Facing the Storm
Pain and Mental Illness
by TwinkleEKV

Mental Health, a most fascinating area of study, but are all diagnosis’ correct? A diagnosis relies on symptoms, or should I say, for a doctor to give a diagnosis, he must rely on symptoms and underlying factors before making such a determination. Can a doctors determination of said illness be based simply on assumption? How about a pre conceived idea or notion that the symptoms are obvious to a specific illness or disorder? Perhaps you know someone that experiences mood swings, altered behavior, or sudden changes in personality with bouts of highs and lows without notable warnings and you probably never even see it coming. This seems to be a tell tale sign of a widely known and diagnosed disorder and before I mention it, many of you will already know where I’m heading.

Depression is defined as sadness, gloom, dejection. A condition of feeling sad or despondent. In Psychiatry it is defined as a condition of general emotional dejection and withdrawal; sadness greater and more prolonged than that warranted by any objective reason. A disorder characterized by an inability to concentrate, insomnia, loss of appetite, anhedonia, feelings of extreme sadness, guilt, helplessness and hopelessness, and thoughts of death. Also called clinical depression. In Pathology, a low state of vital powers or functional activity.

Mania is defined as excessive excitement or enthusiasm; craze. An excessively intense enthusiasm, interest, or desire. In Psychiatry, manic disorder. A manifestation of bipolar disorder, characterized by profuse and rapidly changing ideas, exaggerated sexuality, gaiety, or irritability, and decreased sleep. Violent abnormal behavior. Insanity. Excitement of psychotic proportions manifested by mental and physical hyperactivity, disorganization of behavior, and elevation of mood; specifically : the manic phase of bipolar disorder. An irrational but irresistible motive for a belief or action. A mood disorder; an affective disorder in which the victim tends to respond excessively and sometimes violently.

Lets take a look at this again. Depression equals low and mania equals high. Common sense would lead us to believe that a “normal” mood would be at the center of both and in studying mental illness and Bipolar disorder, we would be correct. Imagine a pole, any pole, even a telephone pole. At the top is mania, in the middle is an even stabalized mood and at the bottom is depression.

Lets take a peek at hypomania. A mild to moderate level of mania is called hypomania, which generally does not impair a persons daily functioning and includes an enhanced mood and productivity.

A manic depressive is called Bipolar 1, the less severe form of Bipolar 1 is Bipolar 2, who’s characteristics include hypomania, instead of full blown manic episodes and then there is Unipolar, which by definition means that there is a depressive phase only.

Hmm! Wouldn’t that simply be depression? Lets review for a moment.  Bi means two, Uni means 1. Bipolar 1 and 2 move up and down the pole, Unipolar means 1, it stays at the bottom. It’s said that mixed episodes do not exist in Bipolar 2, on the contrary, they do exist. It is but a mixed state of being, fluctuating, deflating and back again.

Have you wondered by chance where I might be going with all this? Let me introduce you to pain.

Pain is defined as physical suffering or distress, as due to injury illness, etc. A distressing sensation in a particular part of the body. Pain and ache usually refer to physical sensations (except heartache); agony and anguish may be physical or mental. Pain suggests a sudden sharp twinge. Agony implies a continuous, excruciating, scarcely endurable pain: in agony from a wound. Anguish suggests not only extreme and long-continued pain, but also a feeling of despair. A pang, twinge, stitch. afflict, torment; trouble, grieve. An unpleasant sensation occurring in varying degrees of severity as a consequence of injury, disease, or emotional disorder. Suffering or distress. A physical discomfort associated with bodily disorder (as disease or injury). A state of physical, emotional, or mental lack of well-being or physical, emotional, or mental uneasiness that ranges from mild discomfort or dull distress to acute often unbearable agony, may be generalized or localized, and is the consequence of being injured or hurt physically or mentally or of some derangement of or lack of equilibrium in the physical or mental functions (as through disease), and that usually produces a reaction of wanting to avoid, escape, or destroy the causative factor and its effects. Basic bodily sensation that is induced by a noxious stimulus, is received by naked nerve endings, is characterized by physical discomfort (as pricking, throbbing, or aching), and typically leads to evasive action. A symptom of some physical hurt or disorder. A somatic sensation of acute discomfort.

Now I’m going to propose a thought for others to think upon. When physical pain developes in a person, at some point emotional distress will take over. This is not an assumption, but fact. I don’t even need to get into information explaining the chemical imbalances that play a part in mental illness. Of course, it’s true. What I want to discuss is that when someone is in pain, acute, severe, mild to extreme, it takes so much energy inside ourselves that mental dilemma’s will develop. This can happen over a short period of time or a longer period of time. It might depend on strength, hope, the will to live, the ability to fight off the discomfort, attitude and a minimal level of stress.  Stress increases pain, pain increases instability, instability creates lack of peace of mind. Thoughts of no longer wanting to live and exist expand and increase, however, there is a difference between suicidal ideation and suicidal intent.

On a good pain day the individual may have their high, creativity, feel happiness, smile and laugh, bounce around in a positive manner, demonstrate self esteem, feel excitement, desire, feel optimistic with the emotion that “no one can hold me back”.  Mania?

On a bad pain day the person may feel hopeless, worthless, no longer have the will to live that they had on their “good pain day”. Lose hope, cry, feel agony, sadness, have no drive to get out of bed because either the physical pain or emotional pain has them beat. It is that the physical and emotional has grabbed them up once again. Depression?

On a so so day, he or she may feel fatigued, but flash a smile, hurt, but want to survive, their mood may be that of feeling “okay” considering what they endure through their day to day lives and hope flows through them. A stabalized mood? The center of that pole!

I am at the belief that pain is misunderstood and since many pain syndromes currently have no cure that many people are mis-diagnosed with a mental illness, namely Bipolar disorder as a means to justify that which cannot be accepted or explained.

I urge you all to think about this, I certainly do.

                                                                                         ~twinkle/ellaj

© 2006 twinklev – Unauthorized duplication is prohibited. May be used by permission and with viewable credit to author.