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05/22/2021: Eight Steps to Ending Depression

If anyone understands depression, it's people who have been there and experienced it first hand. I'm one of those people. I was in a major automobile accident and have been suffering with widespread arthritis as a result. After the accident, I spent nine years in various states of constant depression and anxiety. I saw four different therapists who were no help to me at all. They prescribed medications and encouraged me to go to group therapy – a waste of time that I now refer to as "the big wallow."

I eventually met someone who had gone through the same thing, and she referred me to a therapist who helped her. I was reluctant, but eventually I went and saw the therapist, and she gave me a set of steps to end depression and anxiety once and for all, and to avoid falling down that rabbit hole again. And now I'm going to share her steps with you, because I followed those steps, and I have been 100% depression- and anxiety-free since 1989.

Depression and anxiety are essentially two sides of the same coin. Half of all people with depression also suffer from anxiety. They are both part of the same set of mood disorders that also include persistent depressive disorder (PDD, formerly called dysthymia or non-situational depression). These mood disorders affect millions of people (mostly women, and also children) worldwide – 17.3 million in the United States alone (NIMH 2017). Yet despite these numbers, fully two-thirds of all who suffer from these disabling disorders fail to get treatment and, unfortunately, those who do get treatment rarely get a cure.

A cure is important, because these mental disorders have long been associated with other serious physical diseases such as coronary artery disease. In fact, people with mood disorders make far more trips to doctors for their non-depressive physical problems which so often accompany depression or are part of the underlying cause of many mood disorders. After all, living with chronic pain can be depressing. And, if none of that is enough, children are far more likely to develop the same depression or anxiety disorders as their parents. And that is not good. Surely a cure is the answer, and you will notice that the title of this post is "ending" depression, not treating it.

Many people believe they are just stuck with being depressed and anxious, prone to negative thoughts, panic attacks, etc. Their therapists drug them, send them to support groups, and their symptoms improve within a month or so. But why settle for treatment when a cure exists? Because most people who have mood disorders never learn how to undo the causes of their disorders or, worse yet, refuse to undo them. The problem always recurs.

The roots of depression are deep in your mind and memory, filled with life experiences, good and bad. But when you're young, your experiences are not always positive ones, or they are neither positive or negative, but are merely filed away incorrectly in your memory. They may even be misinterpretations that you're hanging onto. But, whatever the case, they were not dealt with at the time, you may have rationalized or denied them, and now, here you are, all grown up, maybe even in your golden years, and you're still dealing with life based on those undealt-with experiences. You might not even remember them at all, or remember them incorrectly. So, as an adult, you have had years to learn how to automatically do the very things that keep you in your depressed and anxious states.

One-on-one therapy can help with those past memories and experiences, but you can lift yourself out of depression by starting to change the things you do (or don't do) that are impacting negatively on your brain chemistry, and replacing them with what impacts positively on your brain chemistry.

If you read my article on chronic pain management, you may already be familiar with some of the eith steps to ending depression. If you are on medication, keep taking it as prescribed until you and your therapist feel you can start reducing the dosage to see how you do without it. I have listed the steps in the order that the therapist who gave them to me said they should be done, and they must be done in this order, because they are a part of a process, and each step is built on the ones prior to it.

Master one step at a time and then stick to it while you move on and work the next step. All these steps ultimately work together to make you a mentally (and physically) healthier person. Some will be easier for you than others, so the amount of time each step takes is … however long it takes. Be patient and keep at it.

Step 1. Support and Enablers. You need support from family and friends to change your life and lift your depression. Resolve your relationship problems, even if the problem with a person dates back to your childhood, even if the person has been gone from your life for a decade, even if the person is long dead. Write them a letter if they live far away or you don't want to talk to them about it. And, if you feel they wronged you, forgive them. But most of all, forgive yourself for anything you've done that was wrong. Relationships go wrong because there are two people and two sides to every argument. That's part of clearing the decks for wellness.

