Accepting a Chronic Pain Diagnosis: A Trip Through the 5 Emotional Stages

An unexpected diagnosis can be tough to bear, but you can find peace by understanding where—and how—to channel your feelings.

You’ve probably heard of the five stages of grief, otherwise known as the Kübler-Ross model, which outline the progression of emotional stages an individual goes through when dealing with a serious issue, such as the loss of a loved one. While variations of the model exist, they all point to how certain emotions can influence one another to form a natural process of coping.

Being diagnosed with a chronic pain condition is no different. The emotions a person goes through are simply adaptive responses to receiving such news and should not be seen as a sign of weakness. By learning how to channel those emotions to achieve better results, as best one can, is key to a happier life.

Using the Kübler-Ross model as a foundation, let’s looks at some of the emotional stages a person with a newly diagnosed chronic pain condition may experience:

Shock and Denial

Upon first hearing that you’ve been diagnosed with a chronic pain condition by a healthcare professional, you may be at a loss for words. This reaction is entirely normal, as it may take a while for things to sink in. This is just the beginning of the grief process.

Being “in denial” means refusing to acknowledge your feelings and trying to conceal the challenges you may be facing, usually by ignoring them. Sometimes we do so unknowingly, but others times we are forcibly detaching ourselves from the situation. In this early stage, you may, for instance, avoid a much-needed doctor evaluation, which can ultimately put into motion a treatment plan and strategies to help guide you through managing the pain condition.

In more serious cases of denial, a person might choose not to follow crucial medical advice after an appointment on the pretense that it is “unnecessary,” or that the condition is not “serious” or will “go away” on its own. You might be ignoring pain, and continue to struggle through it despite the obvious signs that you might not be as physically capable as once before.

How long it may last: It may take you several weeks to get over the shock of a chronic pain diagnosis, and the denial that soon comes after may take even longer to maintain. The key is to own up to the diagnosis and challenge yourself to face up to the facts and begin your necessary treatment plan.

How to move through it: Instead of “sucking it up,” feel free to complain—out loud, to your friends and family. If you’re not comfortable doing that, try writing out your feelings and talking into a smartphone app. By getting the news off and out of your chest, so to speak, you may feel and breathe freer and will be better able to move toward finding solutions.

Anger

The most common defense mechanism—anger—ignites a response that is resistive, impulsive or compulsive, overreactive, and, ultimately, risky. You may be asking yourself why this condition has come to you and how it could possibly have happened. In this stage, some individuals may be pushed over the edge and abuse their medication or unleash their emotions onto their doctors. The path to finding relief is a long one, and takes time to make an impact. You might have to see several doctors and try several treatments (both pharmacological and non-pharmacological) before any positive outcomes are reached.

How long it may last: Much like being in denial, feeling angry at your condition is a natural response that may take a long time to overcome. As you are actively trying to channel your anger in a healthy manner, you may still feel it bubble up every now and then. The key, as is described in the next paragraph, is channeling anger into treatments.

How to move through it: Many non-pharmacological treatments, such as exercises and mindfulness-training, may improve upon your emotional health in a manner that is complementary to your physical well-being. Channeling your anger into an aggressive treatment plan, and expressing your thoughts into beating the condition you have, may be a better use for any destructive or intrusive thoughts you may be experiencing. In other words, put your anger to work for you, not the other way around.

Bargaining, Fear, and Anxiety

Bargaining can include struggling to find meaning in life, not being able to reach out to those you care about, and feeling alone in your condition. This stage often comes with false hope, that is, convincing yourself that you can avoid the grief through a type of “negotiation.” You may experience desperate thoughts, such as deciding to make a major life change, just to feel “normal” again. It is important to share your thoughts with others, whether close family members, friends, a therapist or counselor.

You may also feel guilt or be hounded by constant “what if” feelings. These fearful and anxious thoughts may creep in soon after the reality of your situation starts to seem real. In these scenarios, it may be easy to resist and withdraw from your usual activities in an effort to protect yourself from further injury or pain.

How long it may last: Bargaining usually does not last long, so long as you express your fears and doubts with a close friend, family member, or mental health counselor. Fear and anxiety can linger, but the more you express your feelings to get them out of your head, the better comfort you’ll feel. Also, doing some personal research on your condition may alleviate some of the “unknown”-feeling thoughts you may have. The more prepared you are, the better courses you can take.

How to move through it: It is important to push through and continue to work with your doctors to optimize your treatment plan, including finding ways to treating your emotional health, so that you are can maintain a normal daily life.

Depression

Depression is a very common comorbid symptom of chronic pain, and with good reason. To maintain chronic pain, the mind often takes a toll on ones emotional, psychological, and social well being. If you are showing signs of depression For example, you might continue to withdraw socially or have trouble sleeping. Know that you are not alone when it comes to chronic pain: Research suggests that anywhere from 30 to 50% of people with chronic pain also struggle with depression. In addition, our online community over on Facebook provides a good resource to tell your chronic pain story. If at any point you feel suicidal, call one of the many hotlines available to you: here is a list of hotlines by state, as well as international numbers.

How long it may last: There is no cure for depression, only acute medication such as antidepressants, and preventive measures such as those detailed in the next paragraph.

How to move through it: Psychotherapy is one clear treatment option for depression, while many other patients find alternative therapies to be of use to treat their depression. Trying an alternative therapy such as acupuncture, mindfulness meditation, or herbal remedies may help you find both physical and mental pain relief.

Acceptance and Hope

At the end of the line, the final emotional stage of coping with chronic pain is acceptance, and the hope for a better life. Some patients come to grips with accepting their chronic pain fairly quickly, while others may never reach this crucial step. Acceptance does not mean willfully accepting the pain, but rather, means that you are ready to accept yourself—and your diagnosis—without judgment. You can move toward living in the moment and find peace despite your pain. Your thought process may shift to “This condition is not my fault” or “I can and will cope with this pain.”

You also may find that your behaviors change, such as becoming less focused on the past and more pragmatic about the way things are. You may finally be able to find your groove with physical activity, even if it is more limited than it used to be. You may also begin to use your medications appropriately and consistently. Ultimately, you’ll begin to become one with yourself, rather than letting infiltrating emotions and thoughts get in the way. It will not be uncommon for you to continue to experience past feelings of denial, bargaining, fear, anxiety, depression, and anger, but they will hold less weight to them over time as your thought process changes to be more self-aware of your environment with chronic pain.

Acceptance is not a cure-all, but it does facilitate coping mechanisms and processes as you continue your journey. Chronic pain is a reality for many, and while coping takes time and may come with ups and downs that are difficult to navigate, it is possible to keep moving forward. 

Updated on: 10/02/18
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