Acknowledgement

As I have mentioned before, I have trigeminal neuralgia (TN). TN is characterized by searing mouth pain usually caused from eroding of the myelin sheath around the trigeminal nerve. The pain has been described as the worst pain known to man or as the suicide disease because it has caused some to end their life rather than deal with it. I don't know if I would describe it that way, but you get the idea. It really hurts. No pain killers touch it whether they be ibuprofen or narcotics. However, in many cases it can be controlled by anti-seizure medications and that is true in my case.

But here's the problem--the side effects of the medicine. For me, even at low doses, the meds make me dizzy and sleepy making it hard to function effectively. So I am in a constant struggle to balance the pain control with the side effects of the medicine. During a recent trip to the doctor, he said that after years of trying with meds, maybe it's time to consider something else. There are several procedures that are used to treat TN including brain surgery. However, most of them only have a success rate of 50-60% and need to repeated every couple of years with sometimes permanent side effects. What to do? About a year ago, I was ready for the brain surgery because it has the highest success rate and the longest lasting results. But then I had a remission. Remission is a hallmark of the condition. It comes and goes for no apparent reason. I've never had long remissions like some have, but I do have them. And during remission, when I have no pain and am taking lower doses of the  meds, I think I am willing to put up with whatever side effects the meds have and take no risks.

But now I am having a flare up and I am once again considering the options available to me. While I'm trying to figure out if I want to change the course of treatment, I am trying to do positive self talk to lift my mood. When you're in pain, it's pretty easy to go to negative, self-pity places.

Which brings me to the point of this post. There are two basic kinds of self talk I do--that things could be worse or things are good in spite of the problem. They each work differently for me.

When I play the things could be worse game, it doesn't seem to help me a lot. For example, I say, "I could have a seizure disorder like my friend who requires high doses of medicine. I could have  mouth cancer like my neighbor with no hope to get better."

While I intellectually am truly thankful that I don't have more serious problems such as these, I still feel pretty negative about mine. I think that is because when I play the "things could be worse game," I'm not acknowledging my own difficulty. My pain is not the worst problem in the world, but my pain is a real and it's a problem for me.

So what I have learned, is that I need to acknowledge my problem and think about the positive things around it. For example, I say my mouth really hurts but I have about three hours in the middle of the day, when I seem to find a reasonable balance between the meds and pain. My mouth really hurts but I am able to go outside and work in the yard which seems to wake me up a little and helps forget  about my pain. My mouth really hurts, but I have an understanding, knowledgeable doctor who I work well with to treat it. My mouth really hurts, but it is not a threat to my life. When I think of things in those contexts, I do a much better job of keeping myself out of my negative world.

This may be another version of positive reinforcement works better than negative reinforcement. A concept that I have known about for a very long time, but just this morning in the shower, figured out how it applies to me in this situation. Another reason why my showers are so long sometimes. That is where I do some of my best thinking. :)

What works best for you when you are trying to pull yourself out of a depressed mood?*

*This is not for clinical, long lasting depression. You can't talk yourself out of that. Clinical depression needs the help of a professional.