The Nothingness Inside


Dear Friends,

It has been some time since my last post, but this doesn’t mean that I have forgotten you.  When you live with any chronic illness, sometimes you need to think long and hard about where you will expend your energy.  As of late, my energy has been wrapped up in various things I signed up for and just trying to combat the raging storm brewing in my brain.

As the seasons change and one gives way to the other, I struggle.  The transition from Autumn to Winter is the worst.  As the barometer dips and weaves, bringing on days of crushing pain, the darkness of days seems to consume me.  The cold and the lack of sun seeps into my soul like a constant and unwelcome companion, lurking over my shoulder and whispering all the lies that my brain composes.  It tells me that I am weak, that I am not good enough, that I lack value.  It tells me that I bring nothing to the world of patient advocacy when so many have been doing this work for years, if not decades, before I even received a diagnosis.  Even as I type this, I know that this is not true.  I have even had others tell me that this is not true.  Yet, these are the lies that we often tell ourselves.

Confession time: I have struggled with depression and anxiety disorders for the majority of my adult life.  I am not ashamed. 

For individuals with chronic illness and chronic pain, depression and anxiety are often like the guest you don’t remember inviting, who eats all your food, trashes your house, and stays when everyone has gone.  In short, they are emotionally and physically exhausting.  While people without chronic conditions can and do struggle with their mental health, there is a unique association between chronic illness, depression, and anxiety.  Particularly in the case of pain, there is a bit of ‘chicken and egg’ going on, where it is unclear if pain-related symptoms are psychosomatic or if the pain is the underlying factor.  This uncertain relationship, along with the varied and seemingly unrelated symptoms of many chronic illnesses, has led to many individuals suffering in silence for years before they encounter a doctor willing to look into complaints.

In some cases, depression appears to result from specific biologic effects of chronic medical illness. Examples of this relationship include central nervous system disorders—such as Parkinson’s disease, cerebrovascular disease, or multiple sclerosis—as well as endocrine disorders—such as hypothyroidism. In other cases, the association between depression and chronic medical illness appears to be mediated by behavioral mechanisms; the limitations on activity imposed by the illness lead to gradual withdrawal from rewarding activities. (Simon, 2001)

Addressing mental well-being should be a routine part of any chronic illness management program.  Techniques, like mindfulness, meditation, gratitude journaling, and daily movement can improve the symptoms of your chronic condition and make you happier.

I know that it is difficult and society tends to reinforce many negative stereotypes about mental illness, that it is somehow a character flaw where one just isn’t strong enough to ‘get it together’.  Thus, the lies of our brain are compounded by the lies of society.  These lies make us feel alone, suffering through the utter isolation of our experiences and like there is no one who could possibly understand us.  And worse still, our stubborn brain may tell us that if ‘they’ knew, if everyone knew, they wouldn’t like us.  But, I want to tell you right here and right now, that you are not alone.  I do ‘get it’.

If you suffering from the following symptoms, particularly if they are severe and/or lasting more than a couple of weeks, please seek help

  • Feeling sad, irritable, or anxious
  • Feeling empty, hopeless, guilty, or worthless
  • Loss of pleasure in usually-enjoyed hobbies or activities, including sex
  • Fatigue and decreased energy, feeling listless
  • Trouble concentrating, remembering details, and making decisions
  • Not being able to sleep, or sleeping too much. Waking too early
  • Eating too much or not wanting to eat at all, possibly with unplanned weight gain or loss
  • Thoughts of death, suicide or suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment (NIMH)

Depression is treatable.  There is hope.  If you need some encouragement to talk to your health care provider, reach out to me on Twitter @RieOfLetters or via email:  Please Note: I am not a mental health professional or trained in crisis response.  If you are feeling suicidal or like you might harm yourself in any way, PLEASE utilize the following numbers to speak to someone who is trained for crisis.

National Suicide Prevention Lifeline


1-800-799-4889 (Deaf & Hard of Hearing)

1-888-628-9454 (Español)

With Love,





Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.