Empathy. Empathy is a word that everyone has heard before, but it isn’t one that many truly understand. At least, I hadn’t understood it. Not before I got sick. I hadn’t understood how much that one little word would mean to me at one point in my life.

What is empathy?

     Empathy is “the experience of understanding another person’s thoughts, feelings, and condition from his or her point of view, rather than from one’s own” (Psychology Today). When I think of empathy, I think of understanding. Sharing individual experiences. Compassion. Though it seems simple (right?), empathizing with another person is tougher than it seems. Especially when we’re all too busy staring at our phones and whining about how that annoying kid in math class spoiled the ending to the new Avengers movie. (Yes, that was a little shade thrown there.) Despite the fact that empathy and sympathy are words often used interchangeably, the two have VERY different meanings.

Sympathy VS. Empathy

SYMPATHY – “Feelings of pity and sorrow for someone else’s misfortune.” (Dictionary)

EMPATHY – “The ability to understand and share the feelings of another.” (Dictionary)

     When I was in a pain program (the first time), I was shown a video by a psychologist during a group session that I really connected with. This short video on the difference between sympathy and empathy ultimately helped me to put my feelings about how frustrating it was to be looked at and treated like a “kicked puppy” into words. As helpful as the people around me were trying to be (I think…?), the “I’m sorry” and the “At least you don’t have cancer” and the “It could be worse” wasn’t helping. At all. It actually made me feel worse. After watching this video, I realized that my feelings were validated though I had a right to be frustrated by the ways others were acting, the fact that they couldn’t empathize with me wasn’t because they didn’t want to. It was because they didn’t know how. As Brené Brown explains in the video, empathizing requires a person to feel with another person and be vulnerable. And no one likes to be vulnerable.

If you want to watch this (humorous) 3 minute video, click this LINK.

Empathy in Medicine

     I would assume that most people wouldn’t be surprised to hear that some doctors just don’t have good bedside manners. They don’t have empathy. And they certainly don’t like you if their huge brain filled with the names of diseases and their symptoms just can’t seem to pinpoint what’s wrong with you. It’s unfortunate, but it’s not unheard of. I tend to believe that because doctors, surgeons, and nurses see so many gruesome cases, they become immune to understanding or considering the physical or emotional pain a patient with an unusual case, or any case for that matter, is going through. If they’re not dying, they’re not in that much distress. If they’re not suicidal, they’re not top priority. If they’re not the “norm,” they’re faking their ailment for attention or overreacting.

     It’s sad to see this happen to so many patients, such as myself. When you participate in that week long study that’s supposed to “fix” you, but the doctor never bothers to call you back. When you leave the hospital after your 3-day stay crying because the doctor implied you were making up your pain and wouldn’t help you further. When your pediatrician, who has known you for your whole life, asks you about your “tummy” pain each visit and says, “It’ll probably go away soon.” Doctors are supposed to be the people who try to understand what you’re going through and from that determine the best treatment possible. But that’s not always how it is. They don’t have to help you. It doesn’t’ matter if that’s their job. They don’t have to do anything.

     I’ve found, over the past 3 years, that finding a team or individual doctor that shares your same values and has empathy is key. If you don’t trust or like the people that are treating you, there’s someone else out there in this big world that will listen to your story and see the person behind the illness. Because though empathy is becoming harder and harder to find in medicine, even at the most famous hospitals, it’s not extinct and is still SO important to a patient’s care. We don’t need a robot at our bedside. We need a human.

Outside Resources

To read more about empathy and bedside manner and how it is lacking in the medical field, try out some of the articles below!

