Information

Is there a condition where a person doesn't feel emotional or non-physical pain?

Is there a condition where a person doesn't feel emotional or non-physical pain?

Congenital insensitivity to pain is a rare condition where a person cannot feel pain (physical). Is there any condition relates to emotional pain or any pain not related to physical that a person cannot feel?


Congenital insensitivity to pain (CIP) is a condition in which a person cannot feel physical pain. There is no known analogue encompassing all emotional (psychological) pain.

There are certain conditions in which a person may not be able to feel certain types of emotions, such as in psychopathy and related anti-social personality disorder. This may be related to abnormalities in the limbic system - an area of the brain associated with processing emotion.

However, it is not always clear whether or not individuals who appear to lack the ability to feel certain types of psychological pain (eg, PTSD) in fact cannot feel it, or they can feel it but are indifferent to it, as in emotional numbness or apathy.

Additionally, modern theories of emotion suggest that emotion is "subjective" (context-dependent) - that is, physiological aspects of emotion (such as pain) are only part of the picture, and many other cognitive factors come into play. So for example, in the case of a broken heart, as with psychological pain in general, it appears to share some mechanisms with physical pain - ie, this type of pain is effectively the same as physical pain. Nonetheless, CIP patients appear to be able to feel emotions such as heartache normally, suggesting that the mechanism is much more complex, and physical pain is neither necessary nor sufficient for feeling psychological pain. The added complexity may be the reason why an emotional analogue to CIP is not known - the number of systems that would need to malfunction simultaneously is too unlikely. It is also probable that given the importance of emotion to normal functioning, that a condition of not feeling it would be equivalent to death.

PS: Sorry that I don't have any book recommendations for you, but Wikipedia articles I linked to contain many references to literature you can check out.


Mutations in the NTRK1 gene cause CIPA. The NTRK1 gene provides instructions for making a receptor protein that attaches (binds) to another protein called NGFβ. The NTRK1 receptor is important for the survival of nerve cells (neurons ).

The NTRK1 receptor is found on the surface of cells, particularly neurons that transmit pain, temperature, and touch sensations (sensory neurons). When the NGFβ protein binds to the NTRK1 receptor, signals are transmitted inside the cell that tell the cell to grow and divide, and that help it survive. Mutations in the NTRK1 gene lead to a protein that cannot transmit signals. Without the proper signaling, neurons die by a process of self-destruction called apoptosis. Loss of sensory neurons leads to the inability to feel pain in people with CIPA. In addition, people with CIPA lose the nerves leading to their sweat glands , which causes the anhidrosis seen in affected individuals.

Learn more about the gene associated with Congenital insensitivity to pain with anhidrosis


Disclaimer:

As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Comments

As a patient advocate, healthcare writer, and peer to peer website moderator, I frequently communicate with people like Laura Kiesel. She is one of (literally) millions of women who are regularly written off as head cases by incompetent or poorly trained physicians who have little familiarity with the assessment of pain. As a result of this pattern, women reporting to emergency rooms with chest pain have a substantially higher likelihood of DYING of heart attacks than do men. Likewise a substantial majority of people diagnosed with chronic pain conditions are women whose treatment has been delayed long enough to exacerbate and complicate their underlying conditions.

Early this week, I gave a 3-minute presentation before a panel in an FDA workshop on “educating physicians in safe prescription practices for opioid medications”. At least three of us spoke on behalf of chronic pain patients during the public commentary periods of this workshop.

My personal input was that the Workshop organizers should feel a deep ethical obligation to adjourn the event without offering recommendations on “safe prescription practices”. This is true in large part because the March 2016 CDC guidelines on prescription of opioids do not comprise a safe or reliable standard of care. In fact, there is compelling evidence that the CDC guidelines were influenced by financial and professional conflicts of interest among the core group of consultants which wrote them. Moreover, this group cherry-picked studies from the medical literature in a deliberate and biased attempt to prejudice their findings against opioids and to magnify the percieved risks of this class of medications. The CDC guidelines are resulting in wide-spread discharges of patients who have been stable and well managed for years on opioid medications — and who are fundamentally not at risk for addiction behaviors. This is a fundamental malpractice and an abuse of human rights in denial of care.

When I wrote about the state of American healthcare at the American Council on Science and Health, I titled the article “A Report Card on the American Healthcare System — F”. Particularly for chronic pain patients, that assessment is highly apropos.

I have adhesive arachnoiditis, level 4 endometriosis, and EDS. I have been on the Whole30 since January of this year. I walk 1-1.5 miles everyday, I do private Iyengar Yoga lessons and practice after my walks everyday. I’m taking every supplement known to help nerves, pain, and inflammation. I have medicine to help me get at least 4-8 hours of sleep. I have a large support system including a therapist. I meditate every day to work on my chronic pain. I have a TENS unit. I have lidocaine patches. I take epsom salt ice baths every night. I fasciablast and dry brush to move my lymph and release my bound fascia. I work damn hard and I am STILL IN PAIN. I still need something to take the edge off. Gabapentin only worked for 1 month, 1 MONTH! Lyrica made me plan out my suicide, thank goodness my sis in law was getting married because that saved my life. Cymbalta gave me a three day migraine where I couldn’t leave the bed. SO WHAT OPTIONS DO I HAVE LEFT. As it is now the only thing I’ve been given to deal with the pain that I’ve had for 2 years is Tylenol 3. Nerve pain is different than normal pain and until they come out with options that are ACTUALLY DESIGNED TO TREAT NERVE PAIN, the chronic pain community needs access to opioids. If we don’t have them you will see the death toll go up, it’s not an opinion, it’s a fact.

For 49 years whether it was muscle spasms, displaced vertebrae, tingling in my arms and legs, blackout causing headaches I was told it was all in my head or to exercise more. This being said to a woman who played basketball and volleyball 6days a week. Ran 2miles a day 7miles a day. I believed the doctors that there was nothing wrong with me.
In reality there was a lot wrong with me, chronic meningitis, degenerative disc disease, cauda equina, advanced adhesive arachnoiditis with ossification, scoliosis, bulging discs, arthritis, undiagnosed fevers and rashes. These conditions could have been minimised had I been diagnosed and treated early on in my life. At age 48 I could no longer hold a job. My life is constant unrelenting pain. Coursing shafts of electricity through my arms and legs strong enough to kill every battery powered watch I’ve owned.
And at age 58 I was blessed yet again by doctors who scared of the government powers that be discontinued all medications to control my pain. Irreguard that every other non opiate I was given produced violent allergic reactions whether by rash, fever or incoherent speech.
I have lazy egotistical doctors to thank for many of my problems, and scared cover-my-ass doctors who put my life in jeopardy by removing my access to the high doses of fentanyl in one day. No medication to help with the withdrawls. Excuses about cdc rules and state laws. The truth was and still is my condition is pallative, there is no hope for full recovery, the only thing a doctor could do for me is help manage the pain. By doing this my life was ok, I was able to feel like I contributed. Now I sit and hurt, the pain is too strong to concentrate on anything else. It is a force stronger than me that gets me out of my bed daily. But that force is losing its hold, I think more about when I die than what life I have to look forward to.

So thank you Doctors in my past for not being good or even decent at your jobs. For not living up to your oath of do no harm. Thank you for ruining my future and my past. And yes now I really should exercise.

I have degenerative disc disease, severe arthritis and now I have Arachnoiditis (a very rare disease that for me affects my low back and nerve pain down my left leg). I live in Alabama where there are not enough doctors that know how to treat chronic pain and more importantly don’t know how to treat Arachnoiditis. I am now at a clinic where a pain management doctor who has a practice in D.C., comes down once a month because of the lack of PM doctors. I can tell you that if you saw me out in public (which only be one dr. appointment days) that without a shadow of a doubt you would know chronic pain is NOT invisible. I stay bed ridden most of the day because the CDC has their head in another world, they are making it impossible for doctors to treat chronic pain patients with the right medication so we don’t have to suffer. If the CDC doesn’t allow PM doctors to prescribe the medication necessary NOW, the suicide rate is going to skyrocket! There are patients whose medication has been cut in half. I’ve been on just about everything out there that the doctors are able to prescribe and I’m still in pain. I’m scared to death that when I go back to the doctor next week, they are going to tell me their hands are tied because of the CDC guidelines and they won’t be able to give me enough medication to help my pain.

Thank you so much for writing this article. It’s a voice for so many people like us. That have no voice. I have a long story that would take pages to tell. In a nutshell, I was a very active outdoors person, trained and rode horses avidly among other outdoor activities, was an extremely ambitious worker, and was completely independent. I was in a series of three car accidents over the space of seven years, beginning when I was 31. The first 2 we’re very serious, the first I was ran over by a car. The second I was T-boned at highway speed. I got relatively lucky because I “walked” away from both. I did not receive very thorough medical care, so I do not know if I actually broke any bones or not, but it was said that other than a rib or 2, I did not. I did end up with quite a few “mild” bulging disks in my neck and lower back. Because I am extremely stubborn and extremely tough, my injuries did not keep me down in the beginning years like they would’ve other people. I also was religious about doing physical therapy, and did not believe in opioid therapy. Through a combination of exercise, physical therapy, other alternative therapies, good diet, exercise and some other medically advised procedures, I was able to stay working and almost as active as I used to be for several years. By age 37, adter some events, I realized that my injuries were going to catch up to me and I wouldn’t be able to use my body to make a living much longer and that I also wanted to achieve my longtime dream of becoming an engineer or scientist. Or both. So I packed myself up and moved several hours away to a college town and began college. There, I was in a third accident that was relatively mild. I received treatment for that, but my health rapidly deteriorated. For the next 5 years I was in excruciating pain (still am). My feet were on fire all of the time, I had pain in my legs and back, pain in my neck and down my arms and numbing in my fingers. I lost count of how many doctors I went to in the end, but it was well over 20, maybe as many as 40. Before this I had had the pain of bulging disc’s, and other pain. The pain that I experience now was/is severe and debilitating. Instantly upon standing or sitting, anything that was not laying down, my feet start to burn, and it is horrible horrible pain. Not being able to stand or sit without pain interferes with basically every single activity that I do. I tried to maintain my life for a while, but went from a 4.0 GPA to flunking two classes. I’ve never flunked a class in my entire life, in fact I rarely had ever gotten anything below a B, and certainly never anything lower than a C. I went to doctor after doctor trying to find help amd answers. I did not want to let go of my life. But the pain I was in was – and did – destroy my entire life. In a nutshell I was told multiple times things like I was just not being tough enough and I needed to learn to cope “with the kind of pain that happens as you age”, I was told that I “must have had psychological trauma” when I was young and it was now manifesting as a physical pain as an adult, I was told I was faking, I was told I was lying, I was told that since nothing showed up on my blood tests or on my MRIs that therefore nothing was wrong with me and that I “just” needed counseling. Somewhere along the way a doctor, or two maybe,
diagnosed me with fibromyalgia, but then other doctors told me that that was just a “fake” diagnosis and wasn’t a real disease therefore I wasn’t actually sick. This is all while I’m so disabled that putting on my own clothes, getting my own meals, driving myself places and getting groceries were so nearly impossible that I only did it because I am extremely tough. And stubborn. I know other people that could not have done what I did. And because I was so tough and got through it, that actually my doctors disbelieve me even further. I was told that if I could get myself to the grocery store then I wasn’t disabled. It didnt matter to them that I would have to rest in my car for 20 or 30 minutes before going in AND after coming out before I could drive home. I didn’t matter that I couldn’t walk one direction across the entire store therefore was not able to make a whole grocery run in one trip. It did not matter that often I would barely make it across the store to get my groceries, and then the line would be too long (more than 1 person ahead of me) and I would have to abandon my cart and go home. Never mind the fact that if I did not drive myself I literally had no other way to eat and would have starved to death. I’m the kind of person that could break a leg in the mountains and would crawl 10 miles to help – but was told multiple times that since I did not have hospice care, I was not disabled. I was told I needed to pray more, I need to find God, that I needed to find support groups to get over my pain. I was told that I needed to eliminate all negative thoughts, and only be positive and that would fix my pain. I was told that I needed to eat certain foods and That would fix my pain. When I asked for help for disability I was told that I wasn’t disabled enough, that I was too young to be disabled, I was too young to be sick, was told that I was a beautiful woman and therefore was not disabled, I was told that I was overweight and that’s what was causing all my problems even when I wasn’t overweight when they began. I was told that I had beautiful skin therefore was not disabled. (The “beautiful skin” I had was make up). I have heard all kinds of ridiculous things. By the time I finally got the diagnosis for what was wrong with me, I was so beaten down mentally that I was terrified to even talk to this doctor because I was so sure he was going to also send me away telling me that once again there’s nothing wrong with me. I truly wanted to die. I could not handle the pain and stress and doctors not helping me. in the end my adrenal gland’s stopped working from the pain, other organs started showing signs of stress, and I began developing mental problems and cognitive processing problems from the stress and the pain.