You must also learn to spot your enablers. No one stays depressed without help from an enabler or two … or more. Enablers are not evil people bent on making your miserable. In fact, one way to spot them is that they are such sweet, well-meaning, concerned, and helpful friends, spouses, parents, etc., who feel sorry for you and want to help you and do things for you so that you don't have to do them yourself. People with physical illnesses and disabilities also have enablers. So, you need to let everyone know that you want to get better and that you need them to encourage you to make changes in your life to do so. If anyone is not supportive, you should try to reduce the time you communicate or spend time with them. They will only make it harder for you to get well. And beware, people with mood disorders tend to support each other's disability rather than try to help each other get well. This means you are both enabling each other in a relationship that neither of you may recognize as toxic.

2. Sleep. Adhering to a regular sleep schedule is one of the single most important things anyone can do that will not only help with depression and anxiety, but will also improve your overall physical health. And, if you have physical pain, a sleep schedule will actually help alleviate it. Every night, your body needs to fulfill a regenerative sleep cycle that has several sub-cycles. This cycle cannot be achieved if you don't sleep enough hours every night and don't stay asleep straight through the night. How many hours is enough? Depends on the person, but for optimum health, anywhere from six to eight hours. You will know if you're not getting enough if you are frequently tired during the day and lack the physical and mental energy to get things done. You adjust your sleep cycle based on when you get up in the morning, not when you go to bed at night.

Try to get up at the same time every day, including weekends. Stay awake all day – no napping – and go to bed about eight hours before the time you want to get up in the morning. Do not eat, watch TV, or use your tablet or cell phone for at least an hour before you go to sleep. It usually takes at least two weeks of doing this to get your sleep cycle in order. If there are reasons for the interruptions in your sleep, such as an animal, a mattress, a snoring spouse, too warm room, or some other disruption, try to find solutions for it. Your sleep is the most important bodily function you have aside from breathing and eating. Sleep well and you will feel much better mentally and physically, and you'll have far more energy too.

3. Organization. Some people have organized daily schedules. They get up, make the bed, take a shower, get dressed, feed the kids, go to work or do some other activity, and have things that they have to do, whether or not those things are enjoyable. These people rarely suffer from mood disorders. People with mood disorders rarely have a fixed schedule of any kind. Their days are more or less random, and some are unemployed or have no activity to pursue. Usually they will say they don't have time to do the things they love, but it is more likely that they have the time but are just too disorganized to make anything happen. When you get organized, you will be amazed at how much free time you suddenly have. Make a "to do" list and keep a detailed calendar. Do all your errands on a single day rather than wasting time spreading them throughout the week.

Spend some time organizing your things if you're overrun with clutter. Plastic bins or shelves can really help. Don't panic if the house, garage, or yard is a mess. Just get in the habit of cleaning up after yourself whenever you first make a mess or leave things out. As for the entire house, garage, or yard, just do one small area every day or every other day or once a week – whatever the chore dictates. And when all of those areas are done, start all over again. These areas don't ever have to be made 100% perfect in a single day. Thinking they do is really nothing more than a recipe for failure because you'll just feel too overwhelmed to tackle anything.

4. Exercise. Daily exercise, even at low levels, can dramatically reduce depression (and physical pain). How this occurs has long been debated by scientists. Many experts believe that the hypothalamus and pituitary gland in your brain produce endorphins, your body's natural pain relief chemicals. But, if you also have pain, you might be happy to know that other experts now believe that exercise-related pain relief is due to a neurotransmitter called anandamide, which becomes elevated when you exercise. And still other experts believe that both depression and pain relief from exercise is due to the release of serotonin and norepinephrine. Well, whatever the chemical reaction is in the brain, exercise offers relief.

Start with low-impact exercises such as yoga, tai chi, swimming, or simply walking. Work your way up to hiking, dancing, or gardening. And keep yourself hydrated no matter what kind of exercise you choose to do, as dehydration leads to fatigue and heightened physical pain. I get dehydrated when I work in the yard on a hot day, and I add Nuun to water to keep me on my feet.

