Released in the 1980’s, as part of a record album, titled “Free to Be You and Me” there is one particular song that carries this theme. “It’s All Right to Cry”. The lyrics were sung by Rosey Grier–an actor, singer, minister, and former professional football player (NY Giants & LA Rams). It goes like this: “It’s alright to cry; crying gets the sad out of you.  It’s alright to cry; it just might make you feel better”. I share this music with my grandchildren, yet find it speaks to me as a person who lives with pain.

I want to add not only is it alright to cry, but also to have negative feelings. For those living with pain, we are frequently told a multitude of things which can make someone feel guilty when a negative thought creeps in, such as.

•  “Have a positive outlook”
•  “Depression goes along with pain”
•  “People shouldn’t get angry with what they can’t change.”

I confess that I have always cried easily but since brain trauma (from surgery) and the aftermath of persistent pain, the tears are at the ready at all times. I find that I cry when I am sad, when I hurt, when I am angry and at other negative things as well as when I am overwhelmed by beauty, heartwarming stories, things patriotic, and so on.  But you know what?  It is alright.   It is essential to say; embrace the occasional negative feeling, don’t feel the guilt; cry- it just might make you feel better.

When I first realized I had persistent pain after brain surgery, I mentioned to my physician I was angry with the nurses who cared for me while I was in the hospital. As a pain management nurse who also specialized in palliative and end of life care, I know that one of the most common risk factors for developing persistent pain happens to be the inadequate management of pain post-op (after surgery). My doctor immediately asked if I needed to talk to someone–see a counselor-for these feelings. I explained “No, this was just part of my grieving process”.

After all, when we lose someone or something (such as in my case, the future as I thought it would be) we grieve. You may recall the stages of grieving are denial, anger, bargaining, depression, and acceptance. No one goes through the same stages in the same order and we might even skip one or two. Everyone with persistent pain grieves at some point, usually more than once as there are many losses for us. When we get stuck in our grief, then working with a counselor may be helpful.

Negative feelings can come on unexpectedly or can be more predictable. One example, I know if I am having a bad pain day, I cannot see the glass as half full. I just can’t; that is predictable for me. (Frankly, I would be seriously worried about someone who was relentlessly cheerful even on bad days when the pain was barely tolerable.)  When I have even had really bad pain flares (storms or whatever you call it), where I admit I have had fleeting thoughts that if my life were to end, so would this pain. This has only occurred a few times in a year’s timeframe though and the moment the pain eases, those thoughts are gone.  Another predictable time for negative feelings come when I read something inaccurate or mean about people with pain or pain treatment plans; I will feel a combination of hurt and anger. Unpredictable times where I have experienced negative thoughts or cried seem to occur during stressful events. For example, when something comes up I would like to do with my grandchildren and decide that I cannot risk the pain it will aggravate.  The disappointment that I feel and I think I am causing my family is hard for me to handle. I am sure most of you can think of times when unpredictable events have triggered negative thoughts or caused you to cry.

Do not get me wrong. I am not saying that we should ignore negative thoughts and feelings. What I am saying is that when they become the norm as opposed to the occasional.  Clinical depression can accompany persistent pain.  Health Guide provides useful information about depression.

Signs and symptoms you should see your health care provider are:

• Feelings of helplessness and hopelessness. A bleak outlook—nothing will ever get better and there’s nothing you can do to improve your situation.
• Loss of interest in daily activities. No interest in former hobbies, pastimes, social activities, or sex. You’ve lost your ability to feel joy and pleasure.
• Appetite or weight changes. Significant weight loss or weight gain—a change of more than 5% of body weight in a month.
• Sleep changes. Either insomnia, especially waking in the early hours of the morning, or oversleeping (also known as hypersomnia).
• Anger or irritability. Feeling agitated, restless, or even violent. Your tolerance level is low, your temper short, and everything and everyone gets on your nerves.
• Loss of energy. Feeling fatigued, sluggish, and physically drained. Your whole body may feel heavy, and even small tasks are exhausting or take longer to complete.
• Self-loathing. Strong feelings of worthlessness or guilt. You harshly criticize yourself for perceived faults and mistakes.
• Reckless behavior. You engage in escapist behavior such as substance abuse, compulsive gambling, reckless driving, or dangerous sports.
• Concentration problems. Trouble focusing, making decisions, or remembering things.
• Unexplained aches and pains. An increase in physical complaints such as headaches, back pain, aching muscles, and stomach pain (that don’t improve with treatment).