I did somehow find enough courage to follow through with seeing this last and final doctor. He diagnosed with a really horrible disease called adhesive arachnoiditis. It is severe inflammation inside the spinal cord that leads to swelling of the nerves and then them sticking together and scarring to themselves and to the sides of the spinal cord sac. It matched every one of my symptoms. It is extremely painful. It is incurable. The symptoms are barely treatable, and pallative care is the only option. When I went back to some of my doctors to say that I finally have a diagnosis and that I needed their help with local treatment, I was met with disbelief, and told that the diagnosis was incorrect. And then reiterated to me that there is nothing wrong with me. I was actually told just the other day that I could not possibly be in as much pain as I thought I was in and I must just be imagining the level of pain I was in. It is astounding to me at the lack of compassion and understanding that the medical community has towards people with chronic pain. I have come to believe that everyone compares their own pain to what other people say and are unable to imagine that there is more severe pain than what they themselves experience. I would think someone that was intelligent enough to make it through medical school, should also be intelligent enough to imagine that a patient coming in and telling you their experience is true. And that it just might be worse than what the doctor themselves experienced. And yet doctors are encouraged now to only believe established text book diagnosises. As if everything about the medical body has already been discovered. And anything new, different or unexplainable “simply” does not exist.

Then there is a further component to the chronic pain patient now where there is now the stigma that if you’re in chronic pain you’re automatically a drug addict or “pill seeking”.
So now just the plain act of stating that I am in pain, and that I need help with it, makes the doctors compartmentalize me, putting me into an unfavorable category, as though I do not deserve medical treatment since MY ailment happens to be pain. And yet I have never used my medication to get high, I have never sold it, I have never taken more than the amount prescribed, I am None of the things I hear on the news. Yet I am labeled a possible criminal because I ended up with a disease I neither asked for nor wanted.

Because being in chronic pain makes you so desperate to not be in chronic pain, many of us have tried many many many things. I for one have tried just about everything I’ve ever heard of. Including special diets, special foods, meditating, positive thoughts, counseling, essential oil’s, herbs, vitamins, supplements, acupuncture, prolotherapy, physical therapy, chiropractic, etc – you name it I’ve probably tried it.

Pain is PAIN. And the only thing that helps pain is to either cure the cause or to give you medicine that numbs it. Period. not every cause can be cured. So not all pain can be cured. Sometimes the only option is to numb it. And sometimes the treatment for the cause isnt an already known treatment.

Chronic, severe, intractable pain is a real medical problem. And it’s turning into an epidemic. It is crucial that doctors be trained in it, but instead they are being trained in things like the pain is all in the mind, that you can overcome it with things like positive thinking. True pain cannot be overcome by positive thinking. Positive thinking can keep you from killing yourself over it, but it certainly cannot make the pain LESS. If that were so then we would be able to cure ourselves of cancer, broken legs, diabetes and heart disease soley with positive thinking, without any sort of medical intervention.

Thank you for your article. Thank you for having the courage to say publically your on chronic pain treatment via opiods.
Im sorry for what you’ve experienced, but is very true. There is a huge hole in the medical community lacking information and compassion around how to treat people in chronic pain


What life is like when you don’t feel real

This week (May 16-22) is Mental Health Awareness Week, with “relationships” as the theme. We’ll be running features all week about the mental health of those close to you, the mental health of the artists that inspire you and the different ways that communities and individuals deal with the issue. Slowly but surely, progress is being made in the ways in which we discuss a problem that affects each and every one of us.

Imagine. One day you wake up and when you take a look in the mirror you struggle to recognise your reflection as your own. Even worse, after that you constantly feel like an onlooker watching your life unfold in front of you like a dull scene in a bad movie, having completely lost the ability to connect with those around you because you’re too preoccupied with trying to work out why you feel so strange.

These are the terrifying symptoms of a dissociative disorder often referred to as DP/DR (depersonalisation-derealisation disorder). Trauma or bad drug experiences can trigger it, and it can last anything from a few hours to a number of years. This bizarre and barely mentioned condition leads people to feel detached from their bodies, emotions, surroundings – even their families. From the moment the symptoms set in, life becomes a constant battle to come to terms with an overwhelming sense of unreality where the concept of ‘self’ is almost impossible to grasp.

So, as part of Mental Health Awareness week, we spoke to a few people to find out what it is really like to be permanently detached from reality.

“It’s really hard to focus on things that require critical thought or memory. I've tried mindfullness but that actually made it worse” – Sophie

SOPHIE, 19, LONDON

“Looking at yourself in the mirror or hearing your voice come out of your mouth is really strange with DP/DR as you don't feel like any of it is real. Then that spirals into you feeling like nothing is, and like you're just a floating overly emotional string of thoughts, all alone in an odd reality. Usually it goes away after a few hours or a few days, but I've had it for two and a half years now.

DP/DR often accompanies anxiety and depression – usually amplifying them. Actually, the symptoms are really common. Most people experience it at some point, usually when exhausted after a long day or stressed. Smoking pot, or other psychedelic drugs, can also induce it. It's just complete mental exhaustion, like brain fog. Right now my head feels very cloudy, my eyes feel droopy and I just want to shut them and lie down. My mind keeps wandering and it’s really hard to focus on things that require critical thought or memory. I've tried mindfulness but that actually made it worse.

Mental illness is an incredibly lonely experience. You can have great friends who understand what you're going through and are supportive, but that doesn't really help. My school, in my opinion, only pretended to be really supportive. Despite having a support system, a feeling persists that people will think I’m playing the victim. I think that is really just a reflection of the social stigma around mental illness. You know, the stereotype of a Tumblr teenager, someone who's always talking about their anxiety and depression and 'wallowing in self pity'.

It is annoying that depersonalisation and derealisation are such long and awkward words to use in conversation because that adds to the difficulty of talking about it with people day-to-day.”

JOE, 19, LONDON

“I remember feeling very scared and confused during my first DP/DR experience. I kept explaining to my parents that I just felt wrong. Everything around me and in my head felt wrong. Many sufferers describe DP/DR as feeling like being in a dream or watching a movie of yourself. I had been out for a walk. It was late when I got home so I went to bed where I lay thinking depressed thoughts as I was trying to get to sleep. Then suddenly I started having a small panic attack. I felt my heart racing and my chest getting tight. I rolled over on my back and tried to control my breathing. Then, as if a switch was flicked in my head - DP/DR happened almost instantaneously.

The first thing I noticed was that I had lost all of my emotions. I had no sense of what they were, except dread. I looked in the mirror and at my reflection and it was like I didn’t recognise myself – like I knew who I was but I didn't feel like I knew who I was. I woke my parents up because I was so extremely distressed by what was going on. My mum tried to comfort me and I felt her hand on mine, but it's like all I could feel was the physical sensation of her trying to comfort me. I didn’t feel like I knew who she was. I thought I’d never feel my mother’s love ever again. I looked out the window at the back garden that I grew up with and didn’t feel like I recognised it. It was like none of my memories belonged to me.

Depersonalisation is a terrifying condition. Psychologists believe it is a survival tool the brain uses. It 'numbs' emotional responses, which can allow people to think rationally when they feel severe emotional trauma. For example, if somebody needed to escape from a burning building, depersonalisation/derealisation would kick in to allow that person to focus on escaping, rather than being overwhelmed by fear. After such an event, the dissociative state should lift. However, when DP/DR doesn’t lift it becomes a disorder and it’s horrible to live with.

“I get grossed out by my own brain. How can everything I sense and feel just be a result of this weird lump of fleshy gross matter in my skull? Nothing means anything anymore” – Joe

Because it’s drug-induced, from taking anxiety medication, I feel sometimes like I’m brain-damaged. I worry that I’m permanently messed up sometimes. My ambitions and hopes for the future also seem lost. Recently, I think about my senses and how bizarre they are. What sounds, smells and vision actually are and how they don’t mean anything. I get grossed out by my own brain. How can everything I sense and feel just be a result of this weird lump of fleshy gross matter in my skull? Nothing means anything anymore.

I attempt to distract myself from it by reading. I make music too. Producing (music) can be very good at distracting me because I can get really into it. I bought a self-help book on DP/DR and reading that, along with reading people’s success stories on getting through depersonalisation, has been the most help.

I would encourage any other sufferers to keep themselves busy – even if it's super difficult at first. Even if the world doesn't feel 'the same'. Whatever hobbies and activities you did before, just get back into them. After a while, things will improve. If you feel on the cusp of going crazy, just breathe and focus on your surroundings. Socialise with friends and try not to cut people off.”

AUSTIN, 25, SAN FRANCISCO

“I've had symptoms of DP/DR as early as 15. Of course, back then it was infrequent and inconsequential. More like a ‘huh?’ feeling, or a ‘life doesn't really feel real right now’ moment. It started to pick up at 17, in intensity and frequency. I started to wonder at some points whether it was just me or if this was a normal state of being for everyone. I thought perhaps it was just how adults minds perceived reality.

My symptoms peaked last year, after I graduated college. Now, I don't feel like I exist anymore. I am detached from my emotions and relationships. My long term memory has been impacted and my environment seems flat and sometimes blurry it’s hard to explain. With this condition you feel like the real you is a little person inside your head, watching the world through a TV screen. Social interactions are difficult because there is direct correlation between anxiety and DP/DR symptoms. Another side effect is that time seems to go by really fast.

Overall, it's definitely decreased my quality of life. I've become more depressed, less social, motivated, and confident in my abilities. I have a hard time maintaining friendships because the condition deprives me of emotion and I can't feel love and affection. I don't feel grounded, ever. The only advantage is that I can be emotionally composed in stressful situations. I'm a functional human being but I'm basically uncomfortable 24/7. I'm currently working with a therapist to help me figure out what's causing this in me.

“With this condition you feel like the real you is a little person inside your head, watching the world through a TV screen” – Austin

I have a hard time maintaining friendships and creating new relationships. I have struggled to maintain my four-year relationship because it's hard for me to feel love and affection. When friendships start to fade, I have to remind myself that deep down I know that I love these people, and that it's my mental illness that tricks me into thinking I don't care. Regardless, they are happy that I'm actively trying to get better.

As an artist, I have to try extra hard to be inspired. It's difficult when the things that used to inspire me no longer give me the same dopamine rush they used to. Escapism is a great distraction. Since reality is so uncomfortable for me, watching Netflix and surfing the web provide me with alternate realities I have more control over. Although my quality of life and productivity improved greatly when I ran out of episodes of Girls to watch.

Many who have been ‘cured’ said that all they had to do was simply not think about depersonalisation/derealisation and live life as if it's a non-issue. This has not worked for me. Others have reported success from various vitamins and/or medications. While I am a functioning adult, my mind is stuck in a ‘child’ state. I believe that the dissonance between my child mind and adult body/environment is what causes me to dissociate. For me, personally, I believe that my path to recovery lies in becoming one with myself.”


What Is Emotional Detachment?

When your partner begins to detach from you or has never really been close and connected, it is devastating. You wonder if you've done something wrong to push your partner away.

You might fear he or she has stopped loving you and wants to break up or divorce. You might even think your partner is having an affair or betraying you in some other way.

So what is emotional detachment?

Emotional Detachment can be a mental disorder where someone loses their emotional connection to the people and things around them. It is often triggered by a traumatic event.

An emotionally detached person may subconsciously muffle their emotions for self-protection, and this lack of emotion can show up in several ways.

A detached person will avoid situations or people that make them feel anxious or uncomfortable. This person may even physically separate himself when encountering an emotional situation.

Emotional detachment can also occur in an intimate relationship when one partner avoids emotional intimacy either intentionally or subconsciously in an attempt to maintain emotional control or foster separation.

A healthy intimate relationship requires an emotional investment from both partners. Both of you need to make the effort to strengthen your emotional bonds on a daily basis by . . .

  • Engaging in physical affection.
  • Having regular conversations.
  • Listening attentively to one another.
  • Sharing your hopes, dreams, and vulnerabilities.
  • Initiating sexual intimacy regularly.
  • Working through conflict constructively.
  • Enjoying fun and relaxing experiences together.
  • Having each other's back during difficult times.
  • Respecting each other's boundaries.
  • Working to meet each other's emotional needs.
  • Expressing your love verbally.
  • Offering each other acts of kindness.

If you are experiencing fewer and fewer of these positive behaviors from your partner, he or she might be emotionally detaching from you.

What causes emotional detachment?

There are any number of reasons why this could be happening. Certainly, an affair or the desire to end the relationship could be the reason for emotional disconnect.

But it's possible your partner is just emotionally unavailable and unable to connect with you on a deeper level.

You've been overlooking it for a long time, but it's finally dawning on you that the behavior will never change. You may never have the closeness you desire with this person.

It's also possible that your partner has pain from the past that is causing him or her to become “emotionally numb” in order to cope.

He or she may be dealing with trauma that causes anxiety or depression and has nothing left to offer you in the way of emotional intimacy and support.

Or maybe your partner is afraid of emotional intimacy, fearing he may lose himself if he opens up to you and reveals his inner world and deeper feelings.

Whatever the reason for the emotional detachment, you need to understand what's happening and recognize any emotional detachment issues so you can figure out your next steps.


