Many people who experience depression or bipolar disorder also live with other health concerns. In this Q&A, DBSA’s Young Adult Council members share their experiences balancing a mood disorder with a chronic health condition.
Jamie
Condition: Fibromyalgia
What is fibromyalgia?
Fibromyalgia is a chronic condition that causes widespread body pain, muscle tenderness, muscle, and joint stiffness, headaches, fatigue, sleep problems, mood issues, and more. Researchers do not currently know the cause of fibromyalgia. However, many believe that repeated nerve stimulation causes the brain and spinal cord to increase levels of certain chemicals that signal pain. The National Institute of Arthritis and Musculoskeletal and Skin Diseases explains that studies have shown that people with fibromyalgia develop heightened pain sensitivity. There are several risk factors for developing fibromyalgia, including physical trauma, surgery, infections, genetics, certain diseases (especially rheumatic diseases), and significant/prolonged psychological stress.
How did you discover you had it?
Sometime during my early 20s, after I began a cashier job, I noticed I would get headaches often. The pain would usually come from my neck and shoulders. My back and legs also hurt from standing for long periods. That may sound normal for a cashier, but my previous job had similar physical demands and I didn’t experience as many aches and pains. I did not have a doctor I trusted at the time, so I Googled my symptoms. My mom has the Epstein Barr virus, so I figured I had it too. I got tested and found out I did not have it. I also suspected chronic fatigue syndrome, myofascial pain syndrome, neuropathy, lupus, and even arthritis (since it runs in my family). There was so much overlap with the symptoms I couldn’t figure out what was wrong with me. However, the thing that seemed to distinguish my condition from others was the feeling of bruises on my body. I experienced a lot of anxiety, not just from the symptoms but also because I didn’t know what it was. I felt like this sick person walking around with no idea what was happening to me. I found a rheumatologist, but he rushed me through an exam. I filled out a questionnaire and received a quick physical examination, where the doctor pressed his fingers on my back, shoulders, and legs. Not long after that, he told me that I met the criteria for fibromyalgia and polyarthralgia.
How does it affect you?
Physical activity tends to aggravate my body. Simple actions trigger muscle pain, including standing for long periods, walking long distances, and performing repetitive movements (lifting, bending, squatting, etc.). I don’t usually feel pain immediately after physical activity; I feel it the day after. Depending on how active I was, the pain can last a day or linger for several days. As a result, I struggle to participate in activities I enjoy, such as cleaning, yard work, washing my car, and exercising. Exercise has been a huge battle for me. I am great at starting an exercise routine but terrible at committing to it because of the chronic pain. The pain I feel after exercising sets me back and lowers my motivation to keep going. From an occupational standpoint, I’ve had to overlook several jobs I wanted due to physical demands. Even with my current job that requires light physical activity, sometimes I have to leave work early or take days off. Fibromyalgia can be very emotionally taxing. Most days, it feels like I am not in control of my own body, which causes a lot of depression and anxiety. Nevertheless, I try to have a sense of humor about it and focus on what I can do instead of what I can’t do.
What are some misconceptions about it?
Fibromyalgia can be mistaken for several other conditions since there is a lot of overlap with its symptoms. At first, I mistook fibromyalgia for delayed-onset muscle soreness. Before I heard of fibromyalgia, I tried to reason, “I’m just out of shape. If I exercise consistently, then my body should have better endurance.” But even after exercising over time, I remember constantly being in pain. My body never seems to adapt to physical activity. It’s like learning to exercise for the first time, over and over. People also think just because you’re young, you shouldn’t experience chronic pain. People have said to me over the years, “You’re too young to be in pain…You’re too young to be tired.” Everyone’s body is different and complex, and chronic pain does not discriminate. The idea that physical pain is “all in your head” is common too. Someone once told me I couldn’t let my body rule my mind. I’m not in pain on purpose. Why would I choose to live like this?
How do you manage it?
Besides the usual health habits (eating healthy, exercising, getting enough sleep), I have found the only preventative thing I can do is limit my physical activity. When I’m in situations where physical activity is unavoidable, I will take breaks from walking or sometimes use a wheelchair/walker. Over the years, I have learned my boundaries and when to stop and rest. When I do push my boundaries, I start with non-medical treatment first; I use a heating pad often and place it on my head, neck, arms, or back. Hot showers/baths also feel therapeutic. For me, the heat usually draws out the pain. If I combine that with light stretching, it’s even better. I have had many nights when I couldn’t fall asleep because of muscle aches, and stretching helped me fall asleep. Every once in a while, I will also apply pain cream on my body, but I have had mixed results with that. When I have exhausted those resources, I take over-the-counter ibuprofen; I always have that on hand.
Maddie
Condition: Hypothyroidism
What is hypothyroidism?
Hypothyroidism is characterized as an underactive thyroid, meaning the gland doesn’t produce enough hormones to be within normal and healthy functioning levels. Thyroid hormones regulate the body’s metabolic rate and affect the functioning of other hormones, the nervous system, brain/heart/lung function, brain development, bone maintenance, and more.
How did you discover you had it?
I was diagnosed in 2007 when I had been deemed “failure to thrive” by my family doctor; basically, I was developmentally delayed for my age and had no signs of entering puberty, with the addition of the onset of mental health issues such as panic attacks, often getting infections or sick, and other minor health issues.
