how to validate/deal with complaints of physical pain

[maxsterling]

She's complained of headaches for awhile.  From my observations, they are related to stress.  No kind of medicine seems to solve her issues.  She also claims back pain.  She says she has had this for years, yet when she goes to the doctor they don't pinpoint anything seriously wrong, just that she has a little arthritis which is typical for someone her age, and that she would feel better if she lost weight. But she's had the whole MRI/Xrays/injections and physical therapy.  She also complains of heart palpitations, so she went to a cardiologist.  I think it is anxiety related, but they have her on a heart monitor now just to be sure.  And ever since the wisdom tooth removal, she has been complaining of pain.  First it was just mouth pain, now it is back pain, hand pain, pain in general.  She has been diagnosed fibromyalgia.  Her complaints are about half a dozen per day.

What do I do with this?  I need to be sure to not invalidate her, but sometimes it is tough to take all these complaints seriously considering how much she complains.  But I don't know if I can validate her pain - because I don't know if I am validating the invalid?  I try to phrase things like this: "Wow, that sounds like a bad headache.  I would be miserable and going to a doctor if I felt that bad.  Have you noticed anything that makes it better or worse?"

while I can't crawl inside her skin to know how badly she truly feels, I do worry that she may be making it out to be worse than it is for a) use it as an excuse for not exercising or getting things done b) get attention from me c) get attention from doctors d) an excuse to take pain medications.  In relation to (d) she is a recovering heroin (and other drugs) addict.  She talks like she doesn't really want pain medicine to be her solution long term.  Yet, I notice her complaints of pain have ramped ever since her friend (also a recovering addict) revealed to her that she takes narcotic pain medicines daily and has for years.

I'm just not sure what to do with this.  I'm not sure where my worry is or if this is something I need to concern myself with.  I want to take her at her word in that her pain is severe and needs to be dealt with, but I worry to not be naïve here... .

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[MissyM]

Sorry, Max.  Has she ever been to an alternative type doctor?  I was diagnosed with fibromyalgia years ago and then found a fibro doctor.  He figured out what was really wrong with me, an unusual type of hypothyroidism.  It caused pretty much all of the symptoms you are describing.  Including the heart palpitations that only showed when put on a treadmill and hooked up to a heart monitor.  Just a thought, the pain, headaches, heart palpitations were all there.  Does she have poor sleep?  Has she gained weight without a change in diet?  Those were 2 other symptoms I had.   However, I am not BPD or an addict.

[maxsterling]

Sorry, Max.  Has she ever been to an alternative type doctor?  I was diagnosed with fibromyalgia years ago and then found a fibro doctor.  He figured out what was really wrong with me, an unusual type of hypothyroidism.  It caused pretty much all of the symptoms you are describing.  Including the heart palpitations that only showed when put on a treadmill and hooked up to a heart monitor.  Just a thought, the pain, headaches, heart palpitations were all there.  Does she have poor sleep?  Has she gained weight without a change in diet?  Those were 2 other symptoms I had.   However, I am not BPD or an addict.

Yes to poor sleep.  I think that is clearly sleep apnea.  Gained weight?  Yes, but her diet has changed and her exercise less.  She does take medicine for thyroid, and she has gone to a alternative doctors.  I have no doubt she is in some pain, maybe as severe as she claims, or maybe not.  I'm more concerned with her complaints to me about her pain, and what to do with them.  She does at least go to doctors, but then gets frustrated when her doctors tell her nothing.  But since she has BPD and tends to go through periods where she complains about most everything, almost as if to break the silence, I want to make sure I am not validating the invalid here.  When she is in one of those constant complaining modes, I want to make sure I am not flinching too hard if she cries "wolf", yet smart enough to know when there really is a "wolf".

[MissyM]

She does take medicine for thyroid, and she has gone to a alternative doctors.