Defining Closure Psychology

When a relationship ends, or when a loved one passes away, we often hear about the need for "closure." But what does closure really mean? Psychologists think of closure as the desire for an answer that leaves no room for uncertainty. When we say a person has a need for closure, we're saying they're seeking the answers and resolution that they need to move on.

How Closure Psychology Is Defined

People seeking closure are motivated by the benefits it can provide. For example, closure can give someone a feeling of control where there wasn't one before, and it can provide a stronger foundation on which one can take action and move forward.

Consider the following example: Sean breaks up with Amy via a text message. Amy thought everything was going well and is completely blindsided. Sean refuses to text her anything further, ignores her phone calls, and avoids seeing her whenever possible. Amy seeks out Sean because she wants to know why their relationship ended, and finally gets the closure that she seeks when she discovers that Sean is dating someone else. Amy now has her answer and feels she can move on.

If you're seeking closure, you may feel lost, but you are not alone. Many people have found success through self-help strategies or therapy. You can find closure, too!

According to experts, a person's motivation for closure comes from two sources: the urgency tendency, which is the need to find closure as soon as possible, and the permanence tendency, which is the need to hold on to closure permanently, or for as long as possible. It is because of these tendencies that a person may jump to conclusions that aren't necessarily correct. This, in turn, can create bias.

Biases are created when a person cherry-picks information that tends to support the answer that they desire most, rather than what might actually be true. The person then forms a judgment based on that information that answers their question &ndash even if, in actuality, it's nothing more than a coincidence. The person will feel a sense of closure and be able to move on, even if the conclusion is incorrect.

As can be expected, the intensity of a person's need for closure depends largely on their personality. People with intense needs for closure are often used to being in control and prefer life to go as planned. These people are distressed by the idea of uncertainty and may tend to be more closed-minded. Their sense of security and wellbeing often depends on structure and plans.

Conversely, people with low needs for closure tend to be more creative and open-minded and are more willing to "go with the flow." These individuals may have already made up their minds about a situation, but they are always willing to consider alternatives. They are also more likely to enjoy spontaneous activities and keep friends who are unpredictable.

The Need For Closure Scale (NFCS)

To determine where someone's priorities lie, there is a Need for Closure Scale, or NFCS, which is comprised of 42 items and has been used in many studies and translated into multiple languages. The NFCS evaluates people based on two factors: their decisiveness and their need for order.

To provide a more accurate representation of someone's personality, the scale was condensed back in 2011 down to 15 of the original items found on the NFCS. Those who score higher on the NFCS are considered to be more conservative, which can also correlate with political and social conservativism.

The Need To Avoid Closure

Some people also have a need to avoid closure. The need to avoid closure is born from a person's desire to avoid commitment or confrontation. In other words, someone avoiding closure doesn't want certain questions answered. They might be afraid of what they'll learn. However, there is also the non-specific need to avoid closure, which is the fear of receiving the answer to a question, regardless of whether the answer would have a positive or negative effect.

Why Closure Is Necessary For A Broken Relationship

After a breakup, only you can give yourself the closure that you need. But how do you find closure when you don't fully understand the reason for a relationship ending? It can be especially difficult to move on from someone else's decision. This is why closure is difficult to obtain after death as well.

To achieve closure after a relationship ends, you must be able to understand why the relationship ended and learn how to no longer feel any emotional attachment to, or pain and anger toward the other person. Only when the closure has been achieved can you form new and healthy relationships, both with yourself and with others.

We need to know the reason for relationship ending because we understand our lives as a story, and it's difficult to give a story a proper ending when it ends right in the middle &ndash and we weren't the ones to end it. When someone breaks up with us, be it a friendship or romantic relationship, he or she can tell their story. Since they know the reason for the breakup, they have a beginning, middle, and end, but we don't. We're thrown from what we may have thought to be a safe and happy place into unknown territory.

When we receive closure, we then have the missing piece. We can restructure our stories by correcting any misunderstandings and filling in the gaps. However, when the other person refuses to help provide closure, all that's left are questions: "How could s/he do this to me?", "What could I have done differently?", "Were there signs along the way that I missed that something was wrong?", "How can I trust myself to do the right thing in future relationships?"

How To Give Someone Closure

Perhaps you've been on the receiving end of a bad breakup, and you don't want to do that to someone else. You realize you're in a relationship that is not providing you with what you know you need, or alternatively, you know that you are not able to give the relationship what it needs, and you want to break up with the person and start anew. How do you end a relationship with someone while giving them the closure they need?

Breaking up with someone is not easy. It may seem like the "easy way out" to break up with them over a text message or the phone, but this is generally not a good thing to do. Not only is it a means of avoiding the necessary conflict and communication to healthily end things, but this is a surefire way to inhibit someone's ability to find closure. It may be hard to be honest about your reasons for breaking up with the person, but it is important to take responsibility for your actions and give the person clear reasons for ending your relationship.

Other Solutions

Try journaling. Taking a moment to write your feelings and plans offers clarity. Try documenting your thoughts and emotions into a journal before making a move.

Start meditating. Meditation is a great way to get in touch with your thoughts and emotions. When you are relaxed and thinking clearly, it will be much easier to contemplate the best way to give or get closure.

Brush up on your communication skills. When it comes to getting or giving closure, most of the battle is how you say it. Knowing what to say and how to say it will make a world of difference in the psychology of closure.

Seeking Help

By giving the other person closure, you may still feel guilty for ending the relationship, but at least there won't be any unanswered questions. If you're leaving because you feel communication has broken down to the point where all you do is fight, then tell them that. If you're leaving because you feel that you can no longer give the relationship what it needs (or conversely are not receiving what you need from it), they should hear that, too.

If you're leaving because you fell out of love with your partner, again, this may be a painful thing to have to say, but by admitting it, you are doing yourself a world of good, too. Maybe you didn't realize how much this was true until you put it into words, and now you can stop denying it and start the healing process yourself. Please note, however, that these tips are for those in largely healthy, non-abusive relationships. Please seek help if you are leaving someone because he or she is physically or emotionally abusive.

If you're suffering from a bad breakup or the loss of a loved one, and you feel you cannot move on without some closure, consider reaching out to a professional counselor at BetterHelp. Online therapy options like BetterHelp have been found to be just as effective as in-person therapy. In fact, all participants in a grief-online therapy efficacy study not only improved significantly during treatment, but improvement was stable and continued even three months after online therapy treatment ended.

Online therapy is an incredibly convenient option, accessible anytime and anywhere so long as you have an internet connection to get started. This may be of particular use if you&rsquore struggling with grief and closure &ndash sometimes in the midst of grieving, leaving the house can seem a monumental and wholly undesirable task, even if we want or know that we need help. Utilizing online therapy can help you get out of a slump and achieve a sense of resolution without the added stress of needing to leave the house or sit in an office. Additionally, online therapy tends to be more affordable since therapists don&rsquot need to increase prices to help account for the cost of renting out office or building space.

Read below for some reviews of BetterHelp counselors from people seeking help with achieving closure.

Counselor Reviews

"Chinyere has been amazing with being supportive of me when I need it most and I have no one really else in the world to listen. She has given me good coping tools and made me feel like over time I can get through the pain I&rsquom feeling for the loss of my fiancé. I would highly recommend her!&rdquo

&ldquoLauren Uyeji has consistently listened intently to my issues regarding my breakup and fear of being alone, and has always responded in a timely and insightful fashion. I really couldn't ask more from a counselor. I had a therapist in the past who said barely anything and I remember getting very little from my time with him over a whole year of counseling. Lauren knows how to ask the right questions and give answers that are wise and informative. I feel like I am talking to someone that cares and is seriously considering ways to interact with the things I say. None of the questions she asks feel generic or insincere - they always are directly related to the immediate topic at hand and guide my thinking in ways that I feel actually growth. I would highly recommend Lauren to anyone seeking help with dealing with intense emotions.&rdquo

Giving or getting closure can be difficult. When you focus your energy on doing it the best way you know how, you get the best results. A licensed professional can help get you there. Ending relationships just as healthily as you started them is important to your mental wellbeing. Take the first step today.


What is trauma? What to know

Psychological trauma is a response to an event that a person finds highly stressful. Examples include being in a war zone, a natural disaster, or an accident. Trauma can cause a wide range of physical and emotional symptoms.

Not everyone who experiences a stressful event will develop trauma. There are also various types of trauma. Some people will develop symptoms that resolve after a few weeks, while others will have more long-term effects.

With treatment, people can address the root cause of the trauma and find constructive ways to manage their symptoms.

In this article, we discuss the various types of trauma, trauma symptoms, and the available treatment options.

Share on Pinterest Addressing the root cause of trauma can be an effective way to manage both physical and emotional symptoms.

According to the American Psychological Association (APA), trauma is “an emotional response to a terrible event like an accident, rape, or natural disaster.”

However, a person may experience trauma as a response to any event they find physically or emotionally threatening or harmful.

A traumatized person can feel a range of emotions both immediately after the event and in the long term. They may feel overwhelmed, helpless, shocked, or have difficulty processing their experiences. Trauma can also cause physical symptoms.

Trauma can have long-term effects on the person’s well-being. If symptoms persist and do not decrease in severity, it can indicate that the trauma has developed into a mental health disorder called post-traumatic stress disorder (PTSD).

There are several types of trauma, including:

  • Acute trauma: This results from a single stressful or dangerous event.
  • Chronic trauma: This results from repeated and prolonged exposure to highly stressful events. Examples include cases of child abuse, bullying, or domestic violence.
  • Complex trauma: This results from exposure to multiple traumatic events.

Secondary trauma, or vicarious trauma, is another form of trauma. With this form of trauma, a person develops trauma symptoms from close contact with someone who has experienced a traumatic event.

Family members, mental health professionals, and others who care for those who have experienced a traumatic event are at risk of vicarious trauma. The symptoms often mirror those of PTSD.

The symptoms of trauma range from mild to severe. Many factors determine how a traumatic event affects a person, including :

  • their characteristics
  • the presence of other mental health conditions
  • previous exposure to traumatic events
  • the type and characteristics of the event or events
  • their background and approach to handling emotions

Emotional and psychological responses

A person who has experienced trauma may feel :

  • denial
  • anger
  • fear
  • sadness
  • shame
  • confusion
  • numbness
  • guilt
  • hopelessness
  • irritability
  • difficulty concentrating

They may have emotional outbursts, find it difficult to cope with how they feel, or withdraw from others. Flashbacks, where a person relives the traumatic event in their mind, are common, as are nightmares.

Physical responses

Along with an emotional reaction, trauma can cause physical symptoms, such as:

Sometimes, a person will also experience hyperarousal , or when someone feels as though they are in a constant state of alertness. This may make it difficult to sleep.

Individuals may also go on to develop other mental health issues, such as depression, anxiety, and substance abuse problems.

Some research estimates that 60–75% of people in North America experience a traumatic event at some point. The charity Mind in the United Kingdom lists the following as potential causes of trauma:

  • bullying
  • harassment
  • physical, psychological, or sexual abuse
  • sexual assault
  • traffic collisions
  • childbirth
  • life threatening illnesses
  • sudden loss of a loved one
  • being attacked
  • being kidnapped
  • acts of terrorism
  • natural disasters
  • war

Traumatic events can be isolated or repeated, ongoing events. A person can also experience trauma after witnessing something traumatic happening to someone else.

People have different reactions to traumatic events. For example, those who live through the same natural disaster can respond very differently despite experiencing the same event.

PTSD develops when the symptoms of trauma persist or get worse in the weeks and months after the stressful event. PTSD is distressing and interferes with a person’s daily life and relationships.

Symptoms include severe anxiety, flashbacks, and persistent memories of the event.

Another symptom of PTSD is avoidance behaviors. If a person tries to avoid thinking about the traumatic event, visiting the place where it occurred, or avoiding its triggers, it can be a sign of PTSD.

PTSD may last for years, although treatment can help people to manage their symptoms and improve their quality of life.

Risk factors for developing PTSD include:

  • previous trauma
  • physical pain or injury
  • having little support after the trauma
  • dealing with other stressors at the same time, such as financial difficulty
  • previous anxiety or depression

Most people who experience a traumatic event do not develop PTSD. The National Institute of Mental Health estimate that the lifetime prevalence of PTSD in the United States is 6.8%.


When to Call a Doctor About Your Pain

Some pain can be normal, especially if you've recently had an injury, illness, or surgery. Call your doctor if the pain is intense, it doesn't stop, or it keeps you from doing your regular activities every day.

Sources

British Columbia Medical Journal: "Diagnostic judgment: Chronic pain syndrome, pain disorder, and malingering."

Frontera, Walter R., et al. Essentials of Physical Medicine and Rehabilitation, 2014.

Medscape: "Chronic Pain Syndrome Treatment & Management."

National Center for Complementary and Integrative Health: "Chronic Pain: In Depth."


How to cope with depression after abortion

Emotional side effects are not uncommon after an abortion, or pregnancy termination, whether it was planned or not. In some cases, depression can occur. However, the link between pregnancy termination and depression remains unclear.

