What Is Mental Pain?
Many times a bipolar person in the throes of a depressive episode will describe what can only be called "mental pain." I've heard it described as an all-over bodily reaction that rivals the worst of physical pain in terms of how it takes away all thoughts of anything else but the feeling itself. Some say it is an all-over body "throb" that numbs the mind to the point of being unable to process even the most basic of thoughts. Many have said they'd prefer actual physical pain to this mental anguish...and sadly, some opt for suicide as a permanent escape route. In this essay I want to try to make clear what this pain is and why a validation for the significance of it is so hard to achieve. Validating a person's mental anguish may be the tentative thread that holds that person anchored to reality and to further existence, so it is crucial you understand it.
First let's understand how it differs from physical pain because this difference is what makes it so difficult to understand and accept that a person suffering mental pain is truly deserving of as much care as is the person who suffers from more apparent physical pain. Here are the characteristics of physical pain, followed with how mental pain differs from it. Physical pain:
Most physical pain has an outcome in that either the wound heals and the person returns to normalcy, or if it is chronic pain, the person learns various methods for coping with it through self-awareness and the aid of pain clinics and such. It is different with mental pain. One cannot see a mental wound as one can watch a cut or incision heal. There's no foreseeable outcome with clear demarcations as the healing process unfolds. Mental wounds are invisible and the healing process is not as readily seen by others so the length and duration are always being questioned which in itself can add to the mental pain itself.
Mental pain isn't something you can point to like a broken limb and say, "Oh, I see what is causing your pain. It will heal in five or six weeks and all will be well." There are no markers for mental pain; nothing the hurting person can show you to make clear its depth and extent. To suffer mental pain is to suffer silently in a world not accessible by others except through oblique words that can never do justice to the suffering one is experiencing.
Persons in physical pain expect, and indeed, elicit sympathy and attention from others around them. It is easy to sympathise with physical hurts and discomforts. Significant others can't do enough to help the injured person get through the pain as the healing process goes on; not so with mental anguish. There is no such validation for mental pain, yet that is the very thing most needed by the person during this time. Unfortunately, sufferers of mental pain are far less likely to find sympathy or support for their pain. Instead their pain is often met with unhelpful comments such as "Cheer up; things could be worse" and other such inanities. Rather than offers of help or condolences, the person suffering mental pain is often finally ignored or considered a wet blanket that others would just as soon not be around.
Finally, physical pain can be spiritually enriching, while mental pain rarely can be considered such. Persons surviving mental anguish often describe feeling shattered and scattered following such an episode. Though they may feel some small amount of pride for having made it through yet another painful experience, they do not have that sense of having conquered an injury. There is no sense of having met pain and put it behind them, because there is always the expectation that their pain will come again and be just as devastating to get through as ever. Their wound is forever subject to being reopened and revisited with just as much hurt as before. Imagine how you'd view the pain of a broken bone it every time it had healed, someone came along and re-broke it. Imagine how despondent you'd soon become with each new break you were forced to again heal from. If you can place yourself in this position you might have some small understanding of what recurring mental pain is like. Furthermore, you might come to understand why so many of us take our own lives in an attempt to escape this cycle.
Often I have people write to me off the website here to ask what they can do to help their loved one through a bad depressive episode. Most frequently, they ask what they most ought not to say to the depressed person. Here's a very long list of some of the things that depressed folks find least helpful or useful to them when they are suffering depression. When you've read through these come back to this page and I'll offer some ideas for what you can say to help your friend or loved one survive mental pain.
Finished reading the list? Good, then here we go with some things you CAN say to a depressed person.
Ok, so you know what NOT to say now, but what about what you can or should say or do to help someone in mental pain? Well, being there is the first and foremost thing to do. This doesn't mean you need to be in the depressed person's pocket every second. It doesn't mean you need to keep up a steady stream of conversation either. It means that you need to listen when spoken to; you need to provide a human link to the outside world so your loved one doesn't become completely isolated. Doing so may mean you do nothing more than read a book quietly in their presence, or sit and watch a sunset. It does not mean that you need to keep asking, "What's wrong?" "Talk to me." etc. Just tell the person that you are there to listen if they want to talk, that you are there to help take care of the physical things like washing the dishes and fixing meals if need be, anything that lightens the burden and speeds the healing process. Maybe it just means you are there to run errands that are currently just too much for the depressed person to deal with. Since depressed persons sometimes literally can't get out of bed, then your help will ease some of the stress of "must do's" than can contribute to a more lengthy depressive episode. A depressed person is usually an exhausted person. Perhaps it might mean that you provide the impetus and the ride to the person's therapist or psychiatrist when otherwise they might not go. Above all, listen and watch for the signs that the person may be losing the battle with their mental pain and need the services provided by a hospital. Suicidal ideations play over and over again in the severely depressed person's mind. This never-ending tape wears down the resistance of the person and finally exhausts them as they battle its siren's call. They are particularly vulnerable at this time. Remember to ask honestly of your loved one, "Are you suicidal? Do you have a plan to kill yourself?" If you yourself are so busy chattering away out of discomfort, then you may not hear the most important communications from your friend or loved one. You may miss the telling remark that will let you know that more professional help is needed with this episode than you are able to provide.
Try your best not to blame the person for being in pain. Just as you'd not expect someone with a newly broken leg to heal quickly and get on with it, so does the healing of a pain you can't see take time and attention. Be gentle and give them that time and you will have done the very best that you can do for them.