1. Empathy’s role in Medicine
2. AMA Journal of Ethics- Role of Empathy
3. Value of Empathy in Medicine
4. U.S. News- Why Nice Doctors are Better Doctors
5. Forbes: Doctor Reviews Show Need For Bedside Manner, Personality And Compassion
6. Futurity- 5 WAYS NEW DOCTORS FAIL AT BEDSIDE MANNER

CRPS

     CRPS, Complex Regional Pain Syndrome, also previously known as RSD, Reflex Sympathetic Dystrophy, is a form of chronic pain that usually affects a person’s limbs but can spread to other parts of the body over time. (CPS, Chronic Pain Syndrome, is a more general term used for patients who have chronic pain but don’t fit into the CRPS category.) The exact cause of CRPS, why one person develops it over another, is unknown. At this point in time, CRPS, which carries the nickname of the “suicide disease,” is explained by a person’s nervous system continuing to send false amplified pain signals to their brain after an acute illness, injury, or form of trauma. The condition cannot be “cured,” but the ultimate hope is that if one keeps moving, the pain will reduce over time.

     Since CRPS is more of an umbrella term for chronic nerve pain rather than a specific diagnosis, some patients may experience a few different symptoms than another. While part of my desensitization therapy at the pain program I attended was to put my feet in warm water for 2 minutes at a time, another patient’s physical therapy program included swimming in the pool because it was one of her favorite forms of exercise. For me, the warm temperature of the water (and water in general) causes my foot to go numb, burn, and get a tingling sensation for a period of time after I get out. But for her, swimming was an enjoyable form of exercise that was easier than land exercise.

     However, the majority of patients experience similar pain symptoms with touch to their affected area, pressure, movement, and certain stimuli. It’s amazing, in the worst kind of way, how severe a person’s pain can be when they have a fan blowing near them. When they put a sock on. When they put pants on. Or when they put their heel on the floor. The normal functions that many take for granted each and every day without realizing it. You really don’t know what you have until it’s gone.

     The pain that I, as a CRPS patient, deal with on an everyday basis is only imaginable to those who have a chronic illness/syndrome themself or have witnessed a close family member experience one. The one most awful thing about having CRPS, excluding the pain of course, is the fact that there is so little awareness about it or any chronic pain syndromes in general. Just because you can’t see my pain doesn’t mean I’m faking it or it’s not there. Just because my disease isn’t terminal doesn’t mean I don’t have to fight to stay alive every day. Just because I don’t complain or advertise that I’m in pain doesn’t mean I’m fine, or even good. Just because I don’t make a huge deal and try to get attention for it doesn’t mean it wouldn’t be nice for a friend to reach out once in a while.

     I was reading a post on The Mighty, written by teenage girl Sophie Phillips with CRPS. She had the guts to put into words everything that I’ve been feeling for the past 3 years. I thought it would be best to quote her words rather than butcher her beautiful and personal writing. To read the full post, click on this Link.

     I live with complex regional pain syndrome (CRPS), which is a rare illness of the nervous system that causes excruciating pain ranked higher than that of childbirth, amputation and even cancer pain. According to medics, it is considered the ‘world’s most painful disease,’ ranking a 46/50 on the McGill Pain Scale. CRPS is extremely rare, and is often unheard of amongst the average population. Because of the lack of awareness, even amongst doctors, it often goes undiagnosed.

     CRPS can be life-threatening in many cases, being that it is a gateway illness to other diseases, such as dysautonomia, autoimmune illnesses, and more. These illnesses, caused by CRPS, can cause fatal symptoms… When I was first diagnosed, I was told over and over again by people who were unaware of the true effects of my illness, ‘At least it’s not cancer.’ While yes, cancer is awful and has robbed too many lives of those I loved, my illness is just as valid and worthy of the same level of awareness, understanding and attention. Just because it is rare does not mean that it is unimportant, or that its toll is not as detrimental. All illnesses are valid and should be treated as such.

     The world of illness and disease should not have to be a competition of ‘who has it worse.’ Every illness, common and rare, is worthy of the same attention, awareness, research and deserves action. So while you may have never heard of my disease, do not doubt its magnitude. The truth is, anyone living with a disease is facing adversity, and we should all be recognized for our raging courage and strength, even if we don’t always feel strong. 

What is desensitization?