Hate to ask this but is she on synthroid?  Many people I have known on synthroid continued to have symptoms. Once they switched to Armor or compounded thyroid meds their symptoms went away (I prefer compounded with no fillers or dyes).  My dBPDh is hypoptiutiary, so he has low thyroid, hgh and testosterone.  It makes a big difference on his physical and mental health when he is supplementing these hormones. Of course, being BPD he is not consistent with it. 

Don't mean to say that she is ill but I tend to give people the benefit of the doubt.  Now the complaining is a different issue.  My dBPDh is really working on keeping his complaining down.  I just get fed up with that and he realizes that it makes him feel worse when he complains all the time.  Does your dBPDw try to do anything to control her complaining?  If she is working a program, that would seem shifting to gratitude thinking is a big deal.

[Cat Familiar]

My husband complains constantly about his aches and pains. Fortunately I've gotten him to go to yoga classes with me for almost a year. He's made great progress.

Part of his problem, as I see it, is that he is so sedentary--slouching over the computer most of the day (for fun) then watching hours of TV. What is it with these former jocks who need to watch every game that's televised: football, basketball, baseball, soccer, hockey? Just cleaning his studio for a couple of hours yesterday, he complained that he's disabled now--probably for days. Yet he will be fine to go to yoga this afternoon.

I understand chronic pain--have had shoulder surgery, but I have to keep moving or it gets way worse. It's almost like these BPDers seem to think they should have the body they had as children and not have to do anything to maintain it!

By middle age, nearly everyone has had some injury or chronic degeneration of some part. But by the way they complain, it's almost like pwBPD are so special that they think their problems are far worse than everyone else's, yet they seem to be willing to do nothing about it. (I'm generalizing from my mother, my ex and my current husband.)

[maxsterling]

Missy - she's starting to recognize that her complaining is a bad thing, and has made statements that are at least self-aware that she is doing too much complaining.  I think she is trying to control it, but I haven't seen much in the ay of progress yet.

I don't know what kind of steroid medicine she is on.  But I also give her the benefit of the doubt she has issues, some possibly serious that she needs to discuss with doctors.  Yesterday she went to a cardiologist and they gave her a heart monitor to wear overnight.  I think that was good considering her complaints of heart palpitations and family history of heart disease.  But when I told her that hopefully the heart monitor will provide some kind of answer, she said, "Oh they will probably tell me it's nothing."  Not sure if that means she doesn't trust the Dr or doesn't think her issue is serious.  Today she went to a pain specialist.  Her regular physician sent her there because of rules about prescribing narcotics.  The pain specialist would also not prescribe her narcotics, and suggested other methods of managing pain.  I think she was disappointed, yet hopeful that the Dr discussed options with her and gave her explanations.  Then she commented again about her friend who takes narcotics, and said, "I guess she is wrong."

My feeling is still that her pain and medical issues relating to digestion and her heart are real.  But I think there is also a large component of BPD in there of wanting the "quick fix" and wanting some kind of validation for her situation.

[MissyM]

My feeling is still that her pain and medical issues relating to digestion and her heart are real.  But I think there is also a large component of BPD in there of wanting the "quick fix" and wanting some kind of validation for her situation.

That is hard, my dBPDh has many medical issues and they are real.  One of the things that keeps being stressed to him in recovery is to take care of them and not just sit around and complain about them. 

Thank goodness the pain specialist did not give your dBPDw pain meds, that would have been disastrous.  That is how my dBPDh's addiction started, he had steered clear of illegal drugs and too much alcohol because of his father's addictions.  Once he went down that rabbit hole it got very dark.

All I can do is validate my dBPDh's feelings and then ask him what he plans to do to take care of it.  My dBPDh suffers from chronic back pain (he has metal in his back) and it is real.  Exercise, antidepressants, massage and addressing his pituitary issues all help with the pain but it will always be there.  I try to be understanding and he is trying not to complain all the time.

So I don't know that I have anything else to offer.  Sounds like you are handling it pretty well.  You believe she is ill and aren't trying to take the problem on to fix, kudos to you!

