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Question
Posted by: dizzy | 2012/05/02

Chronic pain and depression

Hi CS

I have been in a relationship with a man for 1 1/2 years and I''ve finally pulled the plug as it is dragging me down so badly. He is has been diagnosed with chronic pain, depression and dependent personality disorder with avoidant features (whatever that means). Whenever he feels the pain (complains of general musculoskeletal pain) or whenever he is overwhelmed with having to make decisions he just crashes. By crashing I mean he sleeps for days, doesn''t come out of his apartment and wont answer the phone (he is also on disability). When he is in pain or crashing he becomes totally preoccupied and selfish not caring about anyone else except himself. Then when he " comes out of it"  he apologises profusely and is loving and sensitive. When he is in crash mode the negative self talk is so depressing and he hurts everyone around him. He does not seem capable of achieving very much in his life except sleeping, paying his bills and occasionally going to the shop. He has no friends other than his ex wife and myself.

Sorry to do this to you but I have three questions.

1. What causes this crashing behaviour?
2. What direction is this chronic pain - ie does the pain set in first and then the depression or vica versa.
3. Is there any hope for people with this type of personality disorder?

I love him dearly but I was getting far too hurt and I couldnt endure the ups and downs any longer.

Thanks so much CS

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Our expert says:
Expert ImageCyberShrink

Sounds like he could, indeed, be a difficult person to live with. The dependent personality disorder is probably pretty obvious to you.
He sounds like a good example of what we call abnormal sickness behaviour. Many of us have chronic severe pain, but most of us ( furtunately ! ) don't choose to behave the way he does about it !
Pain and depression feed each other. Each makes the other worse, and treatment needs to address both components.
I know it feels bad for you to have pulled the plug, but it might actually potentially help him. Behaving as he has been choosing to do, when facied with problems, is only possible when you have a nice, kind, person around who will take up the slack and enable you to indulge in this maladaptive behaviour. He should see a psychologist with experience in such problems, and embark on energetic rehab

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Our users say:
Posted by: cybershrink | 2012/05/02

Sounds like he could, indeed, be a difficult person to live with. The dependent personality disorder is probably pretty obvious to you.
He sounds like a good example of what we call abnormal sickness behaviour. Many of us have chronic severe pain, but most of us ( furtunately ! ) don't choose to behave the way he does about it !
Pain and depression feed each other. Each makes the other worse, and treatment needs to address both components.
I know it feels bad for you to have pulled the plug, but it might actually potentially help him. Behaving as he has been choosing to do, when facied with problems, is only possible when you have a nice, kind, person around who will take up the slack and enable you to indulge in this maladaptive behaviour. He should see a psychologist with experience in such problems, and embark on energetic rehab

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