     Desensitization is an exposure based therapy that helps diminish negative physical and emotional reactions to stimuli. Seattle Children’s Hospital says, “Often times with chronic nerve pain, a cycle develops between decreasing function and higher levels of pain (this is called the pain-function cycle). Desensitization techniques help break that cycle. They provide the brain with different sensations which then begin to be processed more normally.” Basically, in chronic pain patients, desensitization is used on the affected areas to help decrease the pain response to touch, shoes, massages, towels, vibration, water, temperature, rocks, sand, lotion, putty, brushes, etc., and the negative emotional response attached to it. Though these stimuli may still feel uncomfortable to the affected area even with intense and lengthy desensitization therapy, the main goal is to help normalize the sensation as much as possible. Because yanking your foot away from water or screaming when someone brushes it is not normal.

Pacing: The MOST Important Part of Dealing with Chronic Pain or Life in General

     Pacing is an extremely important part of living a life with chronic pain, whether you have CPS, CRPS, AMPS, Fibromyalgia… To be honest, this practice is important for everyone, even those who don’t experience pain.

     Pacing is doing something at a steady pace in order to prevent burning out. Whether you are pacing yourself during a soccer game, at the office, or during school. Everyone has had that one day where they overexerted themself. That one day where they probably felt like awful after because they were so tired. For those of us with chronic pain, we are advised against “pushing through.” Yeah, I definitely could make it the whole school day without taking a break, without allowing myself to think about or listen to my pain. Been there, done that. But by the time I would get home, I would be done for the night. I would have completely run myself into the ground. Therefore, taking effective breaks, drinking water, completing my Keep Moving Plan (This is a plan that I am encouraged to use when the need arises.), and using distraction techniques is recommended.

     Like I said, pacing doesn’t only have to apply to those who should medically practice it. We should all be pacing ourselves. Taking a ten minute transition break between your history and math assignments after school. Setting aside an hour to take part in a pleasant activity during your hectic schedule on the weekend. It’s really not that hard. Over time, it will become second nature.

         I was in Driver’s Ed class the other day, and a conversation was brought up by the visiting police officer that made me a bit upset and frustrated. I understand the point the officer was trying to make about the 6-month-rule for new drivers, but his demonstration and way of going about teaching us about the dangers of violating this rule got me thinking about an entirely different topic that needs to be addressed.

        The beginning of class went a bit like this…

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“Alright,” he said, as he looked around the room at each of our faces.

       Truthfully, at that moment, I felt a bit like I was being put up for auction. I kept my head down, praying he wouldn’t pick me for whatever silly question or trick he had up his sleeve.

“You,” he said, pointing to Anna.

She stood up and walked to the front of the room.

“Now, I want you to stand right there across from me. Closer to the window. We are going to simulate what a car accident looks like. We’re going to charge as fast as we can at each other. No stopping. How many steps do you think it will take for me to reach you, smash in your skull with my forearm, and throw you through the glass window? Let’s hope there aren’t any cars driving by. You good with this?” he said.

“Um… ok,” Anna said.

        She glanced at the rest of the class uncomfortably. I, for one, was extremely confused. What was he trying to prove? We got it. He was the “tough guy” who could kill us all with one punch of his fist (as he made a point to mention many times). So… why was he doing this?

“Get ready. Are you going to get into a running stance or stay standing?” he questioned.

“I guess I’ll just stand?” she replied as he began to get into a running stance while she stood there looking befuddled.

For a second, it seemed like he was actually going to storm towards her.

“WHAT IN THE HELL WAS THAT? I PRETTY MUCH JUST TOLD YOU I WAS GOING TO KILL YOU, SMASH YOU TO BITS, AND YOU DIDN’T TELL ME “NO?!” ARE YOU REALLY THAT STUPID? WHAT ARE YOU GUYS GOING TO DO WHEN YOUR FRIEND, WHO CANNOT LEGALLY DRIVE YOU, TELLS YOU TO GET IN THEIR CAR EVEN THOUGH YOU KNOW IT’S NOT SAFE, AND HE DRIVES LIKE A RETARD?!” he yelled.

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        There were MANY things wrong with the class I attended today, besides the fact that an adult male, who claims to have seen and dealt with everything, would use the word “retard.” I don’t even have the energy to go into that comment right now. It was an ignorant thing to say, and that’s that.

       The one major thing that stuck out to me was my classmate being humiliated and made an example of for not saying the word “no.”

