How Chronic Illness Ruins Your Motivation (and what to do about it)

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If you’ve been ill for any period of time, you know that it’s more difficult to do things you need to do or even enjoy. Usually, when you get better, your energy and motivation levels improve also.

Chronic illness makes that equation slightly more complex.

Even when the pain leaves, the motivation levels may stay as low as they were when you were ill. If you’ve noticed this phenomenon, you may wonder why, beyond the clearest answer – “depression”.

How chronic illness ruins motivation

Robert Malenka of Stanford University and his colleagues studied chronic pain in mice. They showed that persistent pain resulted in mice being less and less likely to work for food in comparison to their pain-free friends.

Long-term pain (in this case, a week for the mice), resulted in nerve-cell changes in the nucleus accumbens which is important for processing reward and reinforcement.

When the pain was relieved, the mice were still less willing to work for food even if they were hungry.

The researchers asked if they did not work for food because…

  1. their pain was too severe?
  2. they no longer valued food as much?
  3. they lacked motivation?

More tests showed that they could walk fine and still valued food. Their pain was relieved. They lacked motivation.

Although Dr. Malenka’s study was valuable, it may not be best to directly translate these findings to humans. What we can take from this is that long-term pain seems to reduce motivation even after the pain has left.

There seems to be a slight edge taken off life when you’re in pain because you grow to expect the pain to continue. More tasks appear futile because they were difficult or unable to be completed in the past.

Moreover, we must also be aware of the complex intertwining with depression, fatigue and emotional tiredness that comes with living with an illness for a long period of time. Quite literally, it can change you physically and mentally.

What can we do about it?

Now we know that chronic pain can influence motivation even when the pain isn’t there, we can start with the first tip:

  1. Forgive yourself

There are days when pain isn’t as bad but we still don’t want to do anything. Now we know why.

To stop yourself from falling victim to the useless command of “just snap out of it!”, understand that it’s more important to be on your own team and to forgive yourself if things don’t always go to plan.

2. Start small…

…and stay small.

I’ve long been an advocate of making small, healthier changes that you can do every day. They are more sustainable, more enjoyable, easier to do and easier to fit into the day. Not everything needs to be a 100% effort – and they’re useless if you can rarely put in that effort.

For example:

  1. 5 minute daily walks
  2. 5 minute meditation
  3. 20 minutes of reading

The daily actions vary from person to person. Some people can manage 30 minutes of walking a day, other people find it difficult to walk to the kitchen sometimes. No need to feel ashamed or arrogant about whatever stage we’re at.

What does “stay small” mean?

It means, on pain-free days or simply days that you feel good, you may not want to take advantage of that and do everything you’ve hoped for. It feeds into the boom and bust cycle of pain management.

Pain ratings:

Day 1: 5/10 | Day 2: 6/10 | Day 3: 4/10 | Day 4: 1/10 NOW WE RUN A MARATHON WHILE COOKING FOR 100 PEOPLE

Day 5: 9/10 – We do nothing.

And repeat.

We want to have a reasonable amount of consistency in our days so that we can consistently feel rewarded for our efforts regardless of our pain levels. That is easier said than done but still possible to a degree.

If we feed into the boom and bust cycle, even those days where your body doesn’t feel like it’s on fire can result in us doing very little.

3. Take time to slow down

Some days, all the medication or tips in the world can’t really help us. But we can try our best to take some time to ourselves and slow down just a bit.

Whether that is through:

  • Taking a few deep breaths
  • Stroking our hands lightly
  • Eating and drinking mindfully
  • Hugging a teddy bear (or person… subject to availability, of course)

We can experiment with healthy ways to stop ourselves from getting lost in the self-hatred or anxiety that comes from a lack of motivation and depression.

Why bother?

Chronic pain often makes us ask ourselves – why bother? We can very easily build resentment towards our condition and ourselves. Who doesn’t want to have more control over their lives?

I won’t tell you that you should feel a certain way after reading this. I certainly won’t say that you should feel motivated. However, do take away that small, sustainable changes can be a healthy way to manage pain and our motivation levels.

