For motivated patients we encourage them to study and incorporate mindfulness into their daily routine. Mindfulness is the psychological process off bringing one’s attention to experiences in the moment. It is best accomplished with training and the practice of meditation. Mindfulness interventions are effective in reducing rumination and worry. Rumination on one’s pain or illness exacerbate depression and underlying anxiety conditions. A classic example is with our Fibromyalgia patients, they commonly ruminate on the condition and identify themselves as ‘Fibro’ instead of focusing on a more positive aspect of their life.
Classic mindfulness treatments we recommend to patients include a very basic mindfulness meditation where a patient sits and quietly focuses on their natural breathing. The patients are taught to allow thoughts to come and go without any judgement, simply allow the thoughts to dissolve away and then focus back on their breathing. A simple 3-5 minutes per day will start to show dramatic benefits in as little as 2 weeks as patients learn to wipe away anxiety and help to distract from the negative effects of pain on the mind.
A few apps that we have found helpful for patients to practice mindfulness include: Headspace, Aura and the app Stop Breath & Think.
As a patient incorporates a mindfulness approach to their daily routine, pain levels decrease, anxiety decreases, empowerment increases and patients inch closer to a cure for their pain.
To ‘cure’ your pain a patient must learn patience. Your chronic pain is a complex web that developed through a course of misfortunate events and set up an engrained neurological pathway signal of pain to your brain. We give the example of a girl walking across a dewy meadow. A girl walks across the meadow in the morning, you would not see her path later in the day. However, if that same girl walks across the meadow everyday for the next 6 months, even if she then misses one day you will be able to see the path she has walked. This is the same as chronic pain patterns.
It took a long time to get to the point of your chronic pain and your ‘cure’ will also take a period of time and be a process to heal. Don’t expect any magical healthcare provider to be able to solve all your ills in one visit. Instead, understand that a patient with patience and understanding will have the best results. Patience also helps to curb anxiety that intensifies pain and hinders the healing process.
We recommend mindful meditation, prayer, exercise or relaxation techniques to help patients practice patience. These techniques will help decrease stress cortisol levels, boost natural endorphins and will help patients become more in tune with their body and help the healing process.
Chronic pain and depression are so closely linked that a viscous cycle can easily set in if one does not honestly address and treat any underlying depression. Studies show that patients with chronic pain have lower levels of the hormones serotonin and norepinephrine compared to patients not in pain. Lower levels of these hormones are known to lead to depression and anxiety. Combine these physiological lower levels of hormones with the frustration patient’s feel regarding their lower quality of life and limitations from their pain and you have a set up for patients to fall into a feeling of hopelessness.
The first step toward finding your ‘cure’ and treating pain is to work to attack depression directly. Depression is a medical condition that should be treated with a multimodality approach. We work with our patients on setting up successful coping skills and techniques to improve their outlook on pain and depression. For a good amount of patients, working with a clinical psychologist or psychiatrist will also be a valuable member of a patient’s pain fighting team. There are prescription medications that not only treat depression related issues but also have FDA indications for pain. Cymbalta is one example, it has FDA indications for Fibromyalgia, Diabetic peripheral neuropathy, chronic low back pain as well as anxiety and depression.
For patients that want to avoid traditional pharmacological medications, supplements like Magnesium have been used to treat stress and are an excellent smooth muscle relaxant. If you want to avoid pills all together, meditation and exercise are two successful strategies that every patient would benefit from. Both meditation and exercise boost endorphin levels, decrease stress hormone levels and give patients an improved outlook on life.
Finally, anyone with depression issues need to find someone to talk with, whether that be a support group, licensed professional, or a close friend. Releasing stress through the power of conversation is vital in helping patients gain both insight and learn tools to better cope with pain and depression.