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        From the time most of us are young, our parents tell us to be leaders and not followers. To this day, I can remember my parents asking me, “If all of your friends jump off a bridge, will you do it too?” My answer was always “no.” Nowadays, us girls are taught to ward off unwanted advances from men by using the word “no.” However, when it comes to adult figures, such as parents, teachers, officials, etc., we are taught to obey them. To show no disrespect. We are taught that adults are on a pedestal so high above us and as children, we are always beneath them (and don’t know as much as them). Therefore, if they ask or tell us to do something, we say “yes” or “ok.” So, my question is, where do we draw the line? How can a person, like the police officer, become angry and call someone stupid for saying “ok” because they didn’t think they had the ability to say “no?”

         Saying “no” can have consequences. Saying “yes” when you know you should be saying “no” can also have consequences. Being reprimanded and shamed for not saying “no” to an authority figure is not foreign to me, which is part of the reason why I think it is an unacceptable act.

        I, as I have mentioned before, have chronic pain. Last year in April, I was dealing not only with chronic abdominal and head pain but also an acute hip injury. I had just gotten off of crutches a week or so prior but was not cleared by the orthopedic. (I was still dealing with severe pain attending physical therapy.) Long story short, I was forced to participate in gym class even though I made the teacher aware of my delicate situation. And I was reinjured. (It is now almost a year later, and I have developed chronic hip and foot pain. I haven’t been able to walk properly in over 6 months, and have been forced to return to a chronic pain rehabilitation center to get assistance in managing my new pains.) In turn, I was rightfully angry with the situation, and my mom arranged a meeting with the school, in which I was blamed (and threatened to be flunked out of gym if I didn’t return?!) for the incident because I didn’t use the word “no.”

       I am not an adult, though my experiences and life situation may cause me to act like one at times. I am a CHILD. I made my situation clear that day, and when my teacher told me that I should be able to handle the activity because it was not physical, I felt pressured to comply. So I did. He was a teacher. I was a student. Good students do what their teachers tell them to do because the teachers know best. I am a good student, and I did what my teacher told me.

      I will live the rest of my life regretting it.

      But would have saying the word “no” have gone smoothly, either? Yes, I would be in a better place than I am now, but it would not have been without there being a problem or a fight or repercussions. I know that if I had said “no” to that teacher, it would have been a problem because we students are not allowed to say “no” to teachers. Been there, done that. When someone tells you to do something, you do it. “No” is not acceptable.

        If you raise your hand and ask your chorus teacher to go to the bathroom and he says “no,” then you don’t go to the bathroom. Even if you really have to go.

        If you tell your coach your foot is bothering you, and you don’t think you can compete in your gymnastics meet, but she says “no,” then you compete, hoping you don’t get injured further in the process.

       Learning to say “no,” to anything, is extremely important. Being unable to say “no,” can be physically dangerous. Being unable to say “no” to drugs. Being unable to say “no” to alcohol. Being able to say “no” to someone who is putting you in danger. Being unable to say “no” is also just plain exhausting. Feeling pulled in so many different directions from various commitments can affect your overall happiness. And who wants that?

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         Maybe the way that parents raise children and the way schools view students and the way society views the word “no” needs to change. “No” is not a bad word. What people need to understand is that saying “no” can come with consequences, but it shouldn’t always. If you say “no” to doing chores or to going to football practice or to doing your homework, there might be a negative outcome. On the other hand, “no” can be a powerful word in a positive or neutral way. No. I don’t want to have sex with you. No. I can’t participate in gym class. No. I don’t have time to do your part of the group project. No. I can’t wait to go to the bathroom. No. I can’t take on that extra shift at work. No. I can’t hang out with you if you are going to talk smack about other people. No. No. No.

(To learn more about why you should learn to say no more often, visit this Link.)

“No says, ‘This is who I am; this is what I value; this is what I will and will not do; this is how I will choose to act.’” – Psychology Today

“The ability to say no is crucial for mental health and self-confidence.” – Psychology Today

     From a young age, most children are taught that it is “good” to be happy and “bad” to be sad. The feeling of sadness has always had a negative connotation attached to it. It’s like we, as human beings, are being told from the day we’re born that it’s not okay to be sad and to avoid crying at all costs, unless you are grieving or are in severe pain. Sadness, anger, and nervousness, and other “negative” emotions have always been kept behind closed doors until recently. My question is… why is there this stigma attached to  these emotions?