The decision to terminate a pregnancy is rarely an easy one, and it is not always the individual’s preferred choice. Whether they choose a termination freely or not, they can have mixed feelings after the procedure.

In the United States, around half of all pregnancies are unplanned. This is one reason for choosing a termination. However, the reasons for not wanting to continue a pregnancy are varied.

Reasons include, but are by no means limited to, social, financial, or relationship pressures and physical or mental health problems in the parent or unborn child.

Regardless of the reason, the emotional response to a termination can range from relief, calm, and happiness to sadness, grief, loss, and regret, depending on the individual’s situation.

If negative feelings are severe and persistent, they could be a sign of depression.

The issue of planned termination is a controversial one, and so is the question of mental health following a termination.

The important thing to remember is that each person’s experience and response will be different.

As researchers for the American Psychological Association (APA) said in 2009, “it is important that women’s varied experiences of abortion be recognized, validated, and understood.”

Share on Pinterest Terminating a pregnancy can lead to feelings of sadness and grief.

For many people, terminating a pregnancy can be a stressful life event.

It is not unusual to experience a range of psychological and emotional responses.

Some people may feel relief at having made the right choice for them and taken action to resolve a difficult situation, while others may experience a range of negative emotions.

Any pregnancy loss will lead to an interruption in the hormone cycle. The negative feelings that occur after a planned termination may be at least partly due to hormonal changes, which are similar to those that occur after an unplanned pregnancy loss.

According to the American Pregnancy Association, common negative feelings include:

  • guilt
  • anger
  • shame
  • remorse or regret
  • loss of self-esteem or self-confidence
  • feelings of isolation and loneliness
  • sleep problems and bad dreams
  • relationship problems
  • thoughts of suicide

In addition, some people may experience grief, stress, or a sense of loss and may feel less able to cope. If suicidal thoughts or self-harm occur, the person should seek urgent help.

The National Suicide Prevention Lifeline offers free and confidential support 24/7. The number to call is 1-800-273-8255.

Religious beliefs, relationship problems, and social stigma can make it harder to cope, especially if these mean that the individual has nobody to talk to about what has happened.

In most cases, as time passes, these negative feelings will subside.

However, if there are additional issues, such as a sense of isolation or previous history of mental health problems, there may be a higher chance of depression occurring.

Depression is a mental health condition and mood disorder.

People with depression may have these signs and symptoms:

  • feeling low or sad
  • having difficulty thinking, focusing, and making decisions
  • feeling irritable
  • lacking energy
  • sleeping too much or too little
  • loss of interest in sex
  • loss of interest in activities that they previously enjoyed

There may also be feelings of guilt and low self-esteem.

Depression can make it hard to work or carry out daily chores. Complications can include relationship breakdown and job loss. For some people, psychotic symptoms may develop.

Depression versus grief

The grief that follows the loss of a loved one can lead to sadness and other symptoms similar to those of depression.

Feelings of grief, sadness, loss, and regret can also occur after a termination or pregnancy loss.

If a person’s symptoms gradually improve with time, it is unlikely that they have depression.

However, symptoms that persist or worsen could indicate depression, in which case it is essential to seek medical help.

Anyone who experiences distress after a termination may find it helpful to seek the support of family, friends, or a community group.

This can help prevent feelings of grief and sadness from developing into depression.

If depression occurs, it is a treatable condition.

  • support, for example, that of a community group or health worker
  • counseling, including cognitive behavioral therapy (CBT)
  • medications, such as antidepressants

Lifestyle factors that may help include:

  • eating a healthful diet
  • taking regular exercise
  • reducing stress as far as possible
  • learning relaxation techniques, such as yoga or meditation

Reducing the risk

Before deciding on a termination, it is advisable to try the following:

  • speaking to people who you can trust
  • weighing up all your options
  • seeking medical help and asking a health worker as many questions as you can
  • trying to avoid isolation, as this can lead to depression
  • avoiding giving in to pressure to do something you do not want to do, whether this is the termination or continuation of the pregnancy

Terminating a pregnancy can also involve some physical risks, in the same way as any other medical or surgical procedure.

It is vital to seek treatment in a registered facility with qualified and experienced professionals to reduce the risk of harm.

The existence of a link between a planned termination and depression remains controversial.

A study published in 2015 suggested that people who have mental health problems before pregnancy may have a higher risk of experiencing negative emotions after a termination.

Research published in 2011 concluded that there was a “moderate to highly increased risk of mental health problems after abortion.” The researchers suggested that undergoing a termination increased the risk by 81 percent and attributed 10 percent of this risk to the termination itself.

Other scientists, reporting in 2008 on a 30-year study, estimated that abortion increased women’s risk of mental health disorders by between 1.5 and 5.5 percent.

In 2008, the American Psychological Association (APA) Task Force on Mental Health and Abortion found that certain conditions appeared to increase the risk of depression after a range of pregnancy outcomes, including a planned termination.

  • poverty
  • a history of violence or emotional problems
  • a history of drug or alcohol use
  • previous unwanted childbirth

The APA have also identified the following risk factors for depression following a termination:

  • perceived stigma and lack of social support
  • a history of mental health problems
  • personality traits, such as low self-esteem
  • features of the pregnancy, including whether the individual wanted it or not

The most important factor appears to be whether or not the mental health problems were already present before the pregnancy.

The American Pregnancy Association add the following as factors that might increase the risk of depression:

  • having a termination due to coercion or persuasion by others
  • moral or ethical conflict due to religious beliefs or personal views
  • having a termination in the later stages of pregnancy
  • lacking support from a partner or significant others
  • ending a pregnancy because of genetic or fetal abnormalities

Genetic factors and life events, such as the loss of a loved one, may also increase the risk of depression.

Other possible risk factors for depression include:

  • a reduced ability to cope with life’s pressures
  • being female
  • exposure to factors that cause stress daily, such as financial or relationship insecurity

However, the exact causes of depression, including pregnancy-related depression, are not known.

In 2009, researchers for the APA noted that the risk of poor mental health was the same whether people chose to terminate or continue their pregnancy.

A study published in The BMJ in 2016 concluded that the likelihood of post-traumatic stress symptoms (PTSS) up to 4 years after a termination was no higher for those who had the procedure than for those who were not allowed to have a termination due to advanced gestational age.

A Swedish study found that few women experienced post-traumatic stress disorder (PTSD) after a termination. They also noted that those who did had experienced trauma unrelated to the procedure.

In August 2018, researchers published findings of a study involving nearly 400,000 women in Denmark. The results suggested that, although women who have an abortion are more likely to use antidepressants, the risk factors leading to this are likely to stem from causes other than the termination.

The researchers conclude: “Policies based on the notion that abortion harms women’s mental health may be misinformed.”

People should also weigh the risk of depression after a termination against the possible health risks of continuing with a pregnancy.

One study , for example, included women who wanted to have a termination but were not able to. Some of these women experienced a range of potentially life-threatening health consequences, such as eclampsia and hemorrhage.

Researchers need to carry out more research to fully understand any links between pregnancy termination and depression.


Psychological pain

Psychological pain, mental pain, or emotional pain is an unpleasant feeling (a suffering) of a psychological, non-physical origin. A pioneer in the field of suicidology, Edwin S. Shneidman, described it as "how much you hurt as a human being. It is mental suffering mental torment." [1] There is no shortage in the many ways psychological pain is referred to, and using a different word usually reflects an emphasis on a particular aspect of mind life. Technical terms include algopsychalia and psychalgia, [2] but it may also be called mental pain, [3] [4] emotional pain, [5] psychic pain, [6] [7] social pain, [8] spiritual or soul pain, [9] or suffering. [10] [11] While these clearly are not equivalent terms, one systematic comparison of theories and models of psychological pain, psychic pain, emotional pain, and suffering concluded that each describe the same profoundly unpleasant feeling. [12] Psychological pain is believed to be an inescapable aspect of human existence. [13]

Psychological pain
Other namesSuffering, mental agony, mental pain, emotional pain, algopsychalia, psychic pain, social pain, spiritual pain, soul pain
Vincent van Gogh's 1890 painting
Sorrowing old man ('At Eternity's Gate'), where a man weeps due to the unpleasant feelings of psychological pain.
SpecialtyPsychiatry, psychology
MedicationAntidepressant medication, Analgesic medication

Other descriptions of psychological pain are "a wide range of subjective experiences characterized as an awareness of negative changes in the self and in its functions accompanied by negative feelings", [14] "a diffuse subjective experience . differentiated from physical pain which is often localized and associated with noxious physical stimuli", [15] and "a lasting, unsustainable, and unpleasant feeling resulting from negative appraisal of an inability or deficiency of the self." [12]


Contents

Stress-reduction strategies can be helpful to many stressed/anxious people. However, many anxious persons cannot concentrate enough to use such strategies effectively for acute relief. (Most stress-reduction techniques have their greatest utility as elements of a prevention plan that attempts to raise one's threshold to anxiety-provoking experiences.)

The five R's of stress and anxiety reduction Edit

Five core concepts are used to reduce anxiety or stress. [2]

  • Recognition of the causes and sources of the threat or distress education and consciousness raising.
  • Relationships identified for support, help, reassurance
  • Removal from (or of) the threat or stressor managing the stimulus.
  • Relaxation through techniques such as meditation, massage, breathing exercises, or imagery.
  • Re-engagement through managed re-exposure and desensitization.

Defense mechanisms are behavior patterns primarily concerned with protecting ego. Presumably the process is unconscious and the aim is to fool oneself. It is intra psychic processes serving to provide relief from emotional conflict and anxiety. Conscious efforts are frequently made for the same reasons, but true defense mechanisms are unconscious.

Some of the common defense mechanisms are: compensation, conversion, denial, displacement, dissociation, idealization, identification, incorporation, introjection, projection, rationalization, reaction formation, regression, sublimation, substitution, symbolization and undoing.

Summary Edit

The major function of these psychological defenses is to prevent the experiencing of painful emotions. There are several major problems with their use.

  • Many of these defenses create new problems that are as bad, or worse, than the emotional problems they mask. Some may be just plain destructive. Example: rejection literally destroys the relationships we care most about.
  • These defenses distort person's ability to perceive reality as it is. And this prevents them from dealing with their problems in a constructive way.
  • These defenses do not get rid of the painful feelings. In fact, by masking them so that person doesn't feel them, they effectively store them up within themselves. Emotions are discharged through expression, so by denying themselves the chance to feel them, they also deny themselves the ability to get rid of them.
  • These defenses do not just screen out painful emotions. They are, in fact, defenses against all emotion. So the more effective person's defenses become in protecting them from painful feelings, the less able they are to experience the joyful and happy feelings that make life worth living.
  • These defenses are not perfect. As more and more hurt is stored away, a tension is developed. Person becomes increasingly anxious, nervous, and irritable. They become emotionally unpredictable. And when defenses weaken, as they will from time to time, person may experience emotional explosions.
  • These defenses prevent person from knowing what is wrong, but they do not prevent us from feeling bad.

Acute stress disorder Edit

Acute stress disorder occurs in individuals without any other apparent psychiatric disorder, in response to exceptional physical or psychological stress. While severe, such reactions usually subside within hours or days. The stress may be an overwhelming traumatic experience (e.g. accident, battle, physical assault, rape) or unusually sudden change in social circumstances of the individual, such as multiple bereavement. Individual vulnerability and coping capacity play a role in the occurrence and severity of acute stress reactions, as evidenced by the fact that not all people exposed to exceptional stress develop symptoms. However, an acute stress disorder falls under the class of an anxiety disorder.

Symptoms Edit

Symptoms show considerable variation but usually include: An initial state of "DAZE" with some constriction of the field of consciousness and narrowing of attention, inability to comprehend stimuli, disorientation. Followed either by further withdrawal from the surrounding situation to the extent of a dissociative stupor or by agitating and over activity.

Autonomic signs of "panic anxiety" Edit

The signs are: tachycardia (increased heart rate), sweating, hyperventilation (increased breathing). The symptoms usually appear within minutes of the impact of the stressful stimulus and disappear within 2–3 days.

Post-traumatic stress disorder (PTSD) Edit

This arises after response to a stressful event or situation of an exceptionally threatening nature and likely to cause pervasive distress (great pain, anxiety, sorrow, acute physical or mental suffering, affliction, trouble) in almost anyone.

Causes Edit

The causes of PTSD are: natural or human disasters, war, serious accident, witness of violent death of others, violent attack, being the victim of sexual abuse, rape, torture, terrorism or hostage taking.

The predisposing factors are: personality traits and previous history of psychiatric illness.

Typical symptoms Edit

Flashbacks are the repeated reliving of the trauma in the form of intrusive memories or dreams, intense distress at exposure to events that symbolize or resemble an aspect of the traumatic event, including anniversaries of the trauma, avoidance of activities and situations reminiscent of the trauma, emotional blunting or "numbness", a sense of detachment from other people, autonomic hyperarousal with hypervigilance, an enhanced startle reaction and insomnia, marked anxiety and depression and, occasionally, suicidal ideation.