[ColdEthyl]

My husband complains constantly about his aches and pains. Fortunately I've gotten him to go to yoga classes with me for almost a year. He's made great progress.

Part of his problem, as I see it, is that he is so sedentary--slouching over the computer most of the day (for fun) then watching hours of TV. What is it with these former jocks who need to watch every game that's televised: football, basketball, baseball, soccer, hockey? Just cleaning his studio for a couple of hours yesterday, he complained that he's disabled now--probably for days. Yet he will be fine to go to yoga this afternoon.

I understand chronic pain--have had shoulder surgery, but I have to keep moving or it gets way worse. It's almost like these BPDers seem to think they should have the body they had as children and not have to do anything to maintain it!

By middle age, nearly everyone has had some injury or chronic degeneration of some part. But by the way they complain, it's almost like pwBPD are so special that they think their problems are far worse than everyone else's, yet they seem to be willing to do nothing about it. (I'm generalizing from my mother, my ex and my current husband.)

Word.

[maxsterling]

Well, the pains have increased.  She has sought more help, more doctors and yoga.  I'm starting to feel in my gut there is either a serious problem here with her various health complaints that may be all related, or that the pain is as it always has been, it's just that she is "feeling" it mode now do to stresses - consciously or subconsciously she wants an excuse.  The other day she mentioned that she may not be "ready" to have a baby next year, due to physical ailments.  Maybe the "pain" is another form of negative self talk and catastrophizing - BPD related.  She fears changes in lifestyle, and rather than address them, her mind is constructing her "pain" as an excuse as to why it's okay to have these fears. 

She also claims the medicines they are giving her aren't working and is upset with doctors for not automatically giving her narcotics.  I think this is spurred on by her friend who takes narcotics for chronic pain.  But she complains of a lot of pain, and to have that many issues that seem to be getting worse leads me to worry that there may be something more serious wrong that will require more serious treatment.  She goes to the GI doctor on tuesday, and yesterday a doctor suggested some kind of surgery on her back.   

[Cat Familiar]

Well, the pains have increased.  She has sought more help, more doctors and yoga.  I'm starting to feel in my gut there is either a serious problem here with her various health complaints that may be all related, or that the pain is as it always has been, it's just that she is "feeling" it mode now do to stresses - consciously or subconsciously she wants an excuse.  The other day she mentioned that she may not be "ready" to have a baby next year, due to physical ailments.  Maybe the "pain" is another form of negative self talk and catastrophizing - BPD related.  She fears changes in lifestyle, and rather than address them, her mind is constructing her "pain" as an excuse as to why it's okay to have these fears. 

I think that pwBPD somatize a lot of their emotions through physical symptoms. It's like the emotions are so intolerable, that it's more comfortable to have physical complaints. And with physical issues, they get sympathy from others.

It appears to me that your wife is looking for an out--so she won't have to deal with a baby and childbirth. Not to say that she doesn't have pain, don't we all? But I suspect that she is trying to drum up an excuse. I don't thing pwBPD like to share the attention with children nor have responsibility for other people.

[enlighten me]

Something I noticed with my exs the same problems. I have read a lot about BPD and hormones and their affects.

Recent research has shown that pwBPD have a smaller than normal hyperthalamus which is where oxytocin is produced. Oxytocin counteracts cortisol. Hightened levels of cortisol can lead to hypothyroidism which as posted gives all the symptoms.

Im suprised that more of us dont have the same problems as cortisol is the stress hormone.

[Cat Familiar]

Something I noticed with my exs the same problems. I have read a lot about BPD and hormones and their affects.

Recent research has shown that pwBPD have a smaller than normal hyperthalamus which is where oxytocin is produced. Oxytocin counteracts cortisol. Hightened levels of cortisol can lead to hypothyroidism which as posted gives all the symptoms.

Im suprised that more of us dont have the same problems as cortisol is the stress hormone.

If I remember correctly, oxytocin is the "bonding" hormone. It makes us feel a part of something with another person.