     Everyone becomes sad at some point in their life. Sadness is a normal emotion. In that same way, everyone feels happiness at some point in their life, even if they don’t recognize it at the time. However, when sadness, hopelessness, anxiousness, or anger become long-term issues that a person carries through their life, it is necessary to acknowledge these emotions and treat them appropriately. But that’s much easier said than done.

     There are many different degrees or levels of the severeness of a mental health issue, and I, as an empathetic person, cannot pretend to understand them all. I can only understand what I know. Due to health issues, I am facing severe clinical depression, anxiety, and symptoms of OCD. A year ago, I would never have admitted that to anyone outside of my family. It seemed as if a diagnosis like that was embarrassing and would make me less of a person (Fact: IT DOESN’T).

     I was reading the article “’It’s nothing like a broken leg’: why I’m done with the mental health conversation” from The Guardian, which was written by Hannah Jane Parkinson, and it really clicked with me. Parkinson described her experience with some severe mental health issues, including a bipolar disorder, and explained how the media glamourizes certain mental health issues but ignores those that are more uncomfortable to talk about. Her perspective on the matter, as someone who faces issues that are not widely talked about, was honestly what I have been waiting to hear for a long time. She says the following:

In recent years the discussion around mental health has hit the mainstream. I call it the Conversation. The Conversation is dominated by positivity and the memeification of a battle won. It isn’t a bad thing that we are all talking more about mental health; it would be silly to argue otherwise. But this does not mean it is not infuriating to come home from a secure hospital, suicidal, to a bunch of celebrity awareness-raising selfies and thousands of people saying that all you need to do is ask for help – when you’ve been asking for help and not getting it. There is a poster in my local pharmacy that exclaims, “Mental health can be complex – getting help doesn’t have to be!” Each time I see it, I want to scream. (paragraph 13)

         Parkinson is exactly right. Sometimes, it feels as if the whole world acts as if the battle to end mental health issues has been won. When people talk about depression, anxiety, etc., most say, “You just have to be your ‘happiest you,’ let things go, and enjoy life to its fullest.” Well, what if my ‘happiest me’ is still depressed? What if I can’t “let things go?” (What does that even mean anyway?) What if I can’t enjoy life to its fullest? (Hello?! The glass is half empty, remember…?) The fact is, although some people benefit greatly from going to therapy and taking prescription medicines (or reading positive quotes about life on Pinterest), not all of us do. Just because we go to a doctor and try to “get help” doesn’t mean we are fixed. It’s not a cut. You can’t just put a bandaid on it. So much awareness about several issues has been raised, but what has really been done? I understand depression. I know I suffer from depression. I talked to someone about my depression and asked for help. Almost three years later… what now?

         Despite the fact that treatment can sometimes take a while before a person sees effects (I hope…), it is important to be aware of and informed about the most common mental health issues. If not for you, then for a family member or a friend.

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Depression

What is it?

Depression is a serious mood disorder that causes prolonged feelings of sadness and causes a person to lose interest and have difficulty performing normal day-to-day activities. Depression affects how a person feels, thinks, behaves, and can lead to several different emotional and physical issues.

Main Symptoms

• Persistent feelings of sadness, hopelessness, and/or emptiness
• Feeling as if things will never get better or change for the good
• Pessimism (always thinking the worst)
• Feeling guilty and/or worthless
• Decreased energy
• Losing interest in activities that were previously enjoyable
• Difficulty with focusing, remembering, and/or making (even the smallest) decisions
• Changes in weight and/or appetite
• Suicidal thoughts/attempts
• Becoming more irritable
• Sleep problems, such as insomnia or sleeping too much
• Aches or pains, headaches, digestive problems, and other medical issues that don’t have a clear physical cause or don’t respond to treatment

Causes

• Biological differences
• Physical changes in a person’s brain
• Brain chemistry
• Hormones
• Inherited traits
• Family history

Risk Factors (What factors make a person most prone to it?)

