Today's post from lifeinslowmotionblog.com (see link below) is personally very relevant because this week, I received an email from a man's daughter, who told me that her father had recently taken his own life after 15 years of chronic neuropathic pain. He had been on strong medication for some years. That medication had dulled the pain but never taken it away and he was just tired, both physically and tired of living in constant pain, which impacted so much on the lives of those around him. I decided to see what was written on this subject and if there were reasons why so many people see no other way out than to remove themselves from the equation. Tragically, suicide never does that because the people left behind end up feeling as guilty as the person himself. With all the pressures of life and the message that we should be healthy and productive members of society, suicide numbers may continue to rise as people feel themselves more and more a burden on the people dear to them and on the state that 'supports' them. Legislators should consider very carefully before they blithely remove the drugs that keep people functioning! This article looks at the reasons why so many people in chronic pain, end up taking their own lives. Don't judge...there but for the grace of god go you. If you know of someone in this position, or are in this position yourself, it may be time to read this article and take action!
Posted on November 7, 2016 by lifeinslowmotion
It is an undeniable fact that individuals with chronic pain have a higher prevalence rate of suicide than the general population.
Tang and Crane (2006) summarized the results of 12 articles examining correlations between suicide and chronic pain, concluding that individuals with chronic pain are twice as likely to die by suicide than the general population. More specifically, approximately 5-14% of individuals with chronic pain attempt suicide, and about 20% report some level of suicidal ideation.
One of my counseling clients who has experienced chronic pain for the past three years recently told me, “I keep praying that God will take me home as I sleep. I would never kill myself, but I just need a break.” In my work as a counselor, I have found that passive suicidal thoughts such as these are the norm among individuals undergoing constant physical suffering.
Although I have never contemplated suicide, my own experience with chronic pain has been eye-opening regarding how people can get to the place of either active or passive suicidal thoughts. Before pain, the thought of suicide seemed foreign and strange. After dealing with long periods of uncontrolled pain, it is not hard for me to see how people find themselves in a place of hopeless that drifts into suicidal intentions.
I am currently reading a book entitled Myths About Suicide by Thomas Joiner, and it has been eye-opening in understanding some of the finer nuances of why individuals with pain and illness die by suicide. Joiner’s theory is that individuals die by suicide due to the merging of three key factors in their lives: perceived burdensomeness, failed belongingness, and learned fearlessness.
When these three factors converge, individuals are able to move past the ingrained human desire for self-preservation to a place in which death is no longer feared. Not only is death no longer feared, but it becomes seen as a better option than life.
As I considered these three factors, it became apparent why suicide is such an immense risk for individuals facing severe and ongoing illness and pain.
Factor #1: Perceived Burdensomeness
Most individuals with pain or illness feel like a burden. There are so many things we can no longer do and so many tasks others must take over for us. Perhaps we can no longer work and contribute financially. Perhaps, we can’t get around on our own and need constant and close caretaking. Wherever we fall on the spectrum of disability, we can’t shake the feeling that we are burdensome to our families and our friends.
When this feeling of burdensomeness becomes strong enough, individuals begin weighing the costs and benefits of life versus death in terms of how it will affect family and loved ones. They begin to wonder, “Would it be more beneficial for the people around me if I were dead than my current state of being alive?”
Factor #2: Failed Belongingness
Many individuals with severe pain and illness struggle to maintain a sense of belongingness. Joiner describes failed belongingness as “the feeling that one is alienated from others and not an integral part of a family, circle of friends, or other valued group” (Joiner, 2011).
This sense of alienation happens for many reasons among individuals with severe pain and illness. Perhaps most significantly, moving into community becomes difficult to impossible when physical limitations leave individuals bedbound, homebound, or severely limited in their mobility. Many times, groups of people are centered around activities, and those with pain and illness become alienated because they are no longer able to engage in activities that once made them feel as though they belonged.
Friends leave, families drift away, and it becomes difficult to find people to relate to when you aren’t up and doing what everyone else is doing.
Factor #3: Learned Fearlessness
Learned fearlessness is a process of habituation that occurs when individuals go through long-term painful situations.
Joiner explains it this way: “past experience with injury, pain, and the like creates a familiarity and fearlessness, which, if combined with desire for death, can prove fatal” (p. 21).
Individuals with severe pain and illness have no choice but to become acquainted with injury and pain. There is no possible way not to experience it. Over and over again, they are desensitized to physical suffering. The thought of death begins to lose its terror because they have faced so many physical terrors already. In the end, severe and unending pain and illness lead to an erosion of the natural fear of dying.
Some Possible Solutions
Here are some of my initial thoughts on what all this might mean for prevention of suicide among individuals with pain and illness.
