 Happiness Isn't Brain Surgery with Doc Snipes. This podcast was created to provide you the information and tools Doc Snipes gives her clients so that you too can start living happier. Our website, docsknipes.com, has even more resources, videos, and handouts, and even interactive sessions with Doc Snipes to help you apply what you learn. Go to docsknipes.com to learn more. I'd like to welcome everybody to today's presentation of Happiness Isn't Brain Surgery with Doc Snipes, practical tools to improve your mood and quality of life. Today we're going to be talking about living with pain and chronic illness. We're going to start out by exploring the prevalence and characteristics of chronic illness, the characteristics of pain, and the effects or at least some of the effects of pain and chronic illness and possible interventions that you might use in order to help you deal with those conditions if and when you have them. So let's start out with chronic illness. Unfortunately, chronic illness seems to be the new normal. And what do I mean by that? It means that about half of all American adults are diagnosed with a chronic illness according to the National Health Council. And I put a link to this in the powerpoint so you can go and look at it because the numbers are kind of startling when you start to look at them. We consider normal what the majority of the population experiences. And from this study, it appears that the majority of the population is diagnosed with at least one chronic illness. What is that saying? What can we do? Well, one of the things we can do is start looking toward prevention and early intervention instead of waiting until they actually happen. But we'll kind of get there later in the presentation. Chronic illnesses are those things that include asthma, cancer, chronic pain. You know, if you have an injury and you have chronic pain, something happens, diabetes, fibromyalgia, heart disease or high blood pressure, lupus, Lyme disease and any form of mental illness that is ongoing. So there are a lot of different things that can happen. And as you're going to see in this presentation, when people develop a physical chronic illness, a lot of times a mental health issue will also develop concurrently because they're stressed about it because their life changes because they're grieving over the loss of certain abilities or functions that they used to have or used to be able to do. We're going to start looking at some of those. So let's start out with pain because pain is one of those things that even if it's not chronic, it can really impact your mood. And if you have an extended period of pain, I know people who've gone in and they've had rotator cuff surgery, other things like that, and it's caused pain for months on end. So any kind of pain that's more than just a couple of days can really start to impact your life, your lifestyle, your mood. We're going to talk about ways to try to prevent the negative impact as much as possible. It's important to remember, though, that everybody has pain sometimes. I mean, if you don't have pain, you're probably not living. So accepting the fact that some days you're going to wake up, you're going to have a kink in your neck, you're going to get a headache, that happens. And sometimes you may even have pain that lasts for, you know, a few days. If you lift too hard, if you do something to pull a muscle. But it generally goes away because our bodies are incredibly resilient. When you have pain, regardless of whether it's acute, which means it just started, and it hasn't been ongoing, so you're trying to figure out what's causing it, or if it's chronic, it's been going on for a while. It's important to know the characteristics of it so you can help your care team better identify what's causing it and things they can do to help intervene. So some of the characteristics of pain that you should consider are, you know, is it acute, which it just happened, you know, last weekend you woke up and it hurt, or it's chronic, it's been going on for a couple of weeks or a couple of months. What's the characteristic of the pain? Is it stabbing, aching, throbbing, burning, all of the above? Does it stab some of the time, throb some of the time? What's the difference? That'll help your care team better differentiate. Is it constant or intermittent stationary, which means it stays in one place, such as you have a shoulder pain, or is it radiating? So it's in your shoulder, but it radiates down your arm to your hand. And do you have any numbness? Those are all things your doctor's going to want to know and all things that your care team, your physical therapist, and all those people are going to want to know because that's how they're going to be able to, number one, identify what may be going on, but also help you identify when things are starting to get better. Because sometimes if it's intermittent pain, if you reduce the frequency with which it occurs, so instead of occurring every other day, it's only occurring once a week, that shows significant improvement. So those are the things they're going to want to look at. But what are the effects of pain and chronic illness? We've talked about pain and, you know, a lot of people have chronic illness. So what are the effects of those on people in general? And I don't want to just say mood because pain and chronic illness affects your entire biopsychosocial lifestyle. It affects how your body functions. It affects your mental health and it can affect your relationships and other things. So let's start with depression because that's one of the most common features that I see when people have been diagnosed with chronic pain or chronic illness and they come to my office and they're like, you know, Doc, I'm depressed. Okay, well let's take a look at what your symptoms are. Depression is diagnosed as fatigue, sleep disturbances, a sense of hopelessness and helplessness and negative thoughts and pessimistic thinking. So let's think about that. If you've got chronic pain or a chronic illness and you wake up every morning and you feel less than optimal, it may prompt some thoughts of hopelessness and helplessness, you know, I just, nothing's ever going to get better. I can't seem to get past this. I'm never going to be the way I used to be. Those are thoughts that are not uncommon to people with pain and chronic illness. When you have those thoughts a lot, it causes stress in your body and can contribute to fatigue and sleep disturbances. When you're in pain, you don't sleep well. You know, I don't think I can identify anybody who will say, oh yeah, I was in excruciating pain when I went to sleep last night and I slept like a baby, especially if they're not taking painkillers to make the pain go away. So understanding that when something is amiss, if you will, in your