Treatment Edit

Psychiatric consultation: exploration of memories of the traumatic event, relief of associated symptoms and counseling.

Prognosis Edit

The course is fluctuating but recovery can be expected in the majority of cases. Few people may show chronic course over many years and a transition to an enduring personality change

Stress ulceration Edit

Stress ulceration is a single or multiple fundic mucosal ulcers that causes upper gastrointestinal bleeding, and develops during the severe physiologic stress of serious illness. It can also cause mucosal erosions and superficial hemorrhages in patients who are critically ill, or in those who are under extreme physiologic stress, causing blood loss that can require blood transfusion.

Ordinary peptic ulcers are found commonly in the “gastric antrum and the duodenum” whereas stress ulcers are found commonly in “fundic mucosa and can be located anywhere within the stomach and proximal duodenum”.


What is trauma? What to know

Psychological trauma is a response to an event that a person finds highly stressful. Examples include being in a war zone, a natural disaster, or an accident. Trauma can cause a wide range of physical and emotional symptoms.

Not everyone who experiences a stressful event will develop trauma. There are also various types of trauma. Some people will develop symptoms that resolve after a few weeks, while others will have more long-term effects.

With treatment, people can address the root cause of the trauma and find constructive ways to manage their symptoms.

In this article, we discuss the various types of trauma, trauma symptoms, and the available treatment options.

Share on Pinterest Addressing the root cause of trauma can be an effective way to manage both physical and emotional symptoms.

According to the American Psychological Association (APA), trauma is “an emotional response to a terrible event like an accident, rape, or natural disaster.”

However, a person may experience trauma as a response to any event they find physically or emotionally threatening or harmful.

A traumatized person can feel a range of emotions both immediately after the event and in the long term. They may feel overwhelmed, helpless, shocked, or have difficulty processing their experiences. Trauma can also cause physical symptoms.

Trauma can have long-term effects on the person’s well-being. If symptoms persist and do not decrease in severity, it can indicate that the trauma has developed into a mental health disorder called post-traumatic stress disorder (PTSD).

There are several types of trauma, including:

  • Acute trauma: This results from a single stressful or dangerous event.
  • Chronic trauma: This results from repeated and prolonged exposure to highly stressful events. Examples include cases of child abuse, bullying, or domestic violence.
  • Complex trauma: This results from exposure to multiple traumatic events.

Secondary trauma, or vicarious trauma, is another form of trauma. With this form of trauma, a person develops trauma symptoms from close contact with someone who has experienced a traumatic event.

Family members, mental health professionals, and others who care for those who have experienced a traumatic event are at risk of vicarious trauma. The symptoms often mirror those of PTSD.

The symptoms of trauma range from mild to severe. Many factors determine how a traumatic event affects a person, including :

  • their characteristics
  • the presence of other mental health conditions
  • previous exposure to traumatic events
  • the type and characteristics of the event or events
  • their background and approach to handling emotions

Emotional and psychological responses

A person who has experienced trauma may feel :

  • denial
  • anger
  • fear
  • sadness
  • shame
  • confusion
  • numbness
  • guilt
  • hopelessness
  • irritability
  • difficulty concentrating

They may have emotional outbursts, find it difficult to cope with how they feel, or withdraw from others. Flashbacks, where a person relives the traumatic event in their mind, are common, as are nightmares.

Physical responses

Along with an emotional reaction, trauma can cause physical symptoms, such as:

Sometimes, a person will also experience hyperarousal , or when someone feels as though they are in a constant state of alertness. This may make it difficult to sleep.

Individuals may also go on to develop other mental health issues, such as depression, anxiety, and substance abuse problems.

Some research estimates that 60–75% of people in North America experience a traumatic event at some point. The charity Mind in the United Kingdom lists the following as potential causes of trauma:

  • bullying
  • harassment
  • physical, psychological, or sexual abuse
  • sexual assault
  • traffic collisions
  • childbirth
  • life threatening illnesses
  • sudden loss of a loved one
  • being attacked
  • being kidnapped
  • acts of terrorism
  • natural disasters
  • war

Traumatic events can be isolated or repeated, ongoing events. A person can also experience trauma after witnessing something traumatic happening to someone else.

People have different reactions to traumatic events. For example, those who live through the same natural disaster can respond very differently despite experiencing the same event.

PTSD develops when the symptoms of trauma persist or get worse in the weeks and months after the stressful event. PTSD is distressing and interferes with a person’s daily life and relationships.

Symptoms include severe anxiety, flashbacks, and persistent memories of the event.

Another symptom of PTSD is avoidance behaviors. If a person tries to avoid thinking about the traumatic event, visiting the place where it occurred, or avoiding its triggers, it can be a sign of PTSD.

PTSD may last for years, although treatment can help people to manage their symptoms and improve their quality of life.

Risk factors for developing PTSD include:

  • previous trauma
  • physical pain or injury
  • having little support after the trauma
  • dealing with other stressors at the same time, such as financial difficulty
  • previous anxiety or depression

Most people who experience a traumatic event do not develop PTSD. The National Institute of Mental Health estimate that the lifetime prevalence of PTSD in the United States is 6.8%.


What life is like when you don’t feel real

This week (May 16-22) is Mental Health Awareness Week, with “relationships” as the theme. We’ll be running features all week about the mental health of those close to you, the mental health of the artists that inspire you and the different ways that communities and individuals deal with the issue. Slowly but surely, progress is being made in the ways in which we discuss a problem that affects each and every one of us.

Imagine. One day you wake up and when you take a look in the mirror you struggle to recognise your reflection as your own. Even worse, after that you constantly feel like an onlooker watching your life unfold in front of you like a dull scene in a bad movie, having completely lost the ability to connect with those around you because you’re too preoccupied with trying to work out why you feel so strange.

These are the terrifying symptoms of a dissociative disorder often referred to as DP/DR (depersonalisation-derealisation disorder). Trauma or bad drug experiences can trigger it, and it can last anything from a few hours to a number of years. This bizarre and barely mentioned condition leads people to feel detached from their bodies, emotions, surroundings – even their families. From the moment the symptoms set in, life becomes a constant battle to come to terms with an overwhelming sense of unreality where the concept of ‘self’ is almost impossible to grasp.

So, as part of Mental Health Awareness week, we spoke to a few people to find out what it is really like to be permanently detached from reality.

“It’s really hard to focus on things that require critical thought or memory. I've tried mindfullness but that actually made it worse” – Sophie

SOPHIE, 19, LONDON

“Looking at yourself in the mirror or hearing your voice come out of your mouth is really strange with DP/DR as you don't feel like any of it is real. Then that spirals into you feeling like nothing is, and like you're just a floating overly emotional string of thoughts, all alone in an odd reality. Usually it goes away after a few hours or a few days, but I've had it for two and a half years now.

DP/DR often accompanies anxiety and depression – usually amplifying them. Actually, the symptoms are really common. Most people experience it at some point, usually when exhausted after a long day or stressed. Smoking pot, or other psychedelic drugs, can also induce it. It's just complete mental exhaustion, like brain fog. Right now my head feels very cloudy, my eyes feel droopy and I just want to shut them and lie down. My mind keeps wandering and it’s really hard to focus on things that require critical thought or memory. I've tried mindfulness but that actually made it worse.

Mental illness is an incredibly lonely experience. You can have great friends who understand what you're going through and are supportive, but that doesn't really help. My school, in my opinion, only pretended to be really supportive. Despite having a support system, a feeling persists that people will think I’m playing the victim. I think that is really just a reflection of the social stigma around mental illness. You know, the stereotype of a Tumblr teenager, someone who's always talking about their anxiety and depression and 'wallowing in self pity'.

It is annoying that depersonalisation and derealisation are such long and awkward words to use in conversation because that adds to the difficulty of talking about it with people day-to-day.”

JOE, 19, LONDON

“I remember feeling very scared and confused during my first DP/DR experience. I kept explaining to my parents that I just felt wrong. Everything around me and in my head felt wrong. Many sufferers describe DP/DR as feeling like being in a dream or watching a movie of yourself. I had been out for a walk. It was late when I got home so I went to bed where I lay thinking depressed thoughts as I was trying to get to sleep. Then suddenly I started having a small panic attack. I felt my heart racing and my chest getting tight. I rolled over on my back and tried to control my breathing. Then, as if a switch was flicked in my head - DP/DR happened almost instantaneously.

The first thing I noticed was that I had lost all of my emotions. I had no sense of what they were, except dread. I looked in the mirror and at my reflection and it was like I didn’t recognise myself – like I knew who I was but I didn't feel like I knew who I was. I woke my parents up because I was so extremely distressed by what was going on. My mum tried to comfort me and I felt her hand on mine, but it's like all I could feel was the physical sensation of her trying to comfort me. I didn’t feel like I knew who she was. I thought I’d never feel my mother’s love ever again. I looked out the window at the back garden that I grew up with and didn’t feel like I recognised it. It was like none of my memories belonged to me.

Depersonalisation is a terrifying condition. Psychologists believe it is a survival tool the brain uses. It 'numbs' emotional responses, which can allow people to think rationally when they feel severe emotional trauma. For example, if somebody needed to escape from a burning building, depersonalisation/derealisation would kick in to allow that person to focus on escaping, rather than being overwhelmed by fear. After such an event, the dissociative state should lift. However, when DP/DR doesn’t lift it becomes a disorder and it’s horrible to live with.

“I get grossed out by my own brain. How can everything I sense and feel just be a result of this weird lump of fleshy gross matter in my skull? Nothing means anything anymore” – Joe

Because it’s drug-induced, from taking anxiety medication, I feel sometimes like I’m brain-damaged. I worry that I’m permanently messed up sometimes. My ambitions and hopes for the future also seem lost. Recently, I think about my senses and how bizarre they are. What sounds, smells and vision actually are and how they don’t mean anything. I get grossed out by my own brain. How can everything I sense and feel just be a result of this weird lump of fleshy gross matter in my skull? Nothing means anything anymore.

I attempt to distract myself from it by reading. I make music too. Producing (music) can be very good at distracting me because I can get really into it. I bought a self-help book on DP/DR and reading that, along with reading people’s success stories on getting through depersonalisation, has been the most help.

I would encourage any other sufferers to keep themselves busy – even if it's super difficult at first. Even if the world doesn't feel 'the same'. Whatever hobbies and activities you did before, just get back into them. After a while, things will improve. If you feel on the cusp of going crazy, just breathe and focus on your surroundings. Socialise with friends and try not to cut people off.”

AUSTIN, 25, SAN FRANCISCO

“I've had symptoms of DP/DR as early as 15. Of course, back then it was infrequent and inconsequential. More like a ‘huh?’ feeling, or a ‘life doesn't really feel real right now’ moment. It started to pick up at 17, in intensity and frequency. I started to wonder at some points whether it was just me or if this was a normal state of being for everyone. I thought perhaps it was just how adults minds perceived reality.

My symptoms peaked last year, after I graduated college. Now, I don't feel like I exist anymore. I am detached from my emotions and relationships. My long term memory has been impacted and my environment seems flat and sometimes blurry it’s hard to explain. With this condition you feel like the real you is a little person inside your head, watching the world through a TV screen. Social interactions are difficult because there is direct correlation between anxiety and DP/DR symptoms. Another side effect is that time seems to go by really fast.

Overall, it's definitely decreased my quality of life. I've become more depressed, less social, motivated, and confident in my abilities. I have a hard time maintaining friendships because the condition deprives me of emotion and I can't feel love and affection. I don't feel grounded, ever. The only advantage is that I can be emotionally composed in stressful situations. I'm a functional human being but I'm basically uncomfortable 24/7. I'm currently working with a therapist to help me figure out what's causing this in me.

“With this condition you feel like the real you is a little person inside your head, watching the world through a TV screen” – Austin

I have a hard time maintaining friendships and creating new relationships. I have struggled to maintain my four-year relationship because it's hard for me to feel love and affection. When friendships start to fade, I have to remind myself that deep down I know that I love these people, and that it's my mental illness that tricks me into thinking I don't care. Regardless, they are happy that I'm actively trying to get better.

As an artist, I have to try extra hard to be inspired. It's difficult when the things that used to inspire me no longer give me the same dopamine rush they used to. Escapism is a great distraction. Since reality is so uncomfortable for me, watching Netflix and surfing the web provide me with alternate realities I have more control over. Although my quality of life and productivity improved greatly when I ran out of episodes of Girls to watch.

Many who have been ‘cured’ said that all they had to do was simply not think about depersonalisation/derealisation and live life as if it's a non-issue. This has not worked for me. Others have reported success from various vitamins and/or medications. While I am a functioning adult, my mind is stuck in a ‘child’ state. I believe that the dissonance between my child mind and adult body/environment is what causes me to dissociate. For me, personally, I believe that my path to recovery lies in becoming one with myself.”


What Is Emotional Detachment?

When your partner begins to detach from you or has never really been close and connected, it is devastating. You wonder if you've done something wrong to push your partner away.

