Rep. Smith: Finding a path back from chronic pain and crippling anxiety

Millions of people in our country suffer from some combination of chronic pain, anxiety and/or depression. I was one of them.

Debilitating anxiety hit me in 2013, during my tenth term as a member of Congress. Chronic pain, starting with hip problems, struck a year later. I battled these health challenges for over six years, going through over a hundred different health care providers of one kind or another, in a desperate quest to figure out what exactly was the cause of my anxiety and pain, and how to best treat those conditions. I did, finally, find help. I got better. I am beyond grateful for this reality, but also keenly aware of how much more needs to be done to improve our health care system and to help those millions of others suffering similar health care challenges.

Stigma remains a significant obstacle for people dealing with anxiety or depression. I had a bout of depression years ago, at the age of 25. Severe anxiety hit me 15 years after that. Both times I told almost nobody about my condition and did little or nothing to try and find treatment. I got better for no apparent reason in both instances, but the anxiety came back and would not leave in 2013; and I was still very focused on making sure I kept my mental health problem as quiet as possible. The last few years have seen improvements in this area, as more people have started speaking publicly about their struggles with mental health. But it is still a significant problem. Too many people don’t seek treatment out of fear of how people will react to any admission of a mental health problem.

We must also do more to make it clear that help and treatment do exist. This was a significant barrier for me. I had no understanding of the basics of good mental health and doubted that some psychiatrist or psychologist could truly do anything to help me get better. I vividly remembered a headline from the satirical magazine, The Onion —  “Psychiatrist Actually Cures Someone.” I believe this perception is more widely held than most people realize. The purpose of removing the stigma around mental health and encouraging people to speak more openly about mental health challenges is not so we can look at these people and feel sorry for them. It is to help them find a path to getting better.

Finding that path also requires us to understand the difference between clinical anxiety or depression and more common feelings of stress or unhappiness. Both should be addressed, but the former presents greater challenges. The clinical variety will always contain issues that go far deeper than the ups, downs, stresses and strains of everyday life. Put simply, the latter comes from stuff we are all too aware of in in our life, the former comes from issues we have repressed and buried in our subconscious. Therapies exist to help with both, but understanding the difference is always a critical step in choosing the right way to address the issue.

Access to health care remains a challenge for far too many people. The uninsured, certainly, but even if you have insurance providers often either do not take your specific insurance or don’t take insurance at all. This happened to me countless times, even as a federal employee with decent health insurance. We desperately need to expand coverage to help people access health care services.

Even when patients find providers those providers often do a poor job of explaining the basics of combatting mental illness. I saw a dozen different mental health care providers and went through three and a half years of psychotherapy before those basics became clear to me. This is not to say that those basics offer some guaranteed instant cure. But they do help as a starting point.

One, you must have a basic belief in your own self-worth—not self-worth based on what you have or have not done in your life, but self-worth simply because you exist as a human.

Two, deal with trauma or other problematic experiences in your life, both current and over the entire course of your life. Be honest with yourself and use psychotherapy where necessary to make sure you are not suppressing these troubling experiences.

Three, cognitive behavioral therapy can really help with both clinical anxiety and depression and in dealing with the normal ups and downs, stresses, and strains of life.

Four, meditation can really help with teaching your brain that it doesn’t have to chase after every thought or emotion that enters it.

Finally, on the chronic pain side, muscle activation therapy is key. I don’t have space to fully explain here but google “Muscle Activation Techniques” and trust me—the MAT people can save many people from a life of chronic pain.

There is so much more to say on this subject, but I hope the above helps. My book, “Lost and Broken, My Journey Back from Chronic Pain and Crippling Anxiety” offers a more detailed account, and also references other places to go for help and information.

Adam Smith represents Washington’s 9th District.