When it comes to learned fearlessness, individuals with chronic pain and illness need real relief from their physical and emotional suffering. The process of habituation that occurs due to sustained exposure to severely undermanaged pain and symptoms can often be avoided, to some extent, if physical pain is taken seriously. Patients with pain and illness need doctors and nurses and other medical professionals to believe their pain is real and believe it is actually as bad as they say it is.
They need counselors and friends who will walk with them through their emotional pain, recognizing it as a real and important issue, but not blaming their pain on their emotional status.
They need pain management options and doctors who are willing to try over and over again to bring sustained relief. Individuals with severe pain need opioids and other medicines that are often stigmatized, and they need to be able to take them without being labeled addicts.
Anecdotal evidence reported by the Pain News Network suggests that the new CDC opioid guidelines could be leading to an increase in deaths by suicide among individuals with chronic pain. According to the Pain News Network, many of their readers have written in, explaining that their doctors have decreased or cut off treatment, leading some of them to consider suicide as a better option than years of uncontrolled pain. Something needs to be done.
When it comes to failed belongingness, individuals with chronic pain and illness need real community to welcome them in. Community is so hard to find for individuals with severe pain and illness.
Sometimes it is impossible for them to go into community, and they desperately need community to come to them. They need family, friends, church members, anyone who is willing, to come and be with them.
An acquaintance once approached me several years ago and asked if I needed help with anything. Did I need help getting to doctor’s appointments? Someone to clean my house? Could they do anything for me? I responded that what I actually really needed at that time was company. Would they be willing to come visit me because I was feeling incredibly isolated and unable to get out and be around people. My schedule was flexible, and they could let me know a good time for them.
It was so strange. The moment I asked for this kind of help, the conversation stopped. They never followed up, never said anything further about my request.
Perhaps this was because visiting someone doesn’t necessarily seem like offering help. But it is. It may be the most important thing that can be offered to people isolated because of physical pain and symptoms.
People with severe pain and illness need relief from suffering, but more importantly they need people who will walk with them through their suffering that will not be going away.
When it comes to perceived burdensomeness, individuals with chronic pain and illness need to believe their value does not come from what they are able to do or contribute.
In considering burdensomeness, I think it is important to recognize that burdens do exists. Yes, sometimes we perceive ourselves as burdensome when this is not the case. But, if we are going to deal with this topic honestly, we have to recognize that our pain represents a cost to the people around us.
Yet here is the important difference. You carry a great burden, but you are not a burden. A burden is not who you are, it does not define you. It does not determine your value or your worth.
Every single person who has ever lived will carry burdens, and some people must carry bigger burdens than others. So often we devalue people who carry bigger burdens, when really our response should be to carry one another’s burdens in love, each of us using the measure of strength we have been given. We carry each other’s burdens because this is part of who we were created to be – those who serve one another in love.
And we do this back and forth, for each other. Those who are healthy do what those who are sick cannot. Those who are sick care for their caretakers as well, proving a listening ear, showing interest in their life, looking out for their needs, and encouraging them to ask for help.
If you are considering suicide, know that the people around you would not be better off without you. Who you are is not measured by how much you are able to accomplish or do. From the moment you were born, you were filled with great value and great worth, given to you by God that can never be taken away, no matter how bad the pain becomes, no matter how long the pain persists.
If you are experiencing suicidal thoughts, please call The National Suicide Hotline at 1-800-273-8255. (USA only...hopefully there exists something similar in your own country Ed.)
Joiner, T. (2011) Myths About Suicide. Cambridge, MA: Harvard University Press
Tang N. K. Y. and Crane, C. (2006). Suicidality in chronic pain: A review of prevalence, risk factors, and psychological links. Psychological Medicine, 36(5), 575-586.
http://www.lifeinslowmotionblog.com/understanding-why-individuals-with-severe-pain-and-illness-die-by-suicide-and-what-we-can-do-about-it/
Today's post from webmd.com (see link below) unfortunately adds somewhat to the hysteria currently surrounding opioid prescription for chronic pain. Yes the statistics are alarming and yes the potential for addiction is high if doctors don't have a serious follow-up program of control but the vast majority of patients with chronic pain, don't take opioids because they want to, they take them because all other alternatives have been exhausted and are not working. In that respect, opioids are an extremely useful and effective painkiller. They do require careful monitoring and that needs to be an active partnership between doctor and patient but the current assumption is that patients can't be trusted to do things properly and that is insulting to say the least. Nobody with chronic pain such as neuropathy wants to be addicted to a drug but everybody wants their symptoms to be reduced so that a normal life is possible. Under the right conditions, opioids can be very effective in doing that. Hopefully, common sense and not hysteria will rule the day.