5. Keep Busy. Find a reason to get out of bed every day. Not your children, not your spouse, not a person, but rather some thing or things that you do that are just for you. It should be for your own enjoyment or your own income, etc., like a hobby, a job, a class, or a volunteer activity. Having purpose in life will take you away from what bothers you, what you can't do, what you wish you could have done, and lead you to feeling fulfillment and satisfaction in your life. Keeping busy is also a way to promote a regular "distraction" that forces you to focus on the here and now, the present, rather than the past or what's bothering you at the moment. You simply have to find a way to get through your day in a way that does not involve laying around doing nothing because you don't feel like doing anything. You're more likely to feel better mentally and physically if you are pursuing your work or favorite hobby or volunteering to help people who are probably far worse off than you are.

Make your life a joyous experience. Take a walk in a park and revel in all of nature's glory. Play games with other people, not just games on your cell phone. Listen to positive, upbeat music. Read books – novels or non-fiction. Learn how to do something new and different by reading or taking a class or two. In fact, consider going back to school if you didn't finish. Avoid TV as much as possible, particularly news channels that dwell on the disaster of the day. You don't need to allow yourself to be depressed by news stations that broadcast negative news in order to make more money from their advertisers, many of which are pharmaceutical manufacturers. How depressing is that?

6. Meditate. This is basically the power of positive thinking and relaxation. Do it three times a day for about 5 minutes each time. It really makes a difference. I always start the day with a short meditation, do it again mid-afternoon, and again a couple hours before I go to bed. Sit upright in a chair in a quiet room or outside on a nice day. Fold your hands in your lap, tilt your head down slightly, and focus on your breathing. Breathe in and out slowly, counting to ten with each inhalation and exhalation. Do this for about a minute or so, and then you can start to send yourself positive messages and feelings of being happy, fulfilled, pain-free or whatever it is that you want to bring into your life. You can think the words or speak them softly. Always keep them positive. Don't say, "I'm never depressed," or "I'm not in pain." Leave out the words no, not, and never. Say instead, "I feel great," "I'm happy with my life," or "My body feels so relaxed," or "I have so much energy." You get the picture. You might want to reflect on a time when you were happy and/or pain-free, and try to remember how that felt.

Also, illness or pain levels are more affected by your psychological outlook than by the physical ailment itself because you tend to focus more on the pain. Meditation helps break down that psychological mechanism so that you can release at least some of your pain and despair. And now, the steps that most people find the hardest to follow, but can have a huge impact on how you feel mentally and physically:

7. Nutrition. This is often the hardest step for people with mood disorders. Depressed people are notorious for their bad eating habits, mostly their love of junk food, their love of comfort food. You don't have to give up all your junk food, but if you are hooked on sweets or mac and cheese, you could be headed for trouble. Food cannot fix what ails you when you're depressed, and it won't relieve physical pain either. It only confirms that something is wrong and that you have gotten into the (bad) habit of eating to relieve your stress, anxiety, depressive state, and/or physical pain.

The best foods are fresh foods rather than processed. Processed foods come in boxes, bags, jars, and cans. They contain large amounts of salt and sugar, and they are waaaaaay more expensive than fresh foods. Many processed foods have misleading labels saying "natural," which doesn't mean anything. You don't have to give up processed foods entirely, but they should not be the mainstay of your daily diet. The same is true of fast food, which is generally made with processed foods. There is no such thing as a bad fruit or vegetable. And, while many experts say you should only buy fruits and vegetables that are in season, many markets carry fruits and vegetables grown in all parts of the world, and there are no reputable studies that indicate they are not good for you.