• Personality traits
• Low self-esteem, pessimistic, self-critical
• Traumatic/Stressful Events
• Abuse, death of a loved one, financial problems
• Family history
• History of other mental health disorders
• Alcohol and/or drug abuse
• Chronic illness
• Cancer, chronic Pain, stroke, heart disease
• Medications

  

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Bipolar Disorder

What is it?

Bipolar disorder is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks.

Main Symptoms

• Periods of unusually intense emotion and unusual behaviors, which are referred to as “mood episodes”
• Extreme changes in energy, activity, and sleep occur along with mood episodes

People having a manic episode may:	People having a depressive episode may:
Feel very “up” Have a lot of energy Increase activity levels Feel “wired” Have trouble sleeping Be agitated/irritable Do risky things	Feel very sad, empty, and hopeless Have little energy Decrease activity levels Change their sleep patterns Feel worried Forget many things Have suicidal thoughts

Risk Factors (What factors make a person most prone to it?)

• Brain structure and functioning
• Genetics
• Family history

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Borderline Personality Disorder

What is it?

Borderline personality disorder is a mental illness that includes a continuous pattern varying moods, self-image, and behavior.

Main Symptoms

• Mood swings
• Uncertainty about purpose in life
• Viewing things in extremes
• Strong efforts to avoid physical and emotional abandonment
• Avoid making attachments with other people for fear of them leaving
• Patterns of unstable relationships
• Distorted self-image
• Impulsive, dangerous, and/or self-harming behaviors
• Intense anger
• Difficulty trusting others
• Feeling disconnected from oneself

Causes

The cause of borderline personality disorder is not yet clear.

Risk Factors (What factors make a person most prone to it?)

• Family history
• Brain structure
• Environment, cultural, and social factors

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Anxiety

What is it?

Anxiety is a nervous disorder in which a person experiences excessive uneasiness, apprehension, and stress. People with anxiety typically also have compulsive behaviors and/or panic attacks.

Main Symptoms

Generalized anxiety disorder: People with generalized anxiety disorder have excessive anxiety or worry about several aspects of their life. This anxiety and fear can cause difficulty in areas of life, such as relationships, school, and work.	Feeling restless or on-edge Fatigue Trouble focusing Irritability Muscle tension Worrisome Sleep Problems
Panic disorder: People with panic disorder have panic attacks that can occur at any time, but can specifically occur in response to an object, situation, or a specific environment.	Panic attacks Heart palpitations Sweating Trembling/shaking Shortness of breath Feelings being out of control
Phobia-related disorders: A phobia is an extreme fear of a specific object or situation. EXAMPLES: Specific Phobias Flying, heights, certain animals, blood, needles Social anxiety disorder Agoraphobia Enclosed spaces, crowds, being outside of home alone, being in open spaces, public transportation Separation anxiety disorder Selective mutism	Having an irrational fear about a specific object or situation Taking certain measures to avoid the feared object or situation Having intense anxiety when encountering the feared object or situation

Risk Factors (What factors make a person most prone to it?)

• Shyness
• Traumatic childhood events
• Family history
• Physical medical conditions

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OCD (Obsessive Compulsive Disorder)

What is it?

OCD is a chronic disorder that causes a person to have thoughts (obsessions), which they cannot control and occur frequently, and behaviors (compulsions) that they feel the need to complete repeatedly.

Main Symptoms

• Not being able to control excessive thoughts/behaviors
• Spending at least 1 hour on these thoughts/behaviors
• Feeling brief relief from anxiety of thoughts by completing behavior
• Experiencing problems in life due to these thoughts/behaviors

Common Obsessions:	Common Compulsions:
Germs Unwanted thoughts incorporating sex, religion, and harm Aggressive thoughts Having things in perfect order or symmetrical	Excessive cleaning and/or hand-washing Ordering and arranging things Repeatedly checking on things Compulsive counting

Causes

The cause is unknown.

Risk Factors (What factors make a person most prone to it?)

