This is Your Brain

Friday, March 14, 2014

So, I was about a year old when this PSA aired, but I figured I'd post it because hey, always good to remind people not to do drugs. Unless they're legally prescribed to you for a specific purpose. Then you should take those drugs. But don't abuse those drugs. Promise? Okay, moving on.

Anyway, happy Friday to everyone out there! We made it! This weekend seemed interminable, but once again, we've arrived on the cusp of the weekend. My brain feels approximately like that fried egg up there, but that isn't the sole reason I posted that video. I actually wanted to post this video:

The first thing I thought when I saw this video was, "Man, I would seriously pay someone a lot of money to have a NOTHING box." I can honestly say that there hasn't been a moment that I can recall where I have been thinking of "nothing". It baffles me that sometimes, I can ask Ken what he's thinking and the answer is legitimately "nothing". HOW. How does that work!? I don't understand. Does not compute.

I've been having a rough time this week, and seriously could use a "nothing box". I couldn't figure out why, in particular. I don't feel terribly depressed or anxious, but I've had some weird symptoms that could be anxiety related. Especially at night, I've found that my lips and hands are tingly when I'm exhaling. There is pretty much no biological reason for this that I can fathom, so I'm going with "it's anxiety related" until proven otherwise. This doesn't necessarily make me feel any better, and it certainly doesn't solve my problem, but hey, it's better than saying that I might have some weird neurological problem, right? On top of that weird symptom, I realized this week that I've been having neck pain for over a month now. This doesn't seem necessarily important to note, but I think it's a large part of the reason why I'm so cranky.

If you search "chronic pain and depression" on PubMed, you get 6,002 articles back, so you could say it's pretty well documented that there is a relationship between pain and depression. Being in pain actually changes how your brain functions, which can, in turn, change how you act. People in chronic pain have been shown to have trouble making even simple decisions and interacting with others, as well as having difficulty concentrating. This is likely because when you're in pain, your brain is constantly being activated. That doesn't sound bad until you realize that your brain is trying to do a lot of other things besides process pain signals, so it ends up making a person in pain have similar deficits to those attempting to multi-task. Essentially... nothing good.  One of the explanations behind why people with chronic pain also have an increased risk of depression is that the pain not only "rewires" the brain, but also causes an increased reaction emotionally to other pain experiences. These brain changes basically make the patient feel hopeless in that the pain will ever stop, which often impedes someone's willingness to be treated for depression. Also not good.

So... I've been pretty cranky and I didn't really understand why. Nothing really seemed to be bothering me in the usual way. Unfortunately, anxiety and depression have this nasty way of  functioning below the level of awareness. I was talking to my brother about it, and apparently, as you start to address cognitive aspects, anxiety/depression often start to manifest themselves biologically or emotionally. (Thanks, anxiety. Love that feature.) On top of that, I've been in near-constant pain for over a month. I wake up in pain, I go to bed in pain, and I spend practically every moment in between those two events in pain. Is it excruciating, terrible, "oh my God, I'm on fire" pain? Not always. But on a scale from 1-10, it settles in at a 6 or a 7 for most of the day, occasionally getting up towards 9 and never much less than 4. I take a daily anti-inflammatory, so I can't even imagine how bad the pain actually is underneath the meds. My only relief is muscle relaxants or narcotics, which knock me out, and occasionally I can get the pain to decrease with heat or ice, although not in any appreciable manner or for any real length of time.

It sucks.

Somewhere along the way, I got it into my head that I don't "deserve" to be cranky because I'm in pain. I'm doing as much as I can to make the pain go away and being cranky about it isn't changing anything. So then I got cranky because I was cranky. How's that for stupid? Intellectually, I know the toll that chronic pain can take on a person, and yet I don't allow myself that same "courtesy". This isn't all that surprising, given my proclivity for not being nearly as kind to myself as I am to others. I think another layer to this is that I am feeling frustrated at the inability of my various doctors to find a basis for this problem, let alone a solution for it. I was so relieved when I found my rheumatologist because he was the first doctor who was willing to listen to my symptoms and my history and who wanted to try to treat what was going on, even when he didn't have the perfect laboratory diagnosis. Now though, we don't know where this pain is coming from and the usual methods of decreasing or stopping pain aren't working for us. Despite the fact that I spent the better part of 7 years "accepting" that medicine might not have the answers for what was wrong with me, going back to that state is incredibly difficult, frustrating, and disheartening.