I just had a conversation with my husband where he talked about how he's never felt a part of anything and that people don't seem to include him or miss him when he's not there--for example his sisters, who live on the opposite coast. This isn't the first time he's said something like this, but I just wonder if he isn't producing a typical amount of that hormone, then he's not bonding with other people.

[enlighten me]

Hi cat

skip is the go to guy for hormones as he is an endocrinologist. But yes your right. Oxytocin is the hormone that forms bonds. It is released by a mother during childbirth to bond to the baby. Also during breasyfeeding. It is released during orgasm aswell and even by hugging. It makes sense that pwBPD may be lacking in it.

It is also released to counter cortisol the stress hormone related to fight or flight. If its not reducing cortisol then the cortisol can cause all sorts of ailments such as anaemia, hypothyroidim, fibromyalgia type symptoms etc etc.

You can get oxytocin as a nasal spray which has been trialled on other disorders but not with BPD as far as I am aware. I would be curious to see whether it would have any affect.

[Cat Familiar]

I also recently read that oxytocin is proving to be helpful for muscle loss due to aging as well as building bones. I wonder if a prescription is necessary. Might be worth trying. 

[enlighten me]

Its available in the US but only used in the UK to induce labour. From what ive read it is only dangerous to pregnant women but im not a medical professional so I wouldnt recomend just buying it without professional guidance.

[maxsterling]

Well, today she goes in for a colonoscopy.  This because she was describing to me symptoms of gastrointestinal distress, and I pointed out to her that one of those symptoms is much more serious than she thought.  She went to the doctor, the doctor agreed - potentially real serious and completely abnormal - so he scheduled a colonoscopy and endoscopy.  Last night amidst the laxative prep, she wanted to change her mind, saying her issues werent serious.  I validated, told her this is important.  Maybe this will reveal something... .

[Cat Familiar]

Well, today she goes in for a colonoscopy.  This because she was describing to me symptoms of gastrointestinal distress, and I pointed out to her that one of those symptoms is much more serious than she thought.  She went to the doctor, the doctor agreed - potentially real serious and completely abnormal - so he scheduled a colonoscopy and endoscopy.  Last night amidst the laxative prep, she wanted to change her mind, saying her issues werent serious.  I validated, told her this is important.  Maybe this will reveal something... .

Max, I hope all is well with her. Good to find out for sure. And you will have several hours of peaceful time as she sleeps off the anesthetic.

[maxsterling]

Well, the procedure found nothing of major concern.  That's a good thing.  Afterwards she has been complaining of severe heartburn (and blamed me for it  )  Her complaints of head or neck pain have also increased.

These complaints are wearing me out, I think mainly because I can't see an end to them.  When she got her wisdom teeth out, I was more able to let the complaints pass because I understood the pain would gradually lessen.  But now, without seemingly anything wrong that the doctors can find, it's much harder for me to see an end.  I keep telling myself that this is nothing I caused or can solve for her - but to hear the dozens of  "this hurts, that hurts" every day... .  I don't doubt that she is feeling pain - but I really wish she could stop vocalizing it to me.

[enlighten me]

A quick question max. Is the pain worse when she is stressed? Also is it seasonal?

[maxsterling]

A quick question max. Is the pain worse when she is stressed? Also is it seasonal?

Stress = absolutely.  If she his having to think about anything stressful, half an hour later she is complaining of pain.  And if we are out with a friend seeing a movie - no complaints until after we get home as if the distraction is enough to make the pain a secondary issue.  Her complaints are worse when she is home alone.

[enlighten me]

When stressing does she drink more caffeine?

The reason im asking these things is that I believe these ailments could be linked to cortisol the stress hormone. caffeine increases cortisol levels. If you google lowering cortisol levels then it might be worth trying it and seeing if theres any improvement.

[formflier]

[

Yes to poor sleep.  I think that is clearly sleep apnea.  Gained weight?  

Has she had a sleep study?  I use a CPAP... .my life is totally better now.  Good sleep is a precious thing.