You might fear he or she has stopped loving you and wants to break up or divorce. You might even think your partner is having an affair or betraying you in some other way.

So what is emotional detachment?

Emotional Detachment can be a mental disorder where someone loses their emotional connection to the people and things around them. It is often triggered by a traumatic event.

An emotionally detached person may subconsciously muffle their emotions for self-protection, and this lack of emotion can show up in several ways.

A detached person will avoid situations or people that make them feel anxious or uncomfortable. This person may even physically separate himself when encountering an emotional situation.

Emotional detachment can also occur in an intimate relationship when one partner avoids emotional intimacy either intentionally or subconsciously in an attempt to maintain emotional control or foster separation.

A healthy intimate relationship requires an emotional investment from both partners. Both of you need to make the effort to strengthen your emotional bonds on a daily basis by . . .

  • Engaging in physical affection.
  • Having regular conversations.
  • Listening attentively to one another.
  • Sharing your hopes, dreams, and vulnerabilities.
  • Initiating sexual intimacy regularly.
  • Working through conflict constructively.
  • Enjoying fun and relaxing experiences together.
  • Having each other's back during difficult times.
  • Respecting each other's boundaries.
  • Working to meet each other's emotional needs.
  • Expressing your love verbally.
  • Offering each other acts of kindness.

If you are experiencing fewer and fewer of these positive behaviors from your partner, he or she might be emotionally detaching from you.

What causes emotional detachment?

There are any number of reasons why this could be happening. Certainly, an affair or the desire to end the relationship could be the reason for emotional disconnect.

But it's possible your partner is just emotionally unavailable and unable to connect with you on a deeper level.

You've been overlooking it for a long time, but it's finally dawning on you that the behavior will never change. You may never have the closeness you desire with this person.

It's also possible that your partner has pain from the past that is causing him or her to become “emotionally numb” in order to cope.

He or she may be dealing with trauma that causes anxiety or depression and has nothing left to offer you in the way of emotional intimacy and support.

Or maybe your partner is afraid of emotional intimacy, fearing he may lose himself if he opens up to you and reveals his inner world and deeper feelings.

Whatever the reason for the emotional detachment, you need to understand what's happening and recognize any emotional detachment issues so you can figure out your next steps.


Disclaimer:

As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

Comments

As a patient advocate, healthcare writer, and peer to peer website moderator, I frequently communicate with people like Laura Kiesel. She is one of (literally) millions of women who are regularly written off as head cases by incompetent or poorly trained physicians who have little familiarity with the assessment of pain. As a result of this pattern, women reporting to emergency rooms with chest pain have a substantially higher likelihood of DYING of heart attacks than do men. Likewise a substantial majority of people diagnosed with chronic pain conditions are women whose treatment has been delayed long enough to exacerbate and complicate their underlying conditions.

Early this week, I gave a 3-minute presentation before a panel in an FDA workshop on “educating physicians in safe prescription practices for opioid medications”. At least three of us spoke on behalf of chronic pain patients during the public commentary periods of this workshop.

My personal input was that the Workshop organizers should feel a deep ethical obligation to adjourn the event without offering recommendations on “safe prescription practices”. This is true in large part because the March 2016 CDC guidelines on prescription of opioids do not comprise a safe or reliable standard of care. In fact, there is compelling evidence that the CDC guidelines were influenced by financial and professional conflicts of interest among the core group of consultants which wrote them. Moreover, this group cherry-picked studies from the medical literature in a deliberate and biased attempt to prejudice their findings against opioids and to magnify the percieved risks of this class of medications. The CDC guidelines are resulting in wide-spread discharges of patients who have been stable and well managed for years on opioid medications — and who are fundamentally not at risk for addiction behaviors. This is a fundamental malpractice and an abuse of human rights in denial of care.

When I wrote about the state of American healthcare at the American Council on Science and Health, I titled the article “A Report Card on the American Healthcare System — F”. Particularly for chronic pain patients, that assessment is highly apropos.

I have adhesive arachnoiditis, level 4 endometriosis, and EDS. I have been on the Whole30 since January of this year. I walk 1-1.5 miles everyday, I do private Iyengar Yoga lessons and practice after my walks everyday. I’m taking every supplement known to help nerves, pain, and inflammation. I have medicine to help me get at least 4-8 hours of sleep. I have a large support system including a therapist. I meditate every day to work on my chronic pain. I have a TENS unit. I have lidocaine patches. I take epsom salt ice baths every night. I fasciablast and dry brush to move my lymph and release my bound fascia. I work damn hard and I am STILL IN PAIN. I still need something to take the edge off. Gabapentin only worked for 1 month, 1 MONTH! Lyrica made me plan out my suicide, thank goodness my sis in law was getting married because that saved my life. Cymbalta gave me a three day migraine where I couldn’t leave the bed. SO WHAT OPTIONS DO I HAVE LEFT. As it is now the only thing I’ve been given to deal with the pain that I’ve had for 2 years is Tylenol 3. Nerve pain is different than normal pain and until they come out with options that are ACTUALLY DESIGNED TO TREAT NERVE PAIN, the chronic pain community needs access to opioids. If we don’t have them you will see the death toll go up, it’s not an opinion, it’s a fact.

For 49 years whether it was muscle spasms, displaced vertebrae, tingling in my arms and legs, blackout causing headaches I was told it was all in my head or to exercise more. This being said to a woman who played basketball and volleyball 6days a week. Ran 2miles a day 7miles a day. I believed the doctors that there was nothing wrong with me.
In reality there was a lot wrong with me, chronic meningitis, degenerative disc disease, cauda equina, advanced adhesive arachnoiditis with ossification, scoliosis, bulging discs, arthritis, undiagnosed fevers and rashes. These conditions could have been minimised had I been diagnosed and treated early on in my life. At age 48 I could no longer hold a job. My life is constant unrelenting pain. Coursing shafts of electricity through my arms and legs strong enough to kill every battery powered watch I’ve owned.
And at age 58 I was blessed yet again by doctors who scared of the government powers that be discontinued all medications to control my pain. Irreguard that every other non opiate I was given produced violent allergic reactions whether by rash, fever or incoherent speech.
I have lazy egotistical doctors to thank for many of my problems, and scared cover-my-ass doctors who put my life in jeopardy by removing my access to the high doses of fentanyl in one day. No medication to help with the withdrawls. Excuses about cdc rules and state laws. The truth was and still is my condition is pallative, there is no hope for full recovery, the only thing a doctor could do for me is help manage the pain. By doing this my life was ok, I was able to feel like I contributed. Now I sit and hurt, the pain is too strong to concentrate on anything else. It is a force stronger than me that gets me out of my bed daily. But that force is losing its hold, I think more about when I die than what life I have to look forward to.

So thank you Doctors in my past for not being good or even decent at your jobs. For not living up to your oath of do no harm. Thank you for ruining my future and my past. And yes now I really should exercise.

I have degenerative disc disease, severe arthritis and now I have Arachnoiditis (a very rare disease that for me affects my low back and nerve pain down my left leg). I live in Alabama where there are not enough doctors that know how to treat chronic pain and more importantly don’t know how to treat Arachnoiditis. I am now at a clinic where a pain management doctor who has a practice in D.C., comes down once a month because of the lack of PM doctors. I can tell you that if you saw me out in public (which only be one dr. appointment days) that without a shadow of a doubt you would know chronic pain is NOT invisible. I stay bed ridden most of the day because the CDC has their head in another world, they are making it impossible for doctors to treat chronic pain patients with the right medication so we don’t have to suffer. If the CDC doesn’t allow PM doctors to prescribe the medication necessary NOW, the suicide rate is going to skyrocket! There are patients whose medication has been cut in half. I’ve been on just about everything out there that the doctors are able to prescribe and I’m still in pain. I’m scared to death that when I go back to the doctor next week, they are going to tell me their hands are tied because of the CDC guidelines and they won’t be able to give me enough medication to help my pain.

Thank you so much for writing this article. It’s a voice for so many people like us. That have no voice. I have a long story that would take pages to tell. In a nutshell, I was a very active outdoors person, trained and rode horses avidly among other outdoor activities, was an extremely ambitious worker, and was completely independent. I was in a series of three car accidents over the space of seven years, beginning when I was 31. The first 2 we’re very serious, the first I was ran over by a car. The second I was T-boned at highway speed. I got relatively lucky because I “walked” away from both. I did not receive very thorough medical care, so I do not know if I actually broke any bones or not, but it was said that other than a rib or 2, I did not. I did end up with quite a few “mild” bulging disks in my neck and lower back. Because I am extremely stubborn and extremely tough, my injuries did not keep me down in the beginning years like they would’ve other people. I also was religious about doing physical therapy, and did not believe in opioid therapy. Through a combination of exercise, physical therapy, other alternative therapies, good diet, exercise and some other medically advised procedures, I was able to stay working and almost as active as I used to be for several years. By age 37, adter some events, I realized that my injuries were going to catch up to me and I wouldn’t be able to use my body to make a living much longer and that I also wanted to achieve my longtime dream of becoming an engineer or scientist. Or both. So I packed myself up and moved several hours away to a college town and began college. There, I was in a third accident that was relatively mild. I received treatment for that, but my health rapidly deteriorated. For the next 5 years I was in excruciating pain (still am). My feet were on fire all of the time, I had pain in my legs and back, pain in my neck and down my arms and numbing in my fingers. I lost count of how many doctors I went to in the end, but it was well over 20, maybe as many as 40. Before this I had had the pain of bulging disc’s, and other pain. The pain that I experience now was/is severe and debilitating. Instantly upon standing or sitting, anything that was not laying down, my feet start to burn, and it is horrible horrible pain. Not being able to stand or sit without pain interferes with basically every single activity that I do. I tried to maintain my life for a while, but went from a 4.0 GPA to flunking two classes. I’ve never flunked a class in my entire life, in fact I rarely had ever gotten anything below a B, and certainly never anything lower than a C. I went to doctor after doctor trying to find help amd answers. I did not want to let go of my life. But the pain I was in was – and did – destroy my entire life. In a nutshell I was told multiple times things like I was just not being tough enough and I needed to learn to cope “with the kind of pain that happens as you age”, I was told that I “must have had psychological trauma” when I was young and it was now manifesting as a physical pain as an adult, I was told I was faking, I was told I was lying, I was told that since nothing showed up on my blood tests or on my MRIs that therefore nothing was wrong with me and that I “just” needed counseling. Somewhere along the way a doctor, or two maybe,
diagnosed me with fibromyalgia, but then other doctors told me that that was just a “fake” diagnosis and wasn’t a real disease therefore I wasn’t actually sick. This is all while I’m so disabled that putting on my own clothes, getting my own meals, driving myself places and getting groceries were so nearly impossible that I only did it because I am extremely tough. And stubborn. I know other people that could not have done what I did. And because I was so tough and got through it, that actually my doctors disbelieve me even further. I was told that if I could get myself to the grocery store then I wasn’t disabled. It didnt matter to them that I would have to rest in my car for 20 or 30 minutes before going in AND after coming out before I could drive home. I didn’t matter that I couldn’t walk one direction across the entire store therefore was not able to make a whole grocery run in one trip. It did not matter that often I would barely make it across the store to get my groceries, and then the line would be too long (more than 1 person ahead of me) and I would have to abandon my cart and go home. Never mind the fact that if I did not drive myself I literally had no other way to eat and would have starved to death. I’m the kind of person that could break a leg in the mountains and would crawl 10 miles to help – but was told multiple times that since I did not have hospice care, I was not disabled. I was told I needed to pray more, I need to find God, that I needed to find support groups to get over my pain. I was told that I needed to eliminate all negative thoughts, and only be positive and that would fix my pain. I was told that I needed to eat certain foods and That would fix my pain. When I asked for help for disability I was told that I wasn’t disabled enough, that I was too young to be disabled, I was too young to be sick, was told that I was a beautiful woman and therefore was not disabled, I was told that I was overweight and that’s what was causing all my problems even when I wasn’t overweight when they began. I was told that I had beautiful skin therefore was not disabled. (The “beautiful skin” I had was make up). I have heard all kinds of ridiculous things. By the time I finally got the diagnosis for what was wrong with me, I was so beaten down mentally that I was terrified to even talk to this doctor because I was so sure he was going to also send me away telling me that once again there’s nothing wrong with me. I truly wanted to die. I could not handle the pain and stress and doctors not helping me. in the end my adrenal gland’s stopped working from the pain, other organs started showing signs of stress, and I began developing mental problems and cognitive processing problems from the stress and the pain.