There are a few caveats to eating some things. For example, when you eat a green salad, avoid head lettuce and romaine and stick with the far more nutritious mixed small greens instead. If you can tolerate them, eat plenty of bell peppers, onions, and garlic, especially the latter, which is known to lower cholesterol. With potatoes, any potato is fine, but sweet potatoes are the healthiest. Just take it easy on the butter and sour cream! Meat, poultry, and fish, like any other foods, are best purchased fresh rather than frozen. Meat is okay, but try not to overdo it. Once a week should be the most. Poultry can be eaten more frequently. Fish is really the best. Stick with salmon, steelhead trout (which is grown-up red snapper), mackerel, sardines, red snapper, rainbow trout, and herring. With salmon, especially, try to get freshwater farmed in the United States. Shellfish can be high in cholesterol – but less so than meat – so take it easy on shrimp, lobster, and crab. Clams, mussels, oysters, and other mollusks are better shellfish choices.

The big no-no's in food and drink are caffeine, sugar, and alcohol. They affect everyone differently, but in general, you should give them up or at least drastically cut down in consumption. Caffeine: This addictive substance is mainly found in soft drinks, coffee, tea, and chocolate, but is also a hidden ingredient in some chocolate yogurts or ice creams. Coffee has the highest concentration with tea coming in second. Caffeine stimulates your nervous system making you feel more alert and energetic, but if you drink it heavily or on a daily basis it can also create withdrawal symptoms as you cycle through daily highs and lows. These symptoms include headaches, nausea, diarrhea, acid reflux, irritability, confusion, sleepiness, and increased blood pressure.

Sugars can cause or contribute to fatigue, sleep problems, irritability, and mood swings, as well as physical ailments such as diabetes, arthritis, certain cancers, and osteoporosis. Simple carbohydrates that convert to sugars – such as potatoes, white rice, or pasta – can increase the body's insulin levels, triggering the body's inflammatory immune response. Processed sugars are the worst and are found in places you would not expect to find it, like potato chips, peanut butters, crackers, breads, etc. Aspartame is not a good substitute because it is an excitotoxin that activates neurons that increase your pain sensitivity, and if your depression is a reaction to pain, this will not help you at all.

Alcohol is an addictive substance that is also a depressant, whether you drink beer, wine, or hard liquor. Yet many people who suffer from depression or pain often turn to alcohol to relieve their symptoms. But, while you might feel relaxed and happy when you drink, you are only worsening your symptoms in the long run, especially if you are on medications or are using alcohol as a daily medication. Alcohol can make you fall asleep more quickly, but the quality of your sleep will not be optimum because alcohol disrupts the natural sleep cycle, which can lead to sleep deprivation, and that leads to fatigue and irritability, and more depression.

8. Other Addictions. You can be addicted to many things other than drugs, cigarettes, alcohol, or any other substance. You can also be addicted to your phone, TV, computer, porn, news, video games, etc. It is not unusual to find depressed people suffering from a combination of addictions. None of them are healthy for you, and one thing they all have in common is the inactivity that goes with them. Addicted people waste an enormous amount of time on their chosen addictions, leaving them physically inactive and often unable to pursue productive activities such as work or hobbies, or to be fully engaged in their relationships.

Get rid of your additions and start living a healthier and more fulfilling life. This is not easy to do. Quitting something cold turkey is best, but like everything else, it can also be done gradually. It's just that doing it a little at a time often results in a lot of relapses along the way. But the important thing is to end the addiction. Get help from professionals if you can't do it by yourself. You can end depression and many other mood disorders. And if you can't end them entirely, you can at least manage them better and improve your life dramatically by making the changes listed above to reduce your levels of depression or anxiety or physical pain. I have given this information to many people over the years, and only one was unable to make these changes, so I am confident that anyone can do it. You owe it to yourself to find true happiness and satisfaction in your life. Ending depression is a goal worth pursuing starting today!

03/25/2021: As Old As You Think

When I look around me, I am always struck by the diversity of people at all ages, how differently they lead their lives and what the result is. Some are "old" at 40, others at 60. I'm sure a lot of that is genetics, but how much of a role does age play in our physical condition? I think its role is a lot smaller than many of us are led to believe.