How does it affect you?
There are so many physical, mental, and emotional symptoms that go alongside hypothyroidism. When my hormone levels aren’t properly managed, I can have symptoms such as hair loss, dry skin, intolerance to cold, constipation, lethargy and low energy, hypersomnia, puffiness and inflammation, joint pain, headaches and migraines, heavy periods, memory issues, trouble concentrating, depression, panic attacks, and agitation and irritability. These are the symptoms that I personally have dealt with in relation to my hypothyroidism, but there are many other symptoms that others deal with and they can vary greatly from person to person. When I am successfully treating my hypothyroidism with synthetic hormones and keeping my levels within normal range, most of these symptoms go away, but some can still flare up intermittently regardless of treatment. Because of my history with mental illness, I am particularly susceptible to the mental and emotional side effects of hypothyroidism, and it can sometimes be difficult to differentiate when I am dealing with a mental health decline or if I need to adjust my thyroid medication dosage. I have struggled throughout the years when dealing with mental health issues and going to the doctor for help because as soon as they see I have hypothyroidism, they often attribute how I’m feeling to my diagnosis. I’ve really had to advocate for myself when it comes to further testing or additional treatment for my mental health symptoms.
What are some misconceptions about it?
Many people think of hypothyroidism or Hashimoto’s as a disease that just makes you gain weight and makes losing weight difficult. It’s much more than that, and for many people diagnosed at a younger age like I was, the host of issues were much more severe because it directly affected my body’s ability to start puberty and grow like the average pre-teen. Additionally, people often think once you get a diagnosis and start on medication, symptoms disappear, and you will feel back to 100% again. For many people that suffer with hypothyroidism, symptoms can be lifelong and will come and go, regardless of treatment, not to mention all the side effects that come with taking synthetic hormones. This disorder is much more than just an easy-to-fix issue that affects middle-aged women, as most people associate hypothyroidism with. It can affect any person regardless of age and gender, and the treatment process is often trial and error that requires close monitoring and management throughout your life.
How do you manage it?
I take synthetic thyroid hormone medication, which is just a daily pill that I will have to take for the rest of my life, and annual blood tests to monitor my thyroid levels and make sure I don’t have to alter my dosage. For the mental and emotional symptoms that come along with hypothyroidism, I make sure I have a mental health regimen: going to therapy, meditating, managing stress levels with self-care (stress can alter your hormone levels easily), taking any additional psychiatric medications prescribed when I am going through a bad depressive episode or dealing with increased panic attacks/anxiety, and making sure I am eating healthy and getting regular exercise.
Olivia
Condition: Tinnitus
What is tinnitus?
Tinnitus involves hearing ringing, buzzing, or other noises in one or both ears that are not caused by external sound. According to the Mayo Clinic, tinnitus may be present all the time, or it may come and go. The phantom sound can be so loud it interferes with your ability to concentrate or hear external sounds.
How did you discover you had it?
It started almost a year ago, while I was at work. I work in a loud environment with a lot of technology. At first, I thought the ringing was coming from a speaker or other piece of equipment. Then, the ringing and hissing happened in quiet environments. I also experienced sharp pains deep inside both my ears. No one around me could hear the sounds, so I knew they were “in my head.” I also started to experience very intense dizzy spells. On several occasions, I had to grab onto walls, furniture, or people to avoid falling to the ground.
I initially thought it was an ear infection, so I went to urgent care. The medicine they prescribed didn’t help. It was becoming difficult for me to concentrate and hear what people were saying, and I started to think I was losing my hearing. I went to an ear, nose, and throat specialist. All of my hearing tests came back normal. The specialist said it was tinnitus, most likely caused by stress.
How do you manage it?
The specialist said I likely carry a lot of stress in my neck and shoulders. I should have known; I often pulled my shoulders up by my ears while driving into work. He referred me to a physical therapist. Over the course of a couple months, the physical therapist worked with me to strengthen my neck and shoulder muscles and improve my posture. I learned to be more conscious of my posture and to recognize when I was translating my mental stress to physical tension. This process was time and money intensive; I went to the physical therapist for an hour twice a week. On top of that, I had to do my “homework” exercises twice a day for roughly 20 minutes each time (40 minutes total each day).
Now, I try to recognize when I tighten my shoulders and neck. I have a few quick exercises I can do on the spot, but when my tinnitus really acts up, I go back to my 20-minute “homework” routine for a few days. I’ve also worked to reduce my overall stress.
How does it affect you?
It’s very scary. Hearing something that isn’t there and feeling so dizzy you could fall to the floor at any time are terrifying. When the dizziness was at its peak, I was afraid to go out in public because I didn’t want to fall. I’ve also felt embarrassed by my tinnitus. I often miss what people say at work or social gatherings, and sometimes I have to ask people to repeat themselves several times. If they don’t repeat what they said loudly enough, sometimes I just say, “Okay,” and pretend I heard.
Although tinnitus has been a tough experience, it has also forced me to acknowledge my stressors. For a time, I was trying to push my mental health to the side; I wasn’t focusing on my wellness and I wasn’t using appropriate coping mechanisms. I was still seeing a psychiatrist, but I wasn’t focusing on my mental health. My tinnitus symptoms “forced” me to go to a doctor and reevaluate my priorities.
