What to Do When Pain Accompanies Bipolar Depression
Neither pain nor bipolar can be effectively treated in isolation; the treatments for one condition invariably affect the other, for better or worse.
Thanks to a pancreatic tumor, major surgery, and migraines along with bipolar I, I’ve become quite the expert in all things excruciating. As such, I’m confident that the distinctions we often draw between physical and psychological pain are at best fuzzy and at worst imaginary. For the brain is indeed—wait for it!—part of the body, not to mention the chief interpreter of pain and mood. Thus, it’s little wonder that pain affects mood and vice versa.
I know from years of experience that I’m far more likely to suffer from depression when I’m in pain and far more likely to suffer from pain when I’m depressed. Of course, this makes for a classic chicken- and-egg dilemma: Which came first—the depression or the pain? As is so often the case with the brain, it turns out that the most reasonable answer here is also the most exasperating: both, and neither. In other words, sometimes it’s the pain, sometimes it’s the depression, and sometimes we just can’t tell. To further complicate matters, plenty of other factors play into our experiences of pain and depression, aside from pain and depression: diet, exercise, and medication, just to name a few.
Still, there’s no denying that for many of us, pain and bipolar disorder seem to love traveling as a team. And while I’ve yet to find a way to divorce the two, I have found myriad ways to cope with both. Here are a few examples of what works for me:
Diet, exercise, and medication
Yes, I just mentioned these as factors that can potentially complicate matters, and indeed they can. But when dealt with appropriately—working with our health care providers and support systems to build better diet, exercise, and medication regimens— these same factors can help ameliorate, instead of exacerbate, our pain and depression. For example, keeping a food diary to identify triggers and remove certain foods from my diet has helped me reduce migraine and gastrointestinal pain, not to mention the depression that so often seems to accompany both.
Once we grow accustomed to one specific approach, it’s easy to forget how many different forms of therapy exist. I’m most familiar with cognitive behavioral therapy (CBT), which I’ve found highly helpful for depression, but several years ago, during an extended bout of chronic pain that lasted roughly two years and for which CBT wasn’t especially helpful, I was introduced to self-hypnosis. With practice, it has become one of the most reliable treatments I’ve found for pain—chronic and otherwise. And while pain control was my primary motive for learning self-hypnosis, I soon found that it also helped stabilize my mood by giving me tools to better regulate my sleep.
Whether it’s a hug, a handhold, or a massage, touch works wonders. Studies show that it can boost serotonin, oxytocin, and dopamine while reducing cortisol levels, thereby easing depression and anxiety and diminishing our perception of pain. Honestly, I’m not a super touchy-feely person, but upon learning more about the science supporting the power of touch to improve our mood and reduce pain, I started making an active effort to hug my husband more, and it helps. I’ve also added massage to my self-care regimen—something I once considered a trivial luxury—and it, too, has helped. Until recently, I had no idea that some health insurance companies partially cover or reimburse massage treatments, but given the data, it makes sense.
While these strategies have helped me manage pain and bipolar disorder, it’s worth noting that none has been a panacea. There is no one-size- fits-all solution to coping with concurrent pain and bp. If there is a “trick” to any of this, it is simply patience and the recognition that neither pain nor bipolar can be effectively treated in isolation, as the treatments for one condition invariably affect the other, for better or worse. The moment we recognize this, however, we can become better advocates for ourselves and work toward building treatment plans that work best for us as whole human beings, not just as mere collections of diagnoses.
Printed as “When Pain & Bipolar Travel As a Team” Fall 2017