In 24 days, I will be 70 years old. Hard to believe, since I don't feel like 70. But then I didn't feel like 60 either. Or 50. Or 40. People generally assume that at 69 I'm old as the hills, a creaky, falling-down wreck of a person, unfit for anything other than sitting around all day watching TV and knitting (no offense to knitters).

Yeah, well the creaky, falling-down wreck part is sort of true since I've been living with bone and joint pain for 41 years courtesy of a major automobile accident at the age of 29. But other than that? Can't complain. I live in a 69 year-old body, complete with scars and wrinkles. But, I feel like I did when I was 40, maybe 50. Is that my imagination? No, it's not. It's a very simple fact about the aging process. You're as old as you think, and if you think you're 40, you're more likely to feel like you're 40.

Your mind has an enormous impact on how you feel and how well you age. Our thoughts are important. Many people see the big 65 as the end of the line. They see it approaching and all they can think about is retirement. Others see it as the start of bodily deterioration and ultimately the end of life. Then there are people like me. I don't think about my age at all. To me, it's just a number. Yeah, I know that sounds like a cliché, but it is what it is.

Part of the reason that I don't think about my age is that I'm a little too busy to think about it. Between taking care of my house, my yard, my cats, my mate, and all my writing and other work, I don't have time to sit around and focus on the countdown to the end of life. I'm too busy living.

I don't have a bucket list. Never did. I spent most of my life doing things that some people simply don't do. I have already traveled, and pursued all my hobbies, interests, and work that I enjoy to this day. I read, paint, take photos. I have a wide circle of friends and acquaintances, and I spend as much time with my family as is possible (the Covid pandemic is raging as I write this).

I love my life. I live my life. So what if I have a few wrinkles and some gray hairs? Big deal. So what if my body's been in pain for 41 years? I learned many years ago to distract myself from pain. What's important is that I don't think about what age I am. I know I won't live forever, but I'm not going to ruin what time I have left by shutting down and waiting for the Grim Reaper to make an appearance.

I think positively about every day. I am grateful for every day. And I plan to live each and every day I have left to the fullest. If I feel like 40 today, then I am going to live like I am 40 every day.

02/08/2021: Managing Chronic Pain

As I write this article -- probably the longest blog I will ever write - I am 69 years old, and I have been suffering from severe chronic pain in my neck, back, and hips since I was injured in a major automobile accident in 1980 at age 29. I had lots of physical therapy and also back surgery in 1984, but while it all helped a little, over the last fifteen years or so the pain has increased. My most recent MRI revealed that my spinal stenosis and general nerve damage are much worse, which account for the pain increase and worsening of the numbness in my feet than I have had in the past, and my right leg is now numb from the hip down. In other words, everything hurts 24/7.

And I am certainly not alone. Many well-known people suffer from severe pain: Kathleen Turner has rheumatoid arthritis; Sinead O'Connor, Morgan Freeman, and Lady Gaga have fibromyalgia; George Clooney injured his back and now has bolts in his spine; John F. Kennedy had chronic back pain; Dorothy Hammill suffers from osteoarthritis; Elizabeth Taylor had scoliosis and then broke her back and had five back surgeries; Jackie Chan damaged his spine and dislocated his hip; Paula Abdul has suffered chronic pain from an accident when she was a teenager; and Montel Williams has multiple sclerosis. This list could go on and on.

No one is exempt from injury and the pain that so often comes with it. And in most cases, no amount of money can fully relieve the pain. Drugs are not the best answer when it comes to managing pain. In fact, many pain medications become ineffective after awhile, many are addictive, and some have some pretty serious side effects that lead to conditions much worse than what they were treating in the first place.