body, you'll feel pain or you may have a chronic illness that keeps you from sleeping as well. Fatigue and sleep disturbances make you feel rundown, make you feel exhausted. When every day you wake up and you can't ever seem to actually wake up, you know, you're just kind of there existing as a shell in your body. Again, you may start feeling senses, sense of hopelessness and helplessness. All right, so we can see how pain and chronic illness can lead to some feelings of depression. Now what do we do? Mindfulness is the first thing. If you are mindful of what you need in the moment and you're mindful of your symptoms, you will notice when they start getting better. You'll notice things that help make them better and things that you can do that help the pain go away, things that you can do that delay another resurgence of the chronic illness, things that you can do if you've got diabetes, for example, to stabilize your blood sugar. So being mindful of how you're living and how you're treating your body and what your body needs. If it needs a nap, you know, taking a short nap may not be the worst thing. Obviously, you're going to want to work with your care team. But mindfulness is the first step because if you're just feeling blah and you're throwing anything at it, you're just kind of spit balling to try to figure out what's going to make it better. It's probably not the most efficient thing in the world. Good sleep habits help even if you're not getting the best sleep. And like I said, if you're in a lot of pain, you're probably not going to get the best sleep. But if you have good sleep habits, you're creating a situation where you could sleep better, which is probably going to improve your sleep a little bit. And every little bit helps maintain your circadian rhythms. So try not to take long naps during the day. Try to get up at relatively the same time each day and go to sleep at relatively the same time each night. So your body knows when it's supposed to be awake and when it's supposed to be asleep. This helps a lot. So your body knows your brain knows when to start secreting those sleep hormones. Identify the things you can control and that are good. So what things can you do? What things are still in your control? If you're feeling hopeless and helpless, true, there may be some things you just can't control right now. However, what can you control? And with a lot of chronic illnesses, taking good care of your body and managing stress are two huge things that will help mitigate the problem. And most of the chronic illnesses are made worse by poor general health behaviors and high stress. So identify what things you can control in your life, in your environment, that make the condition better. And eat healthfully to support serotonin functioning, among other things. Serotonin is one of those chemicals, not the only one, that's involved in your pain perception. So if you don't have enough serotonin, you may feel ache year all over. Now there are others, you know, your endogenous opioids and all those other things. However, let's start with the simple things. You know, get decent nutrition. I'm not saying cut out the things that you love and only eat rabbit food. I'm saying, do what you can to eat healthfully and get some good proteins in there each day. Anxiety is another emotional symptom of pain and chronic illness. When you wake up every morning and you're faced with this condition, you may think that things won't get better. You may worry that things are never going to get better. And what are you going to do? You may get stressed that it's getting worse. You know, you wake up one morning and your little ache year than you were the day before, and you may throw yourself into a panic thinking, oh my gosh, this condition is getting way worse. You may also get stressed out and have anxiety over the consequences of the condition or the pain, such as, are you going to lose your job because you can't stand on your feet for eight hours anymore? Or you have increasing absences because of your condition. What's going to happen to your relationships if you can't be the same person, if you can't do all the same things you were able to do before your diagnosis, what's going to happen to your relationships now? If you're one of those people who loves going to the gym or working out or staying in shape, you know, maybe hiking or doing yoga, you may wonder how you're going to be able to stay in shape and keep your body healthy if you're in pain all the time or if you've got this other chronic illness that just makes you so exhausted, you can barely get out of bed some days. So this anxiety is, you know, definitely, you can see some of the reasons for it. Well, we can't necessarily make all those things go away. So what do we do? Avoid stimulants like caffeine and nicotine. And I say avoid. Ideally, you cut it out. I'm realistic. If you can cut back on it and definitely cut way back on it before bedtime, it'll significantly improve your sleep and probably help your condition. But that's between you and your doctor, how much you're going to cut back on those. Educate yourself about the disorder and the probability that things are going to get worse if you're following your treatment plan. Now, left unchecked, a lot of chronic illnesses will get worse. But if you're doing all the right things, what is the probability that overnight or even over the course of a week, it's just going to spiral out of control. This will help give you a baseline, if you will, or some education. So if you start feeling worse, you can prevent yourself from freaking out about it. Keep a log of your good and bad days. Notice what helps on your good days. And I mean, be open-minded about it. If you get more sunlight, if, you know, the weather, you know, maybe it was a bad day and you notice that a storm front was coming in and your arthritis was acting up. Doctors disagree on whether changes in frontal boundaries affect arthritis, but I think most of us who have arthritis will tell you that we do notice a difference. So whether it's anecdotal or it's actual, keep a, keep a log of those things because whatever works for you, whatever works to help you feel better is what's going to be important. And you can share this with your care team. Practice distress tolerance skills. Distress intolerant thoughts are going to make you feel more anxious. Their thoughts that go something like, I can't keep feeling like this. This is going to drive me absolutely crazy. I don't know if I can go on this way. Distress tolerance skills help you accept that this is the way it is. So what can I do now to improve the next moment? What can I do to make lemonade out of lemons? Or, you know, however you want to phrase it. And I have entire videos, entire podcasts on distress tolerance skills. So we're not going to