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Thread: depression and pain

  1. #1

    depression and pain

    WHY does my dr keep putting depression down as primary reason for not working any more when it is PAIN? i am ready to go to er the pain has been severe, non-relenting for 3 days. i'm not depressed, I'M GOING CRAZY.

  2. #2
    Because Cass doctors do not listen, depression covers a multitude of things...if doctors/pshychiatrists felt the pain we are in, and certainly you are in then, and only then would they understand.....

    Maybe you should ask them if they would like to sit in a chair for even an hour and have someone stick knifes into them, then start to burn their legs, then give them some stuff to make their stomachs hurt so much with cramps, and then electric shock them so their legs spasm out....maybe then they might understand alittle and know what PAIN is.

    Your a very brave woman.

  3. #3
    If you head for the e.r. ask for a neurologist, neurosurgeon or physiatrist if one is on call at the hospital. Those docs will KNOW you are in pain and not drug seeking.

    Depression may be a secondary dx to the pain, but hell, who is not depressed with unrelenting, excruciating pain? The next time you see your doctor, tell him or her why you are not working. You have constant, serious pain and it is not being addressed. You are not depressed other than situationally as related to the pain and the resulting end of your career.

    It's never fun to change docs, but you may need to do that to find one who will treat the pain and identify the actual medical issues you have.

    So sorry you're going through all of this.

  4. #4
    Is your doctor treating your pain, or referring you for treatment? If not, then perhaps ignore my next thought.

    Giving the doctor any benefit of the doubt, you're probably a little depressed - appropriately. Who wouldn't be in your situation. Perhaps the doctor believes that it is easier to get a disability claim for depression approved, than one based upon pain. Could it just be the easiest way to get the disability to work?

    I don't know, just one possible guess.

  5. #5
    Senior Member
    Join Date
    Aug 2007
    last house on the left
    Sounds like you need a pain specialist. It also sounds like your doctor is unwilling/unable to admit to himself how much pain you are in. Dr's sometimes hate things they can't effectively treat, so come up with other reasons. My only advice is to ignore what he writes as long as it keeps the benefits coming and seek pain relief where you can.

  6. #6
    I'm sorry Cass.It's horrible not to be understood & just written off.As Muriel said,I too wish they could experience a day with the multitude of pains we experience.Just 24 would make them care & understand.I do think it's time to see a new dr. or pain specialist though.You're never going to be happy until your pain becomes manageable.Go to the ER if you're hurting so badly.God knows when you would get an appt.

  7. #7

    Once again, I am sorry to hear of and to contemplate your situation.

    When you have ants in your pants, you jump around. Your apparent behavior suggests energy, but this is misleading. There are times when CP people desperate with pain will do frantic activity, do anything or go anywhere rather than sit in pain and go crazy. One of these things is go to the ER, since they know if the average person felt this bad, they would be hospitalized.

    When this effort happens, those around them will say this animated person could surely work. As in, if you are well enough to get up and get yourself to the ER, you could surely work. I had to appar in court once and they would not allow anyone in the court dressed as I do, so I had to grit my teeth and put on full clothing. There I was, fully dressed, telling the judge I could not stand to be fully dressed. It is the same for the examination at the ER. They do not understand, Because there is nothing to measure, and they definitely will not have read the descriptions of central pain. The leading textbook of neurology (Adam's and Victor) does not even describe the symptoms of CP in any particular way that would be helpful. You have to buy a PAIN book, and there again, there is one little chapter on CP, with shingles, diabetic neuropathy, etc getting the lions share of attention. There will always be a couple of chapters on malingering, drug seeking, hysteria, etc, but there will never be a chapter on how to help a person with bad pain get through all the "independent medical examiners" who are more like prosecuting attornies than anything else.

    If all the people with low back pain would go to Mars we might stand a chance at being evaluated without the everpresent cloud of "possible malingerer" hanging over us. As it is now, the career of a pain specialist has a very large component of people who are in pain, but bear no resemblance to us. They would still like to get rid of their pain,

    Since the only reported treatment for central pain as discussed by the NIH pamphlet is reduction in stress, then stress at work is obviously not in your best interests.

    The fact is, that despite the number here who have tried to work with CP, those in really severe pain cannot realistically be competitive in the workplace. People always imagine we could "write books" or something, but the number of people who can do that and make a living at it is miniscule. The world is not lining up to read about severe suffering. They want escape, not ugly reality. You don't have the words in the English language for CP anyway.

