Monday, January 27, 2014

The Black Dog - Brilliant Illustration

Many people who live every day in pain feel like the Black Dog is hounding them. And it feels like the dog never gives up.

The Black Dog is one of the main characters in a brilliant cartoon put out by the World Health Organization. The Black Dog is a constant and heavy presence in the life of a depressed man in this cartoon. This cartoon perfectly illustrates the symptoms of depression and how it can affect almost all parts of our lives.

Many people who watch this cartoon will say that the Black Dog is like the constant pain they feel. The heavy and intruding presence of the Black. Dog is partly from pain and partly from the depression, caused by the pain. Sometimes, it is difficult to separate out these two parts, because pain is a much more vivid and salient symptom.

Over 90% of my patients suffer from chronic or long-term pain. Many suffer from pain + depression. The depression comes, not only from the suffering caused by their constant pain, but also from the limitations and losses caused by their pain.

What is depression? Let this animation with a dog sheds light on it.

Please check out this brief video. It is well worth a few moments of your time. Here is the link:

I hope this illustration can help explain the mysteries of pain + depression and help your life in even a small way.

Yours with care - Mike

Monday, January 20, 2014

Pain + Depression = More Disability

Many people with long-term pain, especially those that have experienced significant losses caused by their pain, also experience depression. This is an understandable reaction to having a life full of pain and losses, that continues day after day.

Even though it may be very difficult to acknowledge, it is important that depression is recognized as part of the overall difficulties for people with long-term or chronic pain. This is important for several reasons.

From a treatment point of view, help with your depression, even depression that is caused by your pain and losses, can help reduce the severity of your long-term pain. Medications and psychological treatments for depression can help with physical pain. These can also help with sleep, energy and tolerances, all of which are important for  individuals struggling to cope with long-term pain.

When individuals are applying for disability benefits, it is important to have your physical injuries, sources of pain, and secondary psychological reactions acknowledged and accepted. All of these factors combine to create the overhaul limitations that can interfere with an your capacity to work.

Sometimes people in pain only discuss their physical injuries. This can hurt you when you are making claims and are out of work. When you only discuss one part of your overall limitations, insurers are bound to underestimate just how limited you may be. It is important for treatment providers and insurers to understand not just the causes of the problem, but also all of the secondary complications and factors that can limit you.

When it comes to secondary psychological reactions of depression, sometimes a simple formula can help us all understand it a little bit better.

Pain (including multiple sources of pain) + depression =  more disability

Essentially, this means that an individual is more disabled by 2 problems (or many problems) than they are by just one problem. Simple, but true.

This is an important topic and I will return to it over and over again more detailed information - what is depression.

Yours with care - Mike

Monday, January 6, 2014

Sudden Onset Matters

Over 90% of my patients, over the past 25 years, have suffered from chronic or long-term pain following car or work accidents.

What makes long-term pain from accidents different from other types of long-term pain is the sudden onset of injury and pain. If a person has long-term pain from arthritis, this pain may have gradually increased over many years, sometimes even decades. The pain can still be very difficult and limiting for the person in pain and their families. It is a little easier though, when a person has years to try and accept and adapt to their pain. They have some time to make changes in their lives to accommodate to the limitations that are caused by their pain.

When pain and injuries are caused by accidents, there is no time. One day, you may be healthy and living life to the fullest. The next day, you may be racked with pain, out of work and frightened of how you are going to manage. This can be a big shock for you and your family.

Sudden onset matters and makes it all the harder to cope and survive long-term injury and pain. people are more at risk for additional stresses, anxiety and depression, under these conditions. I will discuss these implications more in later posts. Please stay tuned.

Yours with care - Mike