To end, I quote Toni Bernhard…

May you make the best use of what is in your power and take the rest as it happens.


As always, thank you for reading!

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Further reading:

12 Ways to Cope with Chronic Pain and Depression

Decreased motivation during chronic pain requires long-term depression in the nucleus accumbens

Study reveals brain mechanism behind chronic pain’s sapping of motivation

Sadness | The Sunday Monday Post

If you’d give me the chance, I’d like to talk about being sad. Lost. Frustrated. Depressed.

But first, I want to celebrate a few things.

I have a friend who is currently transitioning (or “transforming” as she now says) and says she’s the happiest she’s ever been. I’m happy for her.

I have a friend who, after a year of multiple applications, crude bosses and near overwhelming responsibility, managed to get a job directly related to her field. I was there when she got the job offer and believe me, her smile was as big as the sun. I’m happy for her too.

Ms Improving Slowly (or Arguably Honest) had a mighty relaxing holiday and a break from all of my terrible jokes. I’m happy for her too.

My dad got a job rather quickly after his previous position ended and I can always see a small pep in his step after things like this happen. I’m happy for him too (although, it hasn’t motivated him enough to use the exercise bike we have!)

There’s a lot to be happy about when I really attempt to practice appreciative joy. That is, taking yourself out of the equation and simply enjoying the happiness that other people are experiencing. To me, that is one of the greatest upside of empathy. While it is often used in the context of trying to help people who aren’t in a good position, it can also be used to celebrate the positive!

I find, when you care about the important intensely, you begin to share the moments of happiness as you do the moments of sadness. And that is OK. In fact, I think that makes relationships that much richer. So much more valuable. 

When you’re around, regardless of the highs and lows, you’ll experience some good moments. Happiness comes along and it feels good.


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LoboStudio Hamburg

I’m not sure I’ve mentioned publicly, but I’ve dealt with depression for about three years now. In that time, there have been many many low moments. Currently, I think I’m in one of those spirals where everything you hold onto seems slippery and you retreat into yourself.

Just waiting for it to pass.

Of course, it’s difficult to imagine that it ever will! Even with the evidence that happiness has come about before, the hill always seems difficult and impossible to climb. Especially with the fact that a lot of my mood is tied to my pain. And that doesn’t want to leave me in a hurry.

In a “recent” post, I asked myself what the purpose of this blog is. What does Improving Slowly mean? The first principle was to accept that we’re all working drafts. That also means we’re far from perfect. And most definitely our thoughts aren’t always perfect, true, helpful or even valuable.

You may have these moments of extreme self-doubt – the same way I do. Doubting your skill set, what you add to the world, wondering who cares about you and asking yourself whether you should even take another step.

It would be best if you do take the next step. Even if it’s the tiniest step possible. Towards a small moment of peace where you are free of continuous self-judgement and vitriol.

I always say when I’m stressed that there’s always time to take two breaths to yourself. While this doesn’t solve my sadness, it helps me slow down and return to the present instead of dancing in the frenzy of the future.

One.

Two.

With time, even if it takes weeks, I begin to remember that sadness does pass.

The depression may stay around but that’s a much larger battle to tackle one step at a time.

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Jake Thacker


Relationships are important. I’m appreciating that more and more.

It gives me the opportunity to remember there’s more than myself in the world. I don’t need to get lost in my own thoughts all the time. I can enjoy the experiences of others.

Or I can help and be helped.

Being lonely is difficult and stigmatising. It’s something I want to explore in more detail so I won’t do it here. However, if there’s one thing to take from this post, I ask that you tell your friends and family that you appreciate them.

If there’s someone you haven’t spoken to in a while, maybe say hello again (you can probably skip the small talk and just ask something interesting – everyone is “good” or “fine”).

And that’s about it. Sadness happens. It also stops at times. Being sad isn’t a defect – it’s just an emotion.

And they pass.


As always, thank you for reading!

If anyone asks, I’ll be alright. I’m just trying to be more honest and show I’m not perfect but making steps to improve myself.