    My feeling is this, that the specialty of the doctor is not really that relevant. What you are coping with is a mindset--it is a political thing. Hence, medical training is not the determining factor. If you encountered a liberal person, you would probably be believed about the pain. However, most people of that nature do not go through the years of training it takes to be a doctor. Those who push themselves to the limit tend to think others are of the same cloth. However, pain depletes energy and this changes the whole calculus.

    Those who are doctors do not understand the implications of nonstop severe pain. And because most pain can be treated with opioids if worse comes to worse, pain is not viewed as fearsome. When one speaks of cancer pain, it is really the word "cancer" which evokes horror, not the word "pain".

    The consequences of nonstop moderate pain are bad enough. They really cannot imagine nonstop severe CP. It changes the personality and destroys the identity. The pain owns more of you than your own self does. There is a constant battle back and forth to try to find meaning, diversion, and self expression, but in the end, you just want to ease the pain, or try not to think about it. I have always felt Augustine's statement that "physical pain is the greatest evil" contains great wisdom. It destroys happiness.

    If you lift a finger, or go for a drive, or rearrange furniture, people will say "Oh, you could work" but you know better. It is clear you would be the first to find work if you felt well enough.

    Sometimes you have to go through dozens of unthinking docs before you find one who believes you. He still will not understand, even if he backs you. Backing you is about politics, not medicine. Doctors are not in the employment business. Employers are not in the medical business. You are in between.

    There is a specialty in medicine called Occupational Medicine, which theoretically evaluates people whether they can work. In reality, it is companies seeking to avoid paying higher worker's comp taxes who hire these docs, so they get in the habit of saying the person is maybe 25% unable to work. I knew one doctor who was on an airbase driving a sports car. A truck pulled in front and hit him so hard his safety belt attachment broke off. He was in the hospital for a month with all the broken bones. He healed, but about two years later, an undetected aneurysm in his neck, where the seatbelt hit him, ruptured and put him in a coma. He lost use of one half of his body. That wasn't his problem, the pain was. He paid a lot of money to go to an occupational therapist, who helped him a little. Her report demolished his application for WC since she felt somehow obligated to state she had helped him. It is a troubling system. Of course, you get better after a stroke, or after the swollen cord decompresses, whether or not you go to a therapist. That does not make you whole. Work with paralysis is a triumph. Work with severe Central Pain may be just the opposite or may be impossible. Work with severe CP is sort of an anachronism. Some extremely talented and motivated people may be able to do it. I suspect you were one of those but now the pain is catching up with you..

    Until science finds a way to measure pain, and can then observe functional ability correlations with pain, including duration of the pain and amount of body surface involved, this is always going to be a problem. ER's deal with short time pain. They have no expertise at all in chronic pain. If you aren't bleeding out, the ER will find you a yawn in human form. We have emergency rooms but we have no long term suffering rooms. The assumption is that if it is long term, you can obviously deal with it. After all, you have already proven that you can.

    A psychiatrist will go to court saying someone should be let off for murder because they were in post traumatic stress. What about if you are not "post" but presently IN current, ongoing traumatic stress. What would the psychiatrist think about that? Is post worse than present? No, present is worse than post, but no one seems to think through that very well. We need a new term, "Ongoing traumatic stress". It might put an end to the use of "depression" for CP, and something new might evolve. I don't know anyone with CP who is reeking with happiness. So of course there is massive depression, only it is something additive. Pain depression is deperession with a bona fide reason. Not vague at all, and you don't need a psychotherapist to help you "Understand" your feelings. A couple of times I have had a psychiatrist or psychologist start to go down that line, and I have said, "Look, let's just get two bunsen burners. We will put our hands over it and see who withdraws first. If I win, then you have to stop thinking I am weak to pain. I am serious about the challenge. Then, they think I am really crazy--too crazy to treat. You cannot win. YOu cannot shift the mind from mental pain alone to the mental pain associated with unremitting physical pain. The X factor is not taken into consideration.

    Isn't someone with PTSD just trying to make the pain stop? What about us?
    Last edited by dejerine; 11-08-2009 at 02:59 PM.

  8. #8
    Senior Member alan's Avatar
    Join Date
    Jul 2001
    Baltimore, MD
    Too bad we can't project our pains. That would wake people up - make them feel like us for an unknown length of time.

    Proofread carefully to see if you any words out.

  9. #9
    Cass, just trying to help here...
    being in chronic unrelenting pain is depressing - let them treat your 'depression' & then they'll see that terrible pain is there, too & finally start treating it.

  10. #10
    Senior Member fishin'guy's Avatar
    Join Date
    Jun 2008
    Seattle area Wash state
    Cass, sorry your in such pain. I know kinda what your going thru, but mine is so much less than yours, only hits me every 2-3 weeks. God bless, hope your better

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