can the mind manufacture pain?

[amandaelmo]

So I spent the majority of my day in the emergency room yesterday for back and chest pain to be told they couldn’t find anything wrong, which is the story of my life.  I didn’t want to go in the first place, but my sister pressured me into it, so I went. They gave me some ridiculous prescription for ibuprofen after my films came back fine, I did not fill that prescription. That to me is the prescription you give if you either don’t know what is wrong or don’t believe the person.  They didn’t believe I was in pain.  Maybe they think I did it for the attention, I don’t know.  The point of this story is this, I had a thought occur to me a couple weeks ago, my throat was very dry and I was driving and I thought what if I am not driving and I have crashed and my throat is dry cause I am on life support in a hospital with a tube down my throat and me driving is really the dream. This occurs to me cause I am wondering now if it is possible for my mind to be making all this pain up and maybe I am just crazy? How do we really know this isn’t a dream? How can we check? Don’t get me wrong, I don’t think I’m in a dream, not completely but the thought has been occurring more and more to me lately. So if the impossible of that isn’t true, is it possible for the mind to make pain for no reason? And why would it do that, why would it torture its own self?

[amandaelmo]

Thanks for the response, I did go to the doctor today, but I don't feel any closer to getting an anwser, just more testing.  I feel like I am a guinea pig in some kind of lab experimet.  It has occured to me that I don't think the doctors I've seen necessarily understand what's going on, I feel like they are guessing what it could be like some sort of in person web md.  I don't know what's wrong and I don't think I'm explaining it right or maybe they just don't understand. It's odd, when I went to doctor, I have been feeling better the past few days and a lot of the pain had subsudied and now tonightthe pain is back. I'm thinking ow the pain is back cause maybe I am thinking about it ad maybe if I donn't think about it, I would be better, you know the whole think therefore i am thing. As for the questions..my sleep has been bad lately, its very inconsistent, mostly not enough or at least it feels like its not enough. I don't know if I'm depressed, I used to feel that my whole life has been one big depression, but I don't really trust that anymore, some people just dont have very fun lives.  Ad to be honest I really dont know what a dissociative experience is, so I couldnt tell ya if i had one or not. There's weird things like the other day I listened to a vmail from my mother on break, and i really thought i called her and had a conversation with her, so i couldnt remember what we talked about so i called her later and asked what we had talked about cause i couldnt remember and she told me i never spoke to her, later i checked my phone, and she was right i had never called her. It's just a string of weird random things, physical and in the mind, thats kinda why i feel like im going crazy a bit, like its possible its all in my mind, so thats iteresting about the brain interpreting pain.

[Peter Forster]

I am not quite sure what happened, but a whole set of replies that I posted seem to have disappeared. Anyway, my apologies for the delay in answering.

Emergency room doctors are interesting folks, I used to work in an ER and I was sometimes amazed by what they could do, and sometimes shocked by their biases about certain types of problems.

Pain that isn't a symptom of something clear (like a heart attack) probably falls into the latter category.

Pain is always the product of an interaction between nerve signals from the body and the interpretation that the mind attaches to those signals. The system works pretty well, but, as you note, sometimes the mind attaches the label "warning: serious pain and threat" to signals from the body that are not really dangerous or threatening. One reason that it can do that is if you are depressed (in that case the whole threat detection system has been set on "high" and you are going to experience as pain many things that you might not otherwise have notices). Lack of sleep can also change the set point.

The thing is, having said that this pain was not due to a heart attack or a disease of the lungs or chest, does not mean that you have an answer. And there probably is an answer.

The questions to ask are many, but just from my specialty I would wonder - Could you be depressed? Has your sleep been disrupted? Could you be having dissociative experiences? Could this be psychosis (I don't think so but we can't be sure)?

What you should ideally get is a good assessment from a doctor who is not working in an emergency room and will take the time to ask the questions and perhaps follow you for a while and figure out what is going on. That could be a good primary care doctor, or it could be a psychiatrist, really it could be almost any good doctor.

I think that there is an answer and I think that getting that answer is worth the effort.

[lindahand]

You may want to go and see a rhuematologist. It may be something like fibromyalgia, or neuropathic pain. Sometimes the mind does make pain signals where there is no physical sign of damage but that doesn't mean the pain isn't real. According to all the tests I should be fine. However I wake up in pain and go to bed in pain. The pain is very real. And there are medications that help with it such as neurontin (although I am not taking that anymore). And if they suggest you go see a counsellor - do but make sure it is someone who specializes in pain treatment. They can help teach you skills to learn how to cope with the pain.

At one time I was taking a lot of painkillers but came to the realization my pain was the same on or off them so I don't take anything for pain now. Although I know that the lamotrigine I take for bipolar helps with my pain.

You know its not a dream because your sister noticed you were in pain and suggested you go to the ER. Your body was showing your pain through your face likely. You probably noticed that you were tensed up, another pain sign. Rely on the physical sensations to tell you if it is real.

The driving incident may be a bit of psychosis. Might be worth going to see a psychiatrist to talk about it and see if there is something more to it than a day dream. Especially if it happens to you more than once.