I did somehow find enough courage to follow through with seeing this last and final doctor. He diagnosed with a really horrible disease called adhesive arachnoiditis. It is severe inflammation inside the spinal cord that leads to swelling of the nerves and then them sticking together and scarring to themselves and to the sides of the spinal cord sac. It matched every one of my symptoms. It is extremely painful. It is incurable. The symptoms are barely treatable, and pallative care is the only option. When I went back to some of my doctors to say that I finally have a diagnosis and that I needed their help with local treatment, I was met with disbelief, and told that the diagnosis was incorrect. And then reiterated to me that there is nothing wrong with me. I was actually told just the other day that I could not possibly be in as much pain as I thought I was in and I must just be imagining the level of pain I was in. It is astounding to me at the lack of compassion and understanding that the medical community has towards people with chronic pain. I have come to believe that everyone compares their own pain to what other people say and are unable to imagine that there is more severe pain than what they themselves experience. I would think someone that was intelligent enough to make it through medical school, should also be intelligent enough to imagine that a patient coming in and telling you their experience is true. And that it just might be worse than what the doctor themselves experienced. And yet doctors are encouraged now to only believe established text book diagnosises. As if everything about the medical body has already been discovered. And anything new, different or unexplainable “simply” does not exist.

Then there is a further component to the chronic pain patient now where there is now the stigma that if you’re in chronic pain you’re automatically a drug addict or “pill seeking”.
So now just the plain act of stating that I am in pain, and that I need help with it, makes the doctors compartmentalize me, putting me into an unfavorable category, as though I do not deserve medical treatment since MY ailment happens to be pain. And yet I have never used my medication to get high, I have never sold it, I have never taken more than the amount prescribed, I am None of the things I hear on the news. Yet I am labeled a possible criminal because I ended up with a disease I neither asked for nor wanted.

Because being in chronic pain makes you so desperate to not be in chronic pain, many of us have tried many many many things. I for one have tried just about everything I’ve ever heard of. Including special diets, special foods, meditating, positive thoughts, counseling, essential oil’s, herbs, vitamins, supplements, acupuncture, prolotherapy, physical therapy, chiropractic, etc – you name it I’ve probably tried it.

Pain is PAIN. And the only thing that helps pain is to either cure the cause or to give you medicine that numbs it. Period. not every cause can be cured. So not all pain can be cured. Sometimes the only option is to numb it. And sometimes the treatment for the cause isnt an already known treatment.

Chronic, severe, intractable pain is a real medical problem. And it’s turning into an epidemic. It is crucial that doctors be trained in it, but instead they are being trained in things like the pain is all in the mind, that you can overcome it with things like positive thinking. True pain cannot be overcome by positive thinking. Positive thinking can keep you from killing yourself over it, but it certainly cannot make the pain LESS. If that were so then we would be able to cure ourselves of cancer, broken legs, diabetes and heart disease soley with positive thinking, without any sort of medical intervention.

Thank you for your article. Thank you for having the courage to say publically your on chronic pain treatment via opiods.
Im sorry for what you’ve experienced, but is very true. There is a huge hole in the medical community lacking information and compassion around how to treat people in chronic pain


Defining Closure Psychology

When a relationship ends, or when a loved one passes away, we often hear about the need for "closure." But what does closure really mean? Psychologists think of closure as the desire for an answer that leaves no room for uncertainty. When we say a person has a need for closure, we're saying they're seeking the answers and resolution that they need to move on.

How Closure Psychology Is Defined

People seeking closure are motivated by the benefits it can provide. For example, closure can give someone a feeling of control where there wasn't one before, and it can provide a stronger foundation on which one can take action and move forward.

Consider the following example: Sean breaks up with Amy via a text message. Amy thought everything was going well and is completely blindsided. Sean refuses to text her anything further, ignores her phone calls, and avoids seeing her whenever possible. Amy seeks out Sean because she wants to know why their relationship ended, and finally gets the closure that she seeks when she discovers that Sean is dating someone else. Amy now has her answer and feels she can move on.

If you're seeking closure, you may feel lost, but you are not alone. Many people have found success through self-help strategies or therapy. You can find closure, too!

According to experts, a person's motivation for closure comes from two sources: the urgency tendency, which is the need to find closure as soon as possible, and the permanence tendency, which is the need to hold on to closure permanently, or for as long as possible. It is because of these tendencies that a person may jump to conclusions that aren't necessarily correct. This, in turn, can create bias.

Biases are created when a person cherry-picks information that tends to support the answer that they desire most, rather than what might actually be true. The person then forms a judgment based on that information that answers their question &ndash even if, in actuality, it's nothing more than a coincidence. The person will feel a sense of closure and be able to move on, even if the conclusion is incorrect.

As can be expected, the intensity of a person's need for closure depends largely on their personality. People with intense needs for closure are often used to being in control and prefer life to go as planned. These people are distressed by the idea of uncertainty and may tend to be more closed-minded. Their sense of security and wellbeing often depends on structure and plans.

Conversely, people with low needs for closure tend to be more creative and open-minded and are more willing to "go with the flow." These individuals may have already made up their minds about a situation, but they are always willing to consider alternatives. They are also more likely to enjoy spontaneous activities and keep friends who are unpredictable.

The Need For Closure Scale (NFCS)

To determine where someone's priorities lie, there is a Need for Closure Scale, or NFCS, which is comprised of 42 items and has been used in many studies and translated into multiple languages. The NFCS evaluates people based on two factors: their decisiveness and their need for order.

To provide a more accurate representation of someone's personality, the scale was condensed back in 2011 down to 15 of the original items found on the NFCS. Those who score higher on the NFCS are considered to be more conservative, which can also correlate with political and social conservativism.

The Need To Avoid Closure

Some people also have a need to avoid closure. The need to avoid closure is born from a person's desire to avoid commitment or confrontation. In other words, someone avoiding closure doesn't want certain questions answered. They might be afraid of what they'll learn. However, there is also the non-specific need to avoid closure, which is the fear of receiving the answer to a question, regardless of whether the answer would have a positive or negative effect.

Why Closure Is Necessary For A Broken Relationship

After a breakup, only you can give yourself the closure that you need. But how do you find closure when you don't fully understand the reason for a relationship ending? It can be especially difficult to move on from someone else's decision. This is why closure is difficult to obtain after death as well.

To achieve closure after a relationship ends, you must be able to understand why the relationship ended and learn how to no longer feel any emotional attachment to, or pain and anger toward the other person. Only when the closure has been achieved can you form new and healthy relationships, both with yourself and with others.

We need to know the reason for relationship ending because we understand our lives as a story, and it's difficult to give a story a proper ending when it ends right in the middle &ndash and we weren't the ones to end it. When someone breaks up with us, be it a friendship or romantic relationship, he or she can tell their story. Since they know the reason for the breakup, they have a beginning, middle, and end, but we don't. We're thrown from what we may have thought to be a safe and happy place into unknown territory.

When we receive closure, we then have the missing piece. We can restructure our stories by correcting any misunderstandings and filling in the gaps. However, when the other person refuses to help provide closure, all that's left are questions: "How could s/he do this to me?", "What could I have done differently?", "Were there signs along the way that I missed that something was wrong?", "How can I trust myself to do the right thing in future relationships?"

How To Give Someone Closure

Perhaps you've been on the receiving end of a bad breakup, and you don't want to do that to someone else. You realize you're in a relationship that is not providing you with what you know you need, or alternatively, you know that you are not able to give the relationship what it needs, and you want to break up with the person and start anew. How do you end a relationship with someone while giving them the closure they need?

Breaking up with someone is not easy. It may seem like the "easy way out" to break up with them over a text message or the phone, but this is generally not a good thing to do. Not only is it a means of avoiding the necessary conflict and communication to healthily end things, but this is a surefire way to inhibit someone's ability to find closure. It may be hard to be honest about your reasons for breaking up with the person, but it is important to take responsibility for your actions and give the person clear reasons for ending your relationship.

Other Solutions

Try journaling. Taking a moment to write your feelings and plans offers clarity. Try documenting your thoughts and emotions into a journal before making a move.

Start meditating. Meditation is a great way to get in touch with your thoughts and emotions. When you are relaxed and thinking clearly, it will be much easier to contemplate the best way to give or get closure.

Brush up on your communication skills. When it comes to getting or giving closure, most of the battle is how you say it. Knowing what to say and how to say it will make a world of difference in the psychology of closure.

Seeking Help

By giving the other person closure, you may still feel guilty for ending the relationship, but at least there won't be any unanswered questions. If you're leaving because you feel communication has broken down to the point where all you do is fight, then tell them that. If you're leaving because you feel that you can no longer give the relationship what it needs (or conversely are not receiving what you need from it), they should hear that, too.

If you're leaving because you fell out of love with your partner, again, this may be a painful thing to have to say, but by admitting it, you are doing yourself a world of good, too. Maybe you didn't realize how much this was true until you put it into words, and now you can stop denying it and start the healing process yourself. Please note, however, that these tips are for those in largely healthy, non-abusive relationships. Please seek help if you are leaving someone because he or she is physically or emotionally abusive.

If you're suffering from a bad breakup or the loss of a loved one, and you feel you cannot move on without some closure, consider reaching out to a professional counselor at BetterHelp. Online therapy options like BetterHelp have been found to be just as effective as in-person therapy. In fact, all participants in a grief-online therapy efficacy study not only improved significantly during treatment, but improvement was stable and continued even three months after online therapy treatment ended.

Online therapy is an incredibly convenient option, accessible anytime and anywhere so long as you have an internet connection to get started. This may be of particular use if you&rsquore struggling with grief and closure &ndash sometimes in the midst of grieving, leaving the house can seem a monumental and wholly undesirable task, even if we want or know that we need help. Utilizing online therapy can help you get out of a slump and achieve a sense of resolution without the added stress of needing to leave the house or sit in an office. Additionally, online therapy tends to be more affordable since therapists don&rsquot need to increase prices to help account for the cost of renting out office or building space.

Read below for some reviews of BetterHelp counselors from people seeking help with achieving closure.

Counselor Reviews

"Chinyere has been amazing with being supportive of me when I need it most and I have no one really else in the world to listen. She has given me good coping tools and made me feel like over time I can get through the pain I&rsquom feeling for the loss of my fiancé. I would highly recommend her!&rdquo

&ldquoLauren Uyeji has consistently listened intently to my issues regarding my breakup and fear of being alone, and has always responded in a timely and insightful fashion. I really couldn't ask more from a counselor. I had a therapist in the past who said barely anything and I remember getting very little from my time with him over a whole year of counseling. Lauren knows how to ask the right questions and give answers that are wise and informative. I feel like I am talking to someone that cares and is seriously considering ways to interact with the things I say. None of the questions she asks feel generic or insincere - they always are directly related to the immediate topic at hand and guide my thinking in ways that I feel actually growth. I would highly recommend Lauren to anyone seeking help with dealing with intense emotions.&rdquo

Giving or getting closure can be difficult. When you focus your energy on doing it the best way you know how, you get the best results. A licensed professional can help get you there. Ending relationships just as healthily as you started them is important to your mental wellbeing. Take the first step today.


When to Call a Doctor About Your Pain

Some pain can be normal, especially if you've recently had an injury, illness, or surgery. Call your doctor if the pain is intense, it doesn't stop, or it keeps you from doing your regular activities every day.

Sources

British Columbia Medical Journal: "Diagnostic judgment: Chronic pain syndrome, pain disorder, and malingering."

Frontera, Walter R., et al. Essentials of Physical Medicine and Rehabilitation, 2014.

Medscape: "Chronic Pain Syndrome Treatment & Management."

National Center for Complementary and Integrative Health: "Chronic Pain: In Depth."


How to cope with depression after abortion

Emotional side effects are not uncommon after an abortion, or pregnancy termination, whether it was planned or not. In some cases, depression can occur. However, the link between pregnancy termination and depression remains unclear.

The decision to terminate a pregnancy is rarely an easy one, and it is not always the individual’s preferred choice. Whether they choose a termination freely or not, they can have mixed feelings after the procedure.

In the United States, around half of all pregnancies are unplanned. This is one reason for choosing a termination. However, the reasons for not wanting to continue a pregnancy are varied.

Reasons include, but are by no means limited to, social, financial, or relationship pressures and physical or mental health problems in the parent or unborn child.

Regardless of the reason, the emotional response to a termination can range from relief, calm, and happiness to sadness, grief, loss, and regret, depending on the individual’s situation.

If negative feelings are severe and persistent, they could be a sign of depression.

The issue of planned termination is a controversial one, and so is the question of mental health following a termination.

The important thing to remember is that each person’s experience and response will be different.

As researchers for the American Psychological Association (APA) said in 2009, “it is important that women’s varied experiences of abortion be recognized, validated, and understood.”

Share on Pinterest Terminating a pregnancy can lead to feelings of sadness and grief.

For many people, terminating a pregnancy can be a stressful life event.

It is not unusual to experience a range of psychological and emotional responses.

Some people may feel relief at having made the right choice for them and taken action to resolve a difficult situation, while others may experience a range of negative emotions.

Any pregnancy loss will lead to an interruption in the hormone cycle. The negative feelings that occur after a planned termination may be at least partly due to hormonal changes, which are similar to those that occur after an unplanned pregnancy loss.

According to the American Pregnancy Association, common negative feelings include:

  • guilt
  • anger
  • shame
  • remorse or regret
  • loss of self-esteem or self-confidence
  • feelings of isolation and loneliness
  • sleep problems and bad dreams
  • relationship problems
  • thoughts of suicide

In addition, some people may experience grief, stress, or a sense of loss and may feel less able to cope. If suicidal thoughts or self-harm occur, the person should seek urgent help.