Follow me on Facebook and Twitter for more updates!


If you are depressed or anything of the sort, here are some resources (for the UK):

NHS DIRECT
Provides 24 hour access to nurse advice, information about healthcare and about local health services. Contact NHS Direct for help with a current health concern, to ask about out of hours doctors’ services and for emergency health advice.

Helpline: 0845 46 47, every day, 24 hours a day
Websitewww.nhsdirect.nhs.uk

SAMARITANS
Samaritans provides confidential non-judgemental support, 24 hours a day for people experiencing feelings of distress or despair, including those which could lead to suicide.

Telephone: 0845 7 90 90 90, every day, 24 hours a day
Emailjo@samaritans.org
Websitewww.samaritans.org
SANE
SANE is one of the UK’s leading charities concerned with improving the lives of everyone affected by mental illness.

Helpline: 0845 767 8000, every day, 1:00pm-11:00pm
Emailsanemail@sane.org.uk
Websitewww.sane.org.uk

ACTION ON DEPRESSION
Supports the running of self help support groups in various parts of Scotland which offer the opportunity for confidential local support and contact with others in a similar situation.
Provides an information service offering support and information on depression to individuals, their families and friends and professionals working with people who have depression; a quarterly members newsletter and a range of helpful publications.

Telephone: 0808 802 2020 Information Service, Wednesdays, 2:00pm-4:00pm
Emailinfo@actionondepression.org
Websitewww.actionondepression.org

Please go to Depression UK for more detailed links.

I’m 20

I’m 20

Self-review can be difficult. Especially when it feels like the negatives from the previous year have become worse and the positives more rare.

However, there is nothing wrong with this difficulty. This year has been tough but there’s little value in either trying to show a false persona (whether the portrayal is happy or sad) nor would I benefit from ignoring it completely.

I’m turned 20 a week ago and here’s the review of my past year.

What’s happened in the past year?

Writing

My journal has continued and become an even more important part of my life. I started when I was 18 and it’s still going. I’m nearly at 500 days with over half a million words. Even if it just tends to be personal rambling, it shows the usefulness of consistency. In the early days, there were times when I just didn’t want to write anything. Either because I’m too tired or I’ve had a bad day. Now, I don’t do it based on how I feel. It’s just something I do. It’d be weird if I didn’t write every day. I’m pretty sure journalling is more regular for me than eating breakfast or sleeping for 8 hours.

It’s a wonderful habit which has slowly proved itself as a much needed anchor throughout my day.

On the other side of the coin, my blog has been inactive. I will explain why later. I did have a productive month in March but I can’t explain to you why that was the case! The same thing happened last year. Maybe March is just the best month of the year.

I have a few favourites though. My post on living with chronic pain is the best explanation of my current problem. I also enjoyed writing about comparing yourself to others and why we should listen.

University

I study Philosophy for those who don’t know. I’m still at university and it’s not the worst thing in the world. I’ve kept and made new friends. I don’t actually know if I’m any better at philosophy at the moment but I have gained new interests in the field. The main one being about global justice and health.

The course is based on what can and whether anything should be done about healthcare in countries around the world. Currently, there is a great inequality of healthcare around the world and it’s something we all know. However, we are also much less likely to actively do anything about it and much less likely to claim responsibility for all the poverty-related diseases in the world. Questions such as ‘Does Aid Work?’ and ‘Are all humans moral equals?’ were central to the course. I feel the course has made me much more compassionate and at the same time, it’s made me feel like my arguments are actually increasing in relevancy instead of being dismissed as useless.

For anyone reading this who know me in real life, I’ve gone on and on about this course. I apologise for nothing.

Depression and Health

This is what I wrote last year:

“Being in pain every day for over five years has started to take its toll on my mental health. My various coping mechanisms are struggling to handle just how prominent all of these medical problems are in my life.”

Unfortunately, nothing positive has developed. My depression is much worse and my pain continues without change in intensity.