go into those real deeply in this podcast. Use the challenging questions worksheet to identify anxiety-provoking thoughts. Again, I have a whole podcast on that, but basically what the challenging questions worksheet says is what is your thought? For example, things are never going to get better. Okay. What is the evidence? Not what are your feelings? What is the evidence for and against that thought? Let's play, you know, attorney here and try to argue for and against this case. Then you want to look at how reliable is the evidence? Do you have good information that things are never going to get better? And then you want to look at, are you using emotional reasoning? And this again is not facts. This is your feelings. If you feel like things are never going to get better. If you feel hopeless and helpless, but there's no real evidence to support it, then you may be making decisions and having thoughts that are based solely on emotional reasoning. So what other emotions could you have? How could you have an empowered thought? How could you have an optimistic thought that might change your thoughts a little bit? Maybe this condition will never go away. However, there are things you can do to improve your life while you're living with it. People who have HIV, people who have diabetes, people who have high blood pressure, those conditions aren't going to go away. However, most of them live a very high quality of life. They just have to make some minor adjustments. So interpreting it in an empowered state instead of one of disempowerment where the condition is sucking all of your control away is going to help you feel a little bit better. And guilt. Guilt is self-anger. When you feel guilty because you missed your kids ballgame, you're angry at yourself for missing your kids ballgame. So guilt is self-anger for not being able to do all the things you used to do. Not being able to get out of bed today because the pain is too bad. Not being able to fill in the blank. I mean this could go on for hours. And it can cause you to lash out at other people and push them away because you resent the fact that they can do that or you don't want to disappoint them because you know you can't be the friend that you think you quote should be. So there's a lot of cognitive distortions there. Interventions for this. Think about how you would want your child or best friend to feel if they were in your position. Would you want them to feel guilty because they were feeling too bad to get out of bed or they couldn't make your award ceremony because they weren't feeling well? How would you want them to feel? A lot of times we hold ourselves to a higher standard than we hold other people. Get rid of the shoulds. You know I can't be the friend I think I should be. Well what kind of friend can you be? Let's play on your strengths. What can you offer in a relationship? What can you offer as a parent? What can you offer as an employee? And that's what you build on and you just knock that out of the park. Yeah there may be some parts of it that you think you should do that you would like to do that you can't do anymore but if you excel at the things you can do then a lot of times that compensates. So focus on the things you can do and decide whether it's worth using your energy to be mad at yourself in the world for this situation. Does guilt really do any good? Does beating yourself up over something eternally serve a purpose? Feeling guilty for a moment? That's your brain telling you you know what you may have screwed up here. Accept it. Identify it say you know what you're right. Brain you have the right thought here but continuing to lash myself with a wet noodle isn't going to do any good. So how can I prevent this in the future? How can I make up for it? How can I mitigate it in the future? Maybe there are going to be times where you still won't be able to make your kids ball games because you're on call or something. Okay so what do you do instead? How can you be realistic about what you what you can do? So the important points everybody experiences pain sometimes it's just a fact of life. Pain indicates that something may be wrong. It doesn't necessarily indicate that something super catastrophic is wrong. It may indicate you slept wrong and you've got a kink in your neck. It may indicate you haven't had enough water to drink. Pain is generally kind of your body telling you pay attention because something's a little off here but it doesn't necessarily mean that something catastrophic is going to happen. People who experience chronic pain or illness or an extended bout of pain may experience feelings of depression anxiety and guilt. Those are natural feelings. The key is identifying what's causing those feelings and addressing them so you can use your energy in a more productive way to start feeling better and all of these depression anxiety and guilt are stress provoking emotions. We know that increased stress is going to make pain and chronic conditions worse so we need to address those and that's one of the things you can do to help yourself be all that you can be to quote the army. There are so many different ways to address feelings and it's important to figure out what works for you. Anxiety and fear and anger are your body's response to some sort of physical social or self-concept threat so it may not be some tigers coming to eat you up. It may be a threat to your self-concept because whatever is going on is keeping you from being the person that you think you quote should be. Should is a really destructive word. You know let's focus on what you are and what you can do and what you will do instead of what you should do. Guilt is anger directed towards yourself. It serves a purpose like all of our feelings and you feel it you identify it you go yeah I screwed up what can I do to improve the next moment. Holding on to it and nurturing it does nobody any good and depression is a sense of hopelessness and helplessness that arises when the pain anxiety or guilt don't ever seem to remit. So remember depression is your fatigue and your lethargy which may be caused in part by the chronic illness so that's something you can work out with your medical care team. But you also want to pay attention to depression that's caused by negative thoughts and feelings of being completely trapped and not being able to be the person you want to be and address those. Happiness isn't brain surgery is an educational podcast and not a replacement for medical advice. All health decisions should be made in conjunction with your healthcare provider. If you like this podcast please subscribe on your favorite podcast app join our facebook group at docsnipes.com slash facebook or join our community and access additional resources at docsnipes.com. 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