The National Suicide Prevention Lifeline offers free and confidential support 24/7. The number to call is 1-800-273-8255.

Religious beliefs, relationship problems, and social stigma can make it harder to cope, especially if these mean that the individual has nobody to talk to about what has happened.

In most cases, as time passes, these negative feelings will subside.

However, if there are additional issues, such as a sense of isolation or previous history of mental health problems, there may be a higher chance of depression occurring.

Depression is a mental health condition and mood disorder.

People with depression may have these signs and symptoms:

  • feeling low or sad
  • having difficulty thinking, focusing, and making decisions
  • feeling irritable
  • lacking energy
  • sleeping too much or too little
  • loss of interest in sex
  • loss of interest in activities that they previously enjoyed

There may also be feelings of guilt and low self-esteem.

Depression can make it hard to work or carry out daily chores. Complications can include relationship breakdown and job loss. For some people, psychotic symptoms may develop.

Depression versus grief

The grief that follows the loss of a loved one can lead to sadness and other symptoms similar to those of depression.

Feelings of grief, sadness, loss, and regret can also occur after a termination or pregnancy loss.

If a person’s symptoms gradually improve with time, it is unlikely that they have depression.

However, symptoms that persist or worsen could indicate depression, in which case it is essential to seek medical help.

Anyone who experiences distress after a termination may find it helpful to seek the support of family, friends, or a community group.

This can help prevent feelings of grief and sadness from developing into depression.

If depression occurs, it is a treatable condition.

  • support, for example, that of a community group or health worker
  • counseling, including cognitive behavioral therapy (CBT)
  • medications, such as antidepressants

Lifestyle factors that may help include:

  • eating a healthful diet
  • taking regular exercise
  • reducing stress as far as possible
  • learning relaxation techniques, such as yoga or meditation

Reducing the risk

Before deciding on a termination, it is advisable to try the following:

  • speaking to people who you can trust
  • weighing up all your options
  • seeking medical help and asking a health worker as many questions as you can
  • trying to avoid isolation, as this can lead to depression
  • avoiding giving in to pressure to do something you do not want to do, whether this is the termination or continuation of the pregnancy

Terminating a pregnancy can also involve some physical risks, in the same way as any other medical or surgical procedure.

It is vital to seek treatment in a registered facility with qualified and experienced professionals to reduce the risk of harm.

The existence of a link between a planned termination and depression remains controversial.

A study published in 2015 suggested that people who have mental health problems before pregnancy may have a higher risk of experiencing negative emotions after a termination.

Research published in 2011 concluded that there was a “moderate to highly increased risk of mental health problems after abortion.” The researchers suggested that undergoing a termination increased the risk by 81 percent and attributed 10 percent of this risk to the termination itself.

Other scientists, reporting in 2008 on a 30-year study, estimated that abortion increased women’s risk of mental health disorders by between 1.5 and 5.5 percent.

In 2008, the American Psychological Association (APA) Task Force on Mental Health and Abortion found that certain conditions appeared to increase the risk of depression after a range of pregnancy outcomes, including a planned termination.

  • poverty
  • a history of violence or emotional problems
  • a history of drug or alcohol use
  • previous unwanted childbirth

The APA have also identified the following risk factors for depression following a termination:

  • perceived stigma and lack of social support
  • a history of mental health problems
  • personality traits, such as low self-esteem
  • features of the pregnancy, including whether the individual wanted it or not

The most important factor appears to be whether or not the mental health problems were already present before the pregnancy.

The American Pregnancy Association add the following as factors that might increase the risk of depression:

  • having a termination due to coercion or persuasion by others
  • moral or ethical conflict due to religious beliefs or personal views
  • having a termination in the later stages of pregnancy
  • lacking support from a partner or significant others
  • ending a pregnancy because of genetic or fetal abnormalities

Genetic factors and life events, such as the loss of a loved one, may also increase the risk of depression.

Other possible risk factors for depression include:

  • a reduced ability to cope with life’s pressures
  • being female
  • exposure to factors that cause stress daily, such as financial or relationship insecurity

However, the exact causes of depression, including pregnancy-related depression, are not known.

In 2009, researchers for the APA noted that the risk of poor mental health was the same whether people chose to terminate or continue their pregnancy.

A study published in The BMJ in 2016 concluded that the likelihood of post-traumatic stress symptoms (PTSS) up to 4 years after a termination was no higher for those who had the procedure than for those who were not allowed to have a termination due to advanced gestational age.

A Swedish study found that few women experienced post-traumatic stress disorder (PTSD) after a termination. They also noted that those who did had experienced trauma unrelated to the procedure.

In August 2018, researchers published findings of a study involving nearly 400,000 women in Denmark. The results suggested that, although women who have an abortion are more likely to use antidepressants, the risk factors leading to this are likely to stem from causes other than the termination.

The researchers conclude: “Policies based on the notion that abortion harms women’s mental health may be misinformed.”

People should also weigh the risk of depression after a termination against the possible health risks of continuing with a pregnancy.

One study , for example, included women who wanted to have a termination but were not able to. Some of these women experienced a range of potentially life-threatening health consequences, such as eclampsia and hemorrhage.

Researchers need to carry out more research to fully understand any links between pregnancy termination and depression.


Mutations in the NTRK1 gene cause CIPA. The NTRK1 gene provides instructions for making a receptor protein that attaches (binds) to another protein called NGFβ. The NTRK1 receptor is important for the survival of nerve cells (neurons ).

The NTRK1 receptor is found on the surface of cells, particularly neurons that transmit pain, temperature, and touch sensations (sensory neurons). When the NGFβ protein binds to the NTRK1 receptor, signals are transmitted inside the cell that tell the cell to grow and divide, and that help it survive. Mutations in the NTRK1 gene lead to a protein that cannot transmit signals. Without the proper signaling, neurons die by a process of self-destruction called apoptosis. Loss of sensory neurons leads to the inability to feel pain in people with CIPA. In addition, people with CIPA lose the nerves leading to their sweat glands , which causes the anhidrosis seen in affected individuals.

Learn more about the gene associated with Congenital insensitivity to pain with anhidrosis


Contents

Stress-reduction strategies can be helpful to many stressed/anxious people. However, many anxious persons cannot concentrate enough to use such strategies effectively for acute relief. (Most stress-reduction techniques have their greatest utility as elements of a prevention plan that attempts to raise one's threshold to anxiety-provoking experiences.)

The five R's of stress and anxiety reduction Edit

Five core concepts are used to reduce anxiety or stress. [2]

  • Recognition of the causes and sources of the threat or distress education and consciousness raising.
  • Relationships identified for support, help, reassurance
  • Removal from (or of) the threat or stressor managing the stimulus.
  • Relaxation through techniques such as meditation, massage, breathing exercises, or imagery.
  • Re-engagement through managed re-exposure and desensitization.

Defense mechanisms are behavior patterns primarily concerned with protecting ego. Presumably the process is unconscious and the aim is to fool oneself. It is intra psychic processes serving to provide relief from emotional conflict and anxiety. Conscious efforts are frequently made for the same reasons, but true defense mechanisms are unconscious.

Some of the common defense mechanisms are: compensation, conversion, denial, displacement, dissociation, idealization, identification, incorporation, introjection, projection, rationalization, reaction formation, regression, sublimation, substitution, symbolization and undoing.

Summary Edit

The major function of these psychological defenses is to prevent the experiencing of painful emotions. There are several major problems with their use.

  • Many of these defenses create new problems that are as bad, or worse, than the emotional problems they mask. Some may be just plain destructive. Example: rejection literally destroys the relationships we care most about.
  • These defenses distort person's ability to perceive reality as it is. And this prevents them from dealing with their problems in a constructive way.
  • These defenses do not get rid of the painful feelings. In fact, by masking them so that person doesn't feel them, they effectively store them up within themselves. Emotions are discharged through expression, so by denying themselves the chance to feel them, they also deny themselves the ability to get rid of them.
  • These defenses do not just screen out painful emotions. They are, in fact, defenses against all emotion. So the more effective person's defenses become in protecting them from painful feelings, the less able they are to experience the joyful and happy feelings that make life worth living.
  • These defenses are not perfect. As more and more hurt is stored away, a tension is developed. Person becomes increasingly anxious, nervous, and irritable. They become emotionally unpredictable. And when defenses weaken, as they will from time to time, person may experience emotional explosions.
  • These defenses prevent person from knowing what is wrong, but they do not prevent us from feeling bad.

Acute stress disorder Edit

Acute stress disorder occurs in individuals without any other apparent psychiatric disorder, in response to exceptional physical or psychological stress. While severe, such reactions usually subside within hours or days. The stress may be an overwhelming traumatic experience (e.g. accident, battle, physical assault, rape) or unusually sudden change in social circumstances of the individual, such as multiple bereavement. Individual vulnerability and coping capacity play a role in the occurrence and severity of acute stress reactions, as evidenced by the fact that not all people exposed to exceptional stress develop symptoms. However, an acute stress disorder falls under the class of an anxiety disorder.

Symptoms Edit

Symptoms show considerable variation but usually include: An initial state of "DAZE" with some constriction of the field of consciousness and narrowing of attention, inability to comprehend stimuli, disorientation. Followed either by further withdrawal from the surrounding situation to the extent of a dissociative stupor or by agitating and over activity.

Autonomic signs of "panic anxiety" Edit

The signs are: tachycardia (increased heart rate), sweating, hyperventilation (increased breathing). The symptoms usually appear within minutes of the impact of the stressful stimulus and disappear within 2–3 days.

Post-traumatic stress disorder (PTSD) Edit

This arises after response to a stressful event or situation of an exceptionally threatening nature and likely to cause pervasive distress (great pain, anxiety, sorrow, acute physical or mental suffering, affliction, trouble) in almost anyone.

Causes Edit

The causes of PTSD are: natural or human disasters, war, serious accident, witness of violent death of others, violent attack, being the victim of sexual abuse, rape, torture, terrorism or hostage taking.

The predisposing factors are: personality traits and previous history of psychiatric illness.

Typical symptoms Edit

Flashbacks are the repeated reliving of the trauma in the form of intrusive memories or dreams, intense distress at exposure to events that symbolize or resemble an aspect of the traumatic event, including anniversaries of the trauma, avoidance of activities and situations reminiscent of the trauma, emotional blunting or "numbness", a sense of detachment from other people, autonomic hyperarousal with hypervigilance, an enhanced startle reaction and insomnia, marked anxiety and depression and, occasionally, suicidal ideation.

Treatment Edit

Psychiatric consultation: exploration of memories of the traumatic event, relief of associated symptoms and counseling.

Prognosis Edit

The course is fluctuating but recovery can be expected in the majority of cases. Few people may show chronic course over many years and a transition to an enduring personality change

Stress ulceration Edit

Stress ulceration is a single or multiple fundic mucosal ulcers that causes upper gastrointestinal bleeding, and develops during the severe physiologic stress of serious illness. It can also cause mucosal erosions and superficial hemorrhages in patients who are critically ill, or in those who are under extreme physiologic stress, causing blood loss that can require blood transfusion.

Ordinary peptic ulcers are found commonly in the “gastric antrum and the duodenum” whereas stress ulcers are found commonly in “fundic mucosa and can be located anywhere within the stomach and proximal duodenum”.


Psychological pain

Psychological pain, mental pain, or emotional pain is an unpleasant feeling (a suffering) of a psychological, non-physical origin. A pioneer in the field of suicidology, Edwin S. Shneidman, described it as "how much you hurt as a human being. It is mental suffering mental torment." [1] There is no shortage in the many ways psychological pain is referred to, and using a different word usually reflects an emphasis on a particular aspect of mind life. Technical terms include algopsychalia and psychalgia, [2] but it may also be called mental pain, [3] [4] emotional pain, [5] psychic pain, [6] [7] social pain, [8] spiritual or soul pain, [9] or suffering. [10] [11] While these clearly are not equivalent terms, one systematic comparison of theories and models of psychological pain, psychic pain, emotional pain, and suffering concluded that each describe the same profoundly unpleasant feeling. [12] Psychological pain is believed to be an inescapable aspect of human existence. [13]

Psychological pain
Other namesSuffering, mental agony, mental pain, emotional pain, algopsychalia, psychic pain, social pain, spiritual pain, soul pain
Vincent van Gogh's 1890 painting
Sorrowing old man ('At Eternity's Gate'), where a man weeps due to the unpleasant feelings of psychological pain.
SpecialtyPsychiatry, psychology
MedicationAntidepressant medication, Analgesic medication

Other descriptions of psychological pain are "a wide range of subjective experiences characterized as an awareness of negative changes in the self and in its functions accompanied by negative feelings", [14] "a diffuse subjective experience . differentiated from physical pain which is often localized and associated with noxious physical stimuli", [15] and "a lasting, unsustainable, and unpleasant feeling resulting from negative appraisal of an inability or deficiency of the self." [12]