• Genetics
• Brain structure and functioning
• Environment
  • Childhood trauma
• PANDAS
  • Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections

NOTE: OCD is NOT an adjective that should be used to describe someone who is meticulous and detailed. That’s just not what it means. OCD is a mental illness. Phrases like “I am so OCD” or “Be a little more OCD” can be offensive to people with the condition because it sounds demeaning to sum up the agony a person with the illness goes through each day fighting or giving into their urges by describing your perfectionist of a best friend as “so OCD” because she is a try-hard. Well, maybe she is just an overachiever?! My point is, there are many other words that can be used in the situation other than labeling someone with a mental health disorder. Sometimes, we do it without realizing it. I am not innocent, but now that I have more experience with these types of situations, I know how frustrating it can be to feel like someone is misunderstanding what you are going through. Just be careful and think before you speak. Every little thing you say, although you may not think it is a big deal, can affect someone else’s life.

To learn more, click the link below…

LINK

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PTSD (Post Traumatic Stress Disorder)

What is it?

PTSD is a disorder that develops in some people who have been through a traumatic event.

Main Symptoms

Re-Experiencing Symptoms: To be diagnosed with PTSD, a person experiences at least one re-experiencing symptom.	Flashbacks Bad dreams Scary thoughts
Avoidance Symptoms: To be diagnosed with PTSD, a person experiences at least one avoidance symptom.	Avoiding places, events, or objects that serve as reminders of the trauma Avoiding thoughts or feelings relating to the trauma
Arousal and Reactivity Symptoms: To be diagnosed with PTSD, a person experiences at least two arousal and reactivity symptoms.	Being jumpy/easily startled Feeling tense Having trouble sleeping Having angry outbursts
Cognition and Mood Symptoms: To be diagnosed with PTSD, a person experiences at least two cognition and mood symptoms.	Troubling remembering details of trauma Negative thoughts Feeling guilt or blame Losing interest in activities that were once enjoyed

Risk Factors (What factors make a person most prone to it?)

• Dangerous events/traumas
• War
• Getting hurt
• Seeing another person hurt
• Childhood trauma
• Loss of a loved one
• Loss of a job or home
• History of mental illness or substance abuse

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Works Cited

Parkinson, Hannah Jane. “‘It’s nothing like a broken leg’: why I’m done with the

       mental health conversation.” The Guardian, 30 June 2018. The Guardian,

       www.theguardian.com/society/2018/jun/30/nothing-like-broken-leg-mental-health-     

conversation. Accessed 4 Dec. 2018.

Mayo Clinic Staff. “Depression (major depressive disorder).” Mayo Clinic, Mayo

       Foundation for Medical Education and Research, http://www.mayoclinic.org/

      diseases-conditions/depression/symptoms-causes/syc-20356007. Accessed 4 Dec. 2018.

“Health Topics.” National Institute of Mental Health,               

http://www.nimh.nih.gov/health/topics/index.shtml. Accessed 4 Dec. 2018.

 

Pain

        When you type the words “pain definition” into a google search engine, the first explanation you are presented with is as follows: “the physical suffering or discomfort caused by illness or injury.” But what if you begin to feel pain out of the blue for no scientific reason? What if you take Tylenol for that persistent headache and it doesn’t help? What if you ice your knee or use crutches for your foot injury but find no relief? Pain is not black-and-white. There isn’t one perfect solution for every ailment. What works for one person may not work  for another.

        Although bodies physiologically should perceive pain in the same way because humans have the same anatomy, that’s not always the case. Take me, for example. After a year of abdominal pain, I was diagnosed with Abdominal Cutaneous Nerve Entrapment Syndrome. Patients with ACNES possess a nerve, or several nerves, that are trapped between abdominal muscles, which causes excruciating pain, especially with movement. However, after receiving a lidocaine injection, referred to as a “nerve block,” to the corresponding area of nerve entrapment and a lidocaine infusion that ran through my whole body, which was the normal treatment that was supposed to “fix” me, there was no change. Even though the region of pain has no physical problem anymore, since I was misdiagnosed for so long, my nerves continue to fire false signals to my brain telling me there is something extremely wrong with my body. I was always told that “my nervous system is fried.” It’s hypersensitive to any type of pain or illnesses. While a cold might be a nuisance for one person, it can cause me to be bed-ridden for a week.

