October is depression awareness month.
When I think about my longest bout of depression I know I needed treatment for it. But the why of treatment was dominantly pain. Unmanaged pain. So when I went to the pain clinic they treated the Major Depressive Disorder and chronic pain simultaneously with pain medication, Abilify (Because antidepressants make me far more depressed and suicidal), and therapy.
I had a few depression diagnoses and the one that makes the most sense to me is depression due to chronic pain. That is without the chronic pain, there simply wouldn’t have been the depression. That isn’t to say that by the time I went for treatment at the pain clinic I didn’t need medication for the depression because it was pretty severe at that time. As was the pain. And the two were very tangled up.
I wonder how much of that depression was the brain, the pain and then just life stresses. But I know it was all of them combined. Like, my brain, my mind and spirit adamantly rejecting my life ‘This is wrong and I’m not going to take it any more!’ Which gives my brain some feels. And those feels create some nasty thoughts and beliefs. And boom depression. Which then gets tangled and complicated by the pain.
The reason this comes up in my mind is because chronic pain magnifies so much in our lives. And we can be living lives that simply do not fit with coping with that chronic pain. Not that pacing doesn’t help manage pain, but does it with working- because I couldn’t see how. Not in any way society would allow us and also be functioning members of it working our full-time jobs with a smile.
Core Values just stop aligning in my depression with pain
I wonder if it starts with the fact I had specific core values when I started working. As we all do. But with chronic pain I couldn’t align with my own core values. They didn’t change when my health declined. I had chronic pain for decades but working with it was a whole new level of intensity. And I had specific ideas and beliefs about work and my values associated with work and who I was in the workforce.
Core values are principles or beliefs that you hold most dear and that are of central importance in your life. It also covers what you believe are important in the way you live and work .[1] (LifeHack)
Some of those values we gain in childhood. So if I valued being hardworking, reliable, accountable and dependable in the workforce that is who I aimed to be. Who I lived to be. And when I aligned with those, it was awesome. I had goals and ambitions. It was great.
Except I didn’t align with those values as my pain got worse. There was the absenteeism. The presenteeism when the pain, fatigue and brain fog were intense but I was still technically accounted for. Technically ‘present‘. And both of those made me so not reliable. Not quite so dependable. Not what my brain thought hardworking Should be.
it can be detrimental to live a life that doesn’t honor those core values once you’ve identified them (LifeHack)
Aligning Core Values
It would have been fine if I adapted my core values to match my life. But to do that, I would have had to adapt my Life to match my Chronic Pain. In other words, I would have had to find some sort of way to work that worked with me. And then I would have focused my life on other core values. Like creativity is a huge one for me. I also have a lot of core values around knowledge and growth. What matters is the ones around work in particular would have adapted and lessened. And others would have become dominant.
I couldn’t do that. I had a brain full of Should. And Must. And Have to. Push through it. Fake it till you make it.
It is important we reflect on what is most important to us. What we value the most. Instead we get fixated on what we Should or Must do. Have to do. Obligated to do. Even when our values shift to match our chronic pain and illness, we get fixated on these Shoulds. Living a life of this constant friction between what we value (health, well-being, and others) and what we are doing (Working a full-time job that causes more pain and fatigue, making it impossible to focus on any other thing we actually value- such as love, family, or any sort of thing).
But we have to remember it is also important to have shelter. To eat. To pay the bills. And I was very cognizant of my obligations. As we all are. When I went down to part time it hit our budget immensely hard. Adapting to that was difficult. Being forced to go on disability, even more so. And that is a hard hit to the sense of self.
When you are in so much pain you are laser focused on getting through the work day, minute by minute, and then crashing afterwards- you have no capacity left for anything else. Not for any socialization with family or friends. Not for hobbies. Not anything. So there is absolutely no life balance at all. And I definitely valued work-life balance- I just couldn’t attain it. In fact, I not only value work-life balance I think it is fundamental to our mental and emotional well-being. Instead I was stuck in survival mode.
Stuck in that Should/Must/Have to state of mind
Stuck in that Should/Must/Have to state of mind despite the fact my values were adjusting to be focused on my health and well-being created a situation where depression could flourish. I think not living a life aligned with your core values can lead to a lot of unhappiness. And even more so when we have values we can’t align with. Or when we live lives based on what we feel we must do, not what we can do. Add in pain for such an extended time and intensity, and brain wired for depression and it was inevitable depression would hit.
I value being open-minded and I value flexibility. But, damn, I couldn’t think my way out of a box when it came to the problem of working full-time, the income it provided, and the pain I was constantly in. I felt trapped.
I thought of solutions and then discarded them as soon as the hint of ‘But I Have to work full-time’ popped into my mind. Like what about part-time? Nope. Need to have that income. Can’t be dependent on anyone else. Independence being something I used to value immensely and have had to change how I think about it. And how much emphasis I put on valuing it. I wouldn’t even put that in my top ten now. It just isn’t something I focus my life around.
What about a different job that is more flexible? Has better accommodations? Flexwork. Work from home options? I thought of it. Couldn’t find it. This was prior to the pandemic, mind you. The concept that anyone could work from home, disabled or not, was beyond comprehension. Couldn’t fathom even another job because who would hire someone in that amount of pain- what lies would I have to tell to get it, in the state I was in at that time? (My health being My health, I can keep it to myself for any job interview but I felt I wouldn’t be hired)
I was pretty sick by the time I went down to part-time. That was even a problem. And then it became a huge problem when things got even worse. When I went on disability it wasn’t for lack of trying not to. That is for sure. All that trying not to has a way of making you sicker.
So I don’t value success, power, wealth, achievement, drive, leadership, work ethic or ambition that’s for sure. And that is totally fine. In my life, that is totally fine.
Disability and adjusting
When your body makes the decision for you that you can’t work that is when you have to think a whole lot more about what is important again. When working wasn’t an option, I no longer had that Should/Must/Have to impulse forcing me to push beyond my limits. But I also didn’t have the income. And I didn’t have the social time with co-workers. And I didn’t have the goals and ambitions.
That is when you really have to focus on what you value, outside of traditional work. One reason why I think finding a hobby is so vital is not only does it fill the void of work and help with well-being but it fulfills that creativity I need in my life.
I do value creativity, knowledge, growth, empathy, intuition, flexibility, open-mindedness, self-awareness, authenticity, balance, curiosity , well-being.
Eventually, I saw a pain psychologist. I went on Abilify and Tramadol. I do my hobbies. I exercise. I do my Things that help me manage my mood, which is no longer depression but the risk, well, that is always there. And eventually when you slow down your work, or stop it, your values adjust to the life you now lead. As you adjust your self-identity.
Chronically Nikki 
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