So yeah, I'm cranky. I guess that makes sense, when you put together underlying depression/anxiety, near-constant pain, and lack of clear direction as to where my health is going. What I'm trying to tell myself is that I'm allowed to be cranky, even if my only real option is to "suck it up" and deal with the pain. I'm allowed to express frustration, anger, sadness, confusion, whatever. This is a clearly frustrating ordeal. If I were counseling a friend or a patient in my situation, I would absolutely tell them to "feel their feelings" (one of my favorite things to remind people to do) and to validate those feelings. Feeling crappy isn't fun! What I'm not allowed to do is to take my frustration or crankiness out on others, which I think I've been doing a pretty good job at avoiding. I'm not allowed to let my pain or my frustration take over my life. I'm not allowed to let this destroy the otherwise decent existence that I've managed to cultivate this year.

Which brings me back to the brain video that I posted above. I can't put this pain in a box. This pain is in every box. Depression and anxiety is in every box. It's part of the reason I can't sit and think of "nothing". Even when I'm thinking of what I think is "nothing" there is pain, fear, frustration, and confusion underneath of everything. I guess that's why I'm still in therapy. I also guess that's why I'm so terrible at yoga or meditation. My brain really does feel like a giant, interconnected, tangle of crap. For knitters out there... my brain closely resembles yarn barf:

Image credit to Mirror Mirror Blog
Everything is connected to everything else and I can't possibly think of one thing without thinking of twelve other things that may or may not be tangentially connected to the original thing. It's just how I work. When I'm stressed out, the last thing I want to do is "nothing" because then it just stresses me out even more. I have a constant need, perhaps even compulsion, to continue thinking because somewhere in my brain, there has to be an answer. At least, that's what I tell myself.

(Spoiler alert: That is not the case.)

Sometimes, I think that I would love to be able to get to a point in my life where I can think about nothing. Where I can literally just exist without worrying about where I'm going, what I'm going to do next, or what terrors could possibly befall me. I'm certainly not there yet. I'm not sure if I'll ever get there. I don't even know what that would look like or how that would feel, to be able to live like that. I'm actually kind of terrified to find out, because on some level, constantly ruminating and perseverating lends some kind of control, or really, perceived control, to my life. If I'm thinking about it, I'm doing something, and therefore, I'm in control. (Spoiler alert: This is a big, fat, lie that I somehow continue to believe.)

So what is the point of all this? Brains are complicated. Pain, both emotional and physical, is complicated. Life is complicated. (Understate of the century.) So as I head into this weekend, what am I trying to do? I'm trying to enjoy myself. I'm trying to focus on the fact that a great friend is here and I don't get to see her very frequently. I'm trying to look forward to a day when I'm not in pain, even if I don't know when that will be. I'm attempting to keep my brain in a place of excitement and joy for the future, rather than trepidation and abject terror. Yes, there is a lot ahead of me, but there is a lot directly in front of me, right here, that is good.

I have a wonderful husband and two adorable cats. We're starting house hunting (tomorrow!) and the weather is (theoretically) getting warmer. My family is supportive and loves me (and mostly refrain from making me want to punch them in their collective face). I'm freaking starting medical school in June, and that in and of itself, is a gigantic accomplishment. I may be in pain, but there is going to be an end to that. I have to believe that it will eventually resolve because otherwise... well, let's not even talk about that because it's going to be fixed. Things are going to be okay. Somehow.

I hope that you all have a lovely weekend. Spend some time in your "nothing" box if you're lucky enough to have one (because I'm not entirely convinced that they evade women as a population), and remember to be kind to yourselves. Oh, and happy Pi Day. Pie fixes most problems, so when in doubt... eat some pie.

- A

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