Pain Threshold VS. Pain Tolerance

        Pain threshold and pain tolerance, although often used interchangeably, are very different. While pain threshold refers to the point at which one feels pain, pain tolerance refers to how much pain one can take until they “crash.” Every person modulates pain differently based on genetics, sex, long-term health issues, psychological factors, social factors, past experiences, and other individual factors. People with chronic pain, specifically, modulate pain differently than the rest of the population. Dr. Moalem-Taylor explains, “Chronic pain patients can have a lower pain threshold because they process pain quickly, but a higher pain tolerance because they are used to living with pain and have adapted to it.” For those of us with chronic pain, it is important to understand the difference between our pain thresholds and pain tolerances. We are used to living with daily pain that would be extremely debilitating to others. However, many of us feel other types of pain, illnesses, or injuries to a greater degree because of the fact that our bodies are also processing other pain. It can be like a computer system becoming overloaded with information that it cannot process at once. Our bodies receive so many pain signals that it cannot comprehend or it believes to be extremely dangerous, so we practically shut down.

Measuring Pain

        There is no real way to directly measure pain. “Pain scales,” as many doctors call them, are used to measure an individual’s pain at different points of their treatment. Professionals, supposedly, use this data to compare with other data collected when you return for future visits and are asked again to “rate your pain on a scale from one to ten.” No one can understand another’s pain, no matter what number label your pain. Just because I am at a level “seven” today and not a level “ten” doesn’t mean that my level “seven” is your level “seven.” It could be your level “sixty.”

Acute VS. Chronic Pain

        Acute pain and chronic pain are different in every way. Acute pain is a severe pain that is treated within a certain amount of time. Acute pain may be felt when one has an illness, injury, or surgery. Acute pain has a cause for the pain, which is usually a form of tissue damage. The purpose of this type of pain is to alert you that you are hurt and to protect you from any further pain or dangerous activity. In a way, it is meant to convince you to rest and protect the area of harm. On the other hand, chronic pain is pain that is continuous for months or longer. A person may know the reason for their chronic pain. It may have stemmed from an illness, infection, or injury that they never truly recovered from. Nonetheless, chronic pain can also occur with what seems like no reason.

         Dealing with chronic pain is physically and mentally exhausting. Every day is a battle. Sometimes, it’s like trying to play a game you don’t know the rules to. One day, you think you have it figured out, but the next day, everything changes. It’s not something that can be easily explained, even to people that you are close to, because no one but you can really understand how you are feeling. Even others with chronic pain have different experiences. It’s not something like cancer, which is a different battle in its own, or rheumatoid arthritis, both of which have specific symptoms and can be diagnosed based off of whether tumors are present, etc. Chronic pain is tough to explain because sometimes you don’t even know how to explain what you are feeling to yourself. I’ve had those days. Despite this, it’s important to remember that even though many people, even doctors, may not understand what you are going through, and many people that don’t have empathy for your situation will try to isolate you, intentionally or unintentionally, you are a survivor all the same. As long as you recognize the strength it takes for you to wake up each day, that’s all that matters.

To learn more of the basics about chronic pain, visit Link.

Written Sources

“Understanding Pain.” Mayo Clinic, Mayo Foundation for Medical Education and

    Research, 26 July 2016, http://www.mayoclinic.org/understanding-pain/art-20208632.

    Accessed 6 Nov. 2018.

Martin, Laura J., editor. “What Is Chronic Pain Syndrome?” WebMD, 2017,

    www.webmd.com/pain-management/chronic-pain-syndrome-overview#1.     

    Accessed 6 Nov. 2018.

Brancatisano, Emma. “Why Do Some People Feel Pain Differently?” HUFFPOST,

    Huffington Post, 10 Nov. 2016, http://www.huffingtonpost.com.au/2016/10/10/

    why-do-some-people-feel-pain-differently_a_21577905/. Accessed 6 Nov. 2018.