While 99 percent exceed the recommended 3-day dosage limit, a quarter write prescriptions for a full month
-- When American doctors give their patients narcotic painkillers, 99 percent of them hand out prescriptions that exceed the federally recommended three-day dosage limit, new research suggests.
And some doctors exceeded that limit by a lot: Nearly one-quarter gave out month-long dosages, despite the fact that research has shown that a month's use of prescription narcotic painkillers can cause brain changes, the National Safety Council survey found.
"Opioids do not kill pain. They kill people," Dr. Donald Teater, a medical advisor at the safety council, said in a news release. "Doctors are well-intentioned and want to help their patients, but these findings are further proof that we need more education and training if we want to treat pain most effectively."
The problem has reached the point where these highly addictive painkillers, which include commonly prescribed drugs such as Oxycontin, Percocet and Vicodin, now account for more drug overdose deaths than heroin and cocaine combined, according to the report.
Unfortunately, the survey further revealed that while almost 85 percent of doctors screen for signs of prior narcotic painkiller abuse, just one-third ask about a family history of addiction. Only 5 percent offer direct help to patients when signs of abuse are uncovered, and less than 40 percent refer such patients for treatment elsewhere, the survey found.
The survey results, conducted in early March and released Thursday, come at a time when drug overdoses have reached record highs in the United States. Just this month, two federal agencies proposed measures to try to curb the narcotic painkiller abuse epidemic.
On Tuesday, the U.S. Food and Drug Administration ordered that warning labels be used for prescription narcotic painkillers. And last week, the U.S. Centers for Disease Control and Prevention issued tough new guidelines for doctors on prescribing these medications.
In December, the CDC announced that fatal drug overdoses had reached record highs in the United States -- driven largely by the abuse of prescription painkillers and another opioid, heroin. Many abusers use both.
According to that December report, more than 47,000 Americans lost their lives to drug overdose in 2014, a 14 percent jump from the previous year.
The safety council survey, of 200 doctors, found other troubling trends: Roughly three-quarters of doctors indicated that they believed that pain relief is best achieved by offering patients one of two opioids: morphine or oxycodone (Oxycontin). But experts from the safety council noted that over-the-counter pain relievers (including ibuprofen and acetaminophen) are more effective at providing short-term pain relief.
Misinformation particularly seems to be at play when it comes to tackling back pain and dental pain. While more than 70 percent and 55 percent of doctors say they prescribe narcotic painkillers for back pain and dental pain, respectively, these drugs are not considered the ideal treatment for either condition, according to the safety council.
Interestingly, the safety council found in an earlier survey that roughly half of all patients are actually more inclined to see their doctor again if non-narcotic painkillers are offered.
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Copyright © 2013-2016 HealthDay. All rights reserved.
http://www.webmd.com/mental-health/addiction/news/20160325/nearly-all-us-doctors-overprescribe-addictive-narcotic-painkillers-survey
Today's post from baronandbudd.com (see link below) is a heartfelt appeal for recognition that just because you don't look ill, doesn't mean to say that you're perfectly healthy. People living with neuropathy will easily identify with this article because it's a well-known invisible illness and the shame is that even doctors and health professionals, who are so used to looking for clues in faces and body language, can be influenced by the fact that the patient doesn't look to be at death's door! The natural reaction to chronic pain and illness is to present yourself in the best light possible. You don't want the rest of the world to see the extent of your suffering, so you put your best face forward. The problem is that people find it hard to believe you're suffering when you do tell them. Nobody wants to be seen as a 'moaning minnie' but at the same time, you want your condition to be taken seriously. You're damned if you do and you're damned if you don't.
By Rachel Brummert|January 28th, 2015|Fluoroquinolone Antibiotic As I was scrolling through my Facebook news feed, I came across a post from my friend Cheri:
"I was just told I need to take down my Facebook profile picture because I don’t look sick and people might not think I’m actually sick."
It is a sad fact that when you suffer from an invisible illness, people make judgments about your appearance and capabilities based on how you look. In their minds, if you don’t look sick, you’re not sick. That is a damaging assumption to make.
When you "don’t look sick", it’s hard to explain invisible illness and Fluoroquinolone Toxicity to someone. Even when you explain it, you’re still viewed with skepticism or a blank stare. The lack of understanding can lead to feeling isolated. Not only do you deal with an invisible illness, you start to feel invisible too because those around you can’t- or won’t- understand.
My friend Cheri Haddon, 26, from Conyers, Georgia took Cipro in 2011 for a urinary tract infection. She suffered immediate adverse reactions to it and has been disabled since then. When holidays come around, she cannot enjoy being with her family because she is so food and chemically sensitive. She can’t eat the food that her healthy relatives can eat. She becomes sick for months just smelling someone’s perfume or shampoo. She has endured insensitive comments from people around her because on the outside, Cheri "looks fine", while inside, her body is screaming in pain and rebelling against her environment.
