage to the muscles around the injury and—are you ready for this?—I pinched a nerve in my lower back. Let’s just say, I have not healed as I would have hoped.

I’ve spent the past year in severe pain. I was prescribed painkillers, but realizing that I wasn’t getting any better and not wanting to be dependent on the pain medication, I discontinued taking the meds —which meant dealing with increasing pain while trying to keep my act together in the real world. But I did it.

Experiencing this kind of pain has changed me. I understand what I call the “psychic pain” of bipolar disorder, but this? Words cannot begin to describe how physical pain can debilitate a person.

There was a moment not long ago when I was lying in bed feeling like my world was ending. Let’s face it: I only have so many internal resources, and if managing bipolar takes up 50 percent of my inner resources and dealing with physical pain takes up the rest, what, exactly, am left to work with for everything else? Who wants to live in a world of downswings and pain management? And then I felt strength begin to flow into me, the strength that comes sometimes when my life feels like it’s just too hard. It’s like a well with a false bottom: once you press a bit, you find that little something extra that is needed to get up, get out, and get on with your life. And that’s what I did.

Now, I make myself do things whether I’m in pain or not. I have a choice: I can have a memory of pain, or a memory of playing with my nephew (even though I’m in pain). Just like with depression, I can live my life despite what is happening in my body. I want memories of living life, not lying in bed.

I’m getting better. Surgery is scheduled, and I’ve found that people are very understanding about my work limitations related to the injury. The most important step? Dealing with the fact that once again, just like with my bipolar disorder, I’ve lost large sections of my life due to a medical issue. The bike accident was another curve ball, but it happened because I was out there doing things and reaching for goals and living my life. And nothing—not bipolar, not a bike accident, not whatever new curve balls might come my way—is going to stop me from doing all that, and more.

Printed as “Fast Talk: The Inner Wall of Strength,” Summer 2014

About the author
Julie A. Fast is the author of Loving Someone with Bipolar Disorder, Take Charge of Bipolar Disorder, Get It Done When You’re Depressed, and The Health Cards Treatment System for Bipolar Disorder. She is a columnist and blogger for bp Magazine, and she won the Mental Health America journalism award for the best mental health column in the US. Julie was also the recipient of the Eli Lilly Reintegration Achievement Award for her work in bipolar disorder advocacy. Julie is a bipolar disorder expert for ShareCare, a site created by Dr. Oz and Oprah. Julie is CEU certified and regularly trains health care professionals, including psychiatric residents, social workers, therapists, and general practitioners, on bipolar disorder management skills. She was the original consultant for Claire Danes for the show Homeland and is on the mental health expert registry for People magazine. She works as a coach for parents and partners of people with bipolar disorder. Julie is currently writing a book for children called "Hortensia and the Magical Brain: Poems for Kids with Bipolar, Anxiety, Psychosis, and Depression." You can find more about her work at JulieFast.com and BipolarHappens.com.
49 Comments
  1. Wow! You did not get the point of this article did you? The physical pain manifested from mental illness is very real and painful! How dare you try to minimize and laugh at someone’s suffering! I’m glad you found the strength to persevere despite your injuries; but honey, you are welcome to take my pain on any day! Let’s see how well you persevere when the pain is in your head!

    1. Yes that is kind of what I’m thinking. My pain is mental and emotional, and every bit as debilitating. Another discouraging article that i can’t aspire to.

  2. I had my bipolar hip replacement surgery in July/2017. I am still not in a position to walk freely, without any support, I can not walk. My age is 81 plus, may be age factor is a cause. Most of the pain i feel is ion the ham string region and groins.

  3. Hello to Everyone. Thanks for the great comments. I should clarify that this was originally published in the magazine as a personal column. It’s not an article on pain in bipolar disorder. That is something I definitely need to write about in the future as so many people with bipolar experience physical pain such as pain from fibromyalgia. Here is my response to the questions I’ve read below. Thanks for reading and sharing all of your stories. Julie

    I use the words ‘psychic pain’ to describe how horrible I feel when I’m in a rough mood swing. The pain is not physical, but I hurt in so many other ways. Physical pain is of the body. I can touch where it hurts. ‘Psychic pain’ doesn’t manifest physically. It comes at me from all directions.. I’d love to give you an update. I was quite a mess physically for two more years after I wrote this article. I also had to get a lot of treatment for the head injury that happened when I broke my back and dislocated my hip. The truly great news is that I’m better. I walk without a cane. My pain has been reduced by 75% and I plan to be pain free within the year. You can read all about this journey on my Facebook page. I was scared for many years that I wouldn’t recover from the accident. But I kept going forward as though I did believe I would get better. I have a ways to go, but I’m better. The accident thwarted my dream to move to France. Guess what! I am now in France. If you have pain along with your bipolar, I believe there are answers. You can post specific questions to me about how I’m managing the pain these days by writing me on Facebook. I love the comments. We are strong peope!

  4. I’m sure your pain feels very serious to you. I’m sorry, but I had to chuckle. I started missing school at 14 as a ballet dancer for misaligned hips and impinged lower back, and gave up dancing. Started snowboarding full time. A few broken tailbones and some compressed vertebrae I had no idea about for several years until an xray during a diagnostic exam for fibromyalgia (which I have, in addition to joint hypermobility. By 19, I had chronic tendonitis bilateraly in my shoulders, hips, and ankles.) I also have chronic migraines. I figured if I was going to be in pain anyway, why should I give up what I love? I was a snowboard instructor. Later, I was in a devestating motorcycle crash and had concussion #5 (brain bleed), broken collarbone (plated with 8 screws a year later), a 3″ piece of metal in my side, 3 broken ribs, a punctured lung, and a broken back I narrowly avoided paralysis from. I was back on the mountain less than 5 months later after rigorous physical therapy. A year later I took up downhill mountain biking and crashed a lot. Had wrist surgery that fall. Kept riding. I ride in the freestyle terrain park, and busted my face on a 200′ fun box. Not even a big deal. Chipped a bone off my wrist and didn’t notice for months. Up to 10 concussions, 5 while wearing a helmet. Tore my MCL and meniscus this year, have no time to get it fixed, still ride my bike to work a total of 10 miles/day. My shoulders will eventually need surgery (I’ve had 7 from head to toe so far), and taking my shirt off is incredibly painful. So is sleeping. I don’t bother with narcotics anymore, except for my migraines, becausd it’s too much hassle for not enough benefit. I get that a lot of this is a result of my choices. But man, I would love to have some peoples’ problems.

  5. Wow, my story is literally identical. Down to every detail minus one or two. Bipolar one, in Portland, a professional cyclist, injured my pelvic region from riding, now has a chronic pain condition. Crazy stuff. Brilliant article J.

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