I could write for a long time about this depression but I won’t bore you with the rambling. Depression makes me feel alone in the company of my best friends and sad when I’m surrounded with happiness. It has sucked out any motivation I’ve had for the things I used to enjoy and made it difficult to just do normal things. For a while, even during my exam period, I would just lie in bed doing nothing of value. But it’s not like I would sleep either for I also have to deal with insomnia. I’m also still using a walking stick. Which clearly doesn’t help this whole situation.

As you can guess, this year has been filled with a lot of frustration which is often directed at myself. I still meditate but I’ve struggled to find any kind of peace. The days when I would walk outside and just appreciate the sounds and sights are far and few between.

Very recently, I was actually told I can’t have anti-depressants yet because I needed to test stronger painkillers! That seemed to just highlight some of the absurdity of the whole situation.

But that’s ok. Things like that happen to people all the time. I’m not alone with this depression but I don’t know how much comfort that brings to me any more.

So that helps explain why I haven’t written that much over the past year and my current difficulty with university.

I’ll get better. I haven’t lost all hope in the world. I need to get to a million words in my journal, after all.

Looking Forward

To every psychologist I’ve spoken to, they’ve asked me: What are your goals for the end of our sessions?

I have to filter out the standard “I don’t want to be depressed” answers because it isn’t that useful.

To all of them, I have said in response “I want to be ok with how I’m feeling”. That doesn’t mean that I have to feel happy all the time. It is centred on finding peace with myself and mindful of who I am. And really just being involved in my own life rather than being a passive spectator of the days that come and go.

Aside from the standard goals of becoming a better writer and developing new skills, I’d say that is the most important. If that means that I’m not on a walking stick when I’m 21, all the better. If I still have to deal with chronic pain, hopefully I’ll still be able to find some peace in my day.

And that is it. Here’s to a better future.

 

Some days will be difficult

Some days will be tiresome to get through. Some days, nothing will go your way. Some days will be bad from the moment you wake up to the moment you go to bed.

Those tough days might become a tough week. A tough week might become a tough month.

If you’re dieting, during those difficult days, you might give up and eat whatever you want.

If you’re trying to read more, you might watch YouTube videos all day.

If you’re studying for an exam, you might throw your pen at the wall and declare yourself stupid.

These difficult days happen and I think it’s important to remember: They’re a normal part of any journey.

In the midst of these days, it is often extremely difficult to see where the end is. We feel much worse because we’re suffering and don’t know when it’ll end! If it goes on for long enough, we might begin to convince ourselves that it’ll never end. Or even worse, that if it actually doesn’t end, I’ll always struggle and never adapt. I’ll never achieve the goals that I want because I don’t have the will power or I don’t have the energy or I always make mistakes because that’s the way I am.

We need not feel this way. Difficult days are normal. For some, they will unfortunately go on for much longer. However, such days are not a signal for us to give up on our goals and especially not ourselves. They aren’t the clear reminder showing us we’re better off quitting and that our good intentions will only lead us to bitter failure.

During these days, take some solace in the fact that our emotions often come and go without our permission. And so, it helps to take a deep breath.

Slow down.

Then return to the present.

The present contains none of the future worries or past regrets. It contains none of the anger, sadness, frustration or hatred. It just contains you and your breathing.

You might, or in fact, probably will, still feel like things aren’t going your way. But now, by slowing down slightly, you have taken a break from the distraction and frustration the day has presented you with.

Remember that some days will be difficult. Sometimes they’ll last for far longer than you think you can handle. But as with all things, they’ll pass with time. You’ll find your peace again.

When it comes, you’ll savour it and maybe the tears you once cried during a difficult day will now be tears of joy.

If you’re experiencing difficult times at the moment, I wish you the best and hope the dark cloud passes and the sky becomes clear once more.

As Ralph Waldo Emerson says better than I:

This is my wish for you: Comfort on difficult days, smiles when sadness intrudes, rainbows to follow the clouds, laughter to kiss your lips, sunsets to warm your heart, hugs when spirits sag, beauty for your eyes to see, friendships to brighten your being, faith so that you can believe, confidence for when you doubt, courage to know yourself, patience to accept the truth, Love to complete your life.