Q: Very Deep Emotional Pain
When I feel emotional pain, I feel deep deep deep emotional pain---to the point
of hurting so bad I can't hardly stand up. It's like somebody jabbed a knife
into me. It this a common bipolar trait. Help, no one can understand my deep,
deep pain. They think I'm overreacting but it's very, very real!!!!!! What can I
do about it. Sometimes it lasts for 10 min. or 20, or 2 hrs. then suddenly
dissipates for no reason. I feel so so alone when I go thru this deep deep kind
of pain. Like I'm totally alienated from the rest of the world
Dear Trudy --
I don't think we could go that far. But is it related to bipolar disorder? I
would think probably so, at least in some fashion.
This could be a "temperamental feature". Here's what that means. Some
people who have bipolar relatives, but who do not have bipolar disorder as such
themselves, can sometimes be "up" in energy and mood, all the time. They
don't cycle, they just stay up there, noticeably more positive, energized, and
productive than people around them. They tend, as you might imagine, to do
quite well in life. This has been called "hyperthymic temperament", from the
Greek word "thymos" which means feelings. These people have strong feelings --
generally positive ones -- all the time.
The near opposite has been called "depressive temperament". Some people
just live down there all the time. They don't cycle either. "Eeyore" from the
Pooh stories, if you know them, has been cited as the example for this.
Now, I suppose there could be an emotional equivalent in terms of capacity to
feel pain as well: more potential to experience pain, from the same emotional
experience, than other people. I've not heard this described, nor has a patient
of mine described it, at least as the sole problem. I've definitely seen folks
who seemed to be having this experience when they were having other
symptoms. But generally it would ease when their symptoms did. Thus I hope
it makes sense why I would be trying to explain the "temperament" concept.
Perhaps you are "just wired" that way.
As for "what can I do about it?" Well, I'm sure you're frustrated with
people expecting you to handle this pain as though it were like the kind of pain
they know about from their own experience. So I don't want to add to that by
sounding like I "don't believe"; I hope that the paragraphs above suggest I'm
taking you seriously. At the same time, when you get right down to it, if this
is really "temperamental", I'd think your main option is to become a real expert
in the techniques people (who don't have to live with this all the time, but are
living with it now, so are ready for treatment!) are using to handle these
kinds of symptoms. These are primarily two, that have some solid research
behind them at least. The first is cognitive behavioral therapy, which is
really hard to get expert at on your own, you generally will do best to have a
therapist who knows that technique help you (although you can read about the
guts of the technique, though reading is different than doing, in a book
called Feeling Good, by David Burns, M.D.. This technique has been
around a long time but sometimes it's hard to find a therapist who's really
proficient at it. Check by asking "do you do cognitive behavioral therapy?" Do
you prefer to use other techniques? and look for the gal/guy who emphasizes
The second technique is much "newer" in terms of research, but in my opinion
is a major addition to the CBT approach. It's called "mindfulness-based
cognitive behavioral therapy", as described in a book of that title by Zindel
Segal and colleagues -- but this too would be best to get from a therapist who
knows it and does it. The book is mostly a description for therapists of how
the technique came to be described, which aspects of Zen and other "eastern"
ways of handling thoughts and feelings have been incorporated, and how to teach
the technique in groups of clients. However, the use of this "mindfulness"
aspect of CBT I think is an important addition, especially for someone like
Finally, I'd hope that your bipolar disorder is well controlled. If it
wasn't, it's more than likely you'd see some reduction in this experience when
you were no longer cycling (in fact, if you were still cycling, I'd wonder if
you'd had times when to your surprise someone said something hurtful and you
didn't have your usual reaction, and thought that strange). Good luck
with all that.
Published January, 2004