Over the years, I have read sooooo many books on pain management. And, I have attended a wide variety of pain management clinics and seminars. I have learned a thing or two about managing pain. So, I decided to write up what I've learned, because in trying to solve my own pain issues, I have met many other people who are in the same boat as I am. And most of the celebrities I mentioned a couple paragraphs back have already discovered the same things I learned.

Some people may choose to do nothing to alleviate their pain and just blame the world for their sorry fate as they whine, cry, and in all ways embrace their pain and discomfort on the couch all day. Others, like me and some of the above-mentioned celebrities, take the proactive approach to managing pain. And you know what? I have seen that there are six things that can dramatically reduce pain for anyone, regardless of the original cause of their pain. This is not just my own little hare-brained opinion. It's a medical fact. And this is not a pick-and-choose your favorite remedy, it is a combination of all six things. Pick one and work on it until you have it down, then go on to another and deal with it, and so on, until you learn to effectively manage your pain.

1. Avoid or drastically cut down on caffeine. Caffeine is an addictive substance that stimulates the central nervous system of your body. It makes you feel more awake, alert, and energetic, but if ingested heavily and regularly on a daily basis, it can also cause a wide range of problems as you cycle through the ups and downs of caffeine highs and withdrawals that it creates within your body. Among the symptoms that are manifested by caffeine intake are: headaches, muscle aches, fatigue, bone problems, nausea, diarrhea, acid reflux, irritability, confusion, blood pressure increases, and even fertility issues.

Caffeine is primarily found in soft drinks, coffee, tea, and chocolate. Coffee has the highest concentration of caffeine, with tea – iced tea in particular – coming in second. High levels of caffeine are frequently "hidden" in the ingredients of products, such as some chocolate yogurts or chocolate ice creams. The amount of caffeine in soft drinks varies considerably and some can contain almost as much as that found in coffee, so be sure to read the labels and try to gradually reduce your intake and/or switch to decaf.

2. Avoid or drastically cut down on sugar. Sugar, and simple carbohydrates that convert to sugars, increase the body's insulin levels which is known to increase and/or cause pain in your organs and joints by triggering the body's inflammatory immune response. Processed sugars are the worst, and using aspartame as a sugar substitute can also cause pain because it is an excitotoxin which activates neurons that increase pain sensitivity. Sugars can also cause or contribute to fatigue, sleep problems, irritability, and mood swings, not to mention diabetes, arthritis, certain cancers, and osteoporosis.

Like caffeine, sugar is in many products where you would not expect to find it. It's found in potato chips, some peanut butters, crackers, breads, yogurt, and many condiments such as ketchup. And the simple carbs that convert to sugars include potatoes, white rice, and pasta. All of these hidden sugars add up, so one of the ways you can dramatically reduce their intake is to avoid processed foods as much as possible. This also provides the benefit of eliminating some of the additives that many experts believe are unsafe for human consumption, such as colorants and preservatives.

3. Avoid or drastically reduce alcohol consumption. This means beer, wine, and hard liquor. Many people who suffer from chronic pain turn to alcohol to relieve their symptoms. But this can create a very dangerous double-edged sword, because you might feel relaxed and happy after drinking, but in reality, all alcohols are depressants, so they really are not helping you at all, especially if you are also on prescription medications or are self-medicating with alcohol and drinking daily.

Alcohol can cause problems that ultimately adversely affect your pain levels because alcohol disrupts the sleep cycle. Yes, you sleep, but the quality of sleep is not optimum if you can't stay asleep or if you don't reach the point in the sleep cycle where your muscles all relax – a very important part of reducing muscle and joint pain in particular. This sleep deprivation leads to fatigue and irritability, both of which are contributors to pain in and of themselves. They exacerbate pain and reduce your ability to cope with pain.

4. Exercise daily. Daily exercise, even at low levels, can dramatically reduce pain levels. How this occurs has long been debated by scientists. Many have long believed that the hypothalamus and pituitary gland in your brain produce endorphins, your body's natural pain relief chemicals. But other experts now believe that the exercise-related pain relief is due to a neurotransmitter called anandamide, which becomes elevated when you exercise. And still other experts believe that the pain relief from exercise is due to the release of serotonin and norepinephrine, which also reduce depression. Well, whatever the chemical reaction is in the brain, exercise is great for pain relief.