Looking at Cheri’s photos, as well as mine, you’ll see us smiling, being social with friends and family. But those photos don’t tell the complete story. Hidden behind the smiles is body-wide pain, brain fog, nausea, dizziness, neuropathy, flaring tendons, fluctuating heart rate, and much more that you can’t see. For the one second it took to take the picture, we manage to paint a smile on our face, masking what is really going on behind those smiles. A photo cannot possibly open a window into what we are feeling like on the inside, and what you don’t see afterward is that it could take us days, weeks, or longer to recover from whatever was going on in that photo.
There is a photo of me on Facebook and in it my husband and I are having lunch with 3 other friends.
What you see:
I am smiling.
My hair is done.
I am wearing makeup.
I am wearing a nice sweater.
I’m just another diner in a restaurant out with her friends, cracking jokes, listening to what her friends have been up to.What you don’t see:
I am wearing enough concealer under my eyes that would rival Tammy Faye Baker to cover the dark circles under my eyes because insomnia has kept me up for 3 consecutive nights.
The tremors in my hands made me drop my fork 6 times since I arrived.
All of my joints are screaming in pain and the morphine I took before I left the house isn’t touching the pain.
My left foot is numb and my right foot feels like I stepped on hot thumbtacks.
My cognitive function is poor and when I ordered my lunch, I switched words and the waitress didn’t understand what I was trying to say.
I am taking slow deep breaths in an attempt to calm my heart rate from arrhythmia.
I am in panic mode because I couldn’t remember if I took my seizure medicine that morning.
Our table is near the table of the elderly gentleman who made a snide comment to me as I walked up the ramp to the restaurant because I can’t do steps and he could.
I would be bed-ridden for close to a week after the photo was taken.
There is a photo of Cheri on Facebook with her mom and her dog on her mother’s birthday.
What you see:
She is smiling.
She is wearing a pretty sweater.
She looks happy. What you don’t see:
She is in pain.
She is nauseous.
She took her sunglasses off in the house long enough to take the photo and her eyes hurt because she is sensitive to light.
She is having brain fog.
This was the first time she was able to wear "real clothes" in 3 weeks because daily activities can be difficult for her.
She was bed-ridden after the photo was taken.
Cheri’s post about someone telling her to take down her profile picture because people won’t believe that she is sick sums up what we face, even from people in our close circles. It shouldn’t take a photo of us looking like we are on our death bed to convince people that we are, in fact, suffering from a terrible illness.
They say that a picture speaks a thousand words. I think it depends on who is reading it.
To someone who isn’t chronically ill, Cheri’s picture tells the story of a healthy-looking young woman bonding with her mother. A healthy person might say "Cheri, you look great, I’m glad you’re all better".
When I look at it, I can see the hallmark squint in her eyes which speak of pain from light sensitivity. I see that she is swallowing her pain. I see that it took a lot for her to get dressed and smile and participate so her mother could have a nice birthday. I see that she feels alone because she can’t eat the same foods that her family can, and I see that she can’t be in an environment that non-sick people can be in because she is so sensitive to chemicals, new furniture smells, perfume, etc. I see in the one second it took to take that photo that she is silently suffering. I see it because my smile in my own photos tell the same story of being chronically ill with an invisible illness.
In the one second it took to take the photographs of us, we got to look just like normal people, with normal lives, who are not sick with an invisible illness.
That’s the difficult part of invisible illness. By outward appearances, you can’t tell how much someone is suffering. Asking someone to take down a photo because it makes it look like you’re not sick negates what we are going through. It implies that we should be posting pictures of ourselves crying, screaming, vomiting, gasping for breath, in the throes of a seizure, or limping so people believe that we have an illness and that we are struggling.
You can’t see air, yet we believe you are breathing. You can’t see pain, yet we believe you are hurting. So why is it so hard to believe that we are chronically ill with an invisible illness and we are just trying to survive the only way we know how?
The conversation about chronic and invisible illness needs to change.
About the Author: Rachel Brummert Rachell Brummert is the Executive Director of the Quinolone Vigilance Foundation- www.saferpills.org. In her position, she guides strategic planning for the foundation and acts as its spokesperson. As someone who has been personally impacted by quinolone toxicity, she oversees the implementation and evaluation of the organization’s programs, and promotes collaboration with researchers, donors, politicians, community groups, and others to further the organization’s mission.
The views expressed herein reflect the opinions of the author and do not necessarily reflect the views of Baron & Budd, P.C., its affiliates or its employees.
http://baronandbudd.com/protecting-whats-right/2015/01/invisible-illness-fluoroquinolone-toxicity-peripheral-neuropathy/
