Reader’s Question