The easiest exercises are the low-impact ones such as walking, swimming, yoga, and tai chi. These are the most popular forms of exercise for people suffering from all kinds of pain. These forms of exercise reduce pain as they build strength, endurance, and coordination. Simply stretching periodically throughout the day can help as well. Gardening is a good exercise as it puts you in touch with nature and also exercises almost every muscle in your body, but as an avid gardener, I highly recommend starting out with the less strenuous activities, because gardening for even an hour can be quite a workout. Whatever exercise you do (and even when you're not exercising), be sure to keep well-hydrated with water, because dehydration is a major contributor to pain.

5. Meditate daily. This is basically the power of positive thinking and relaxation. Do it three times a day for about 5 minutes each time. It really makes a difference. I always start the day with a short meditation, do it again mid-afternoon, and again a couple hours before I go to bed. Sit upright in a chair, fold your hands in your lap, tilt your head down slightly, and focus on your breathing. Breathe in and out slowly, counting to ten with each inhalation and exhalation. Do this for about a minute or so, and then you can start to send yourself positive messages and feelings of being pain free. You can think the words or speak them softly. Keep them positive. Don't say, "I'm not in pain." Say instead, "I feel great," or "My body feels so relaxed," or "I have so much energy." You get the picture. You might want to reflect on a time when you were pain free and try to remember how that felt. Sometimes our pain levels are far more psychological than physical, perhaps because we spend so much time focused on our pain. Meditation helps us break down that psychological mechanism so that we can release at least some of our pain.

6. Keep busy. This is probably the single most important thing you can do to reduce your pain. Work or take up a serious hobby. These will distract you from the pain. This may seem like an impossible task when you don't feel well, but part of pain relief is learning to shift your focus onto something that is bigger than your pain. And when you do, you will quickly discover that almost everything is bigger than your pain. In fact, every pain management clinic or seminar I ever attended, and every doctor I've ever consulted, has emphasized distraction through work and hobbies as the very first order of the day when it comes to pain management. And if you listen to people who have very severe pain, you will quickly learn that they are about the busiest people you will ever care to meet, and you would never know they were in pain because when they are busy, they don't have time to even think about the pain. That's me.

You simply have to find a way to get through your day in a way that does not involve laying around doing nothing because you don't feel like doing anything. People who spend their days lounging around because they are in pain are far more likely to feel their pain more intensely and also to become prone to depression and addiction. Work that you enjoy and that does not cause you undue stress is a great distraction from pain. So is a good old-fashioned hobby. Spend at least four hours every day on your work or hobby. People who have serious pain issues find that they don't react to their pain as much or at all when they are pursuing their work or favorite hobby. Many artists and musicians have discovered that their arthritis and the pain associated with it are greatly lessened when they are making art and music.

What do you do with the rest of your day? There are so many ways to distract yourself, but the main thing is to live your life, to enjoy your life. Take a walk in a park and revel in all of nature's glory. Play games. Listen to music. Read books. Watch movies. Avoid TV as much as possible, particularly news channels that dwell on the disaster of the day. You don't need to allow yourself to be depressed by news stations that broadcast negative news in order to make more money from their advertisers, many of which are pharmaceutical manufacturers. How depressing is all of that?

We all have the ability to make ourselves feel so much better and to make our lives so much more worthwhile. Do you really want to feel unwell? Of course not! Remember that pain management is a process, not an event. Your pain won't disappear overnight. But if you follow the above six steps all the time, you will find that within a matter of a few weeks you will begin to feel much improved. You may never get over your pain entirely. I sure haven't. But you can reduce your symptoms and live a happier life. And that's a lot better than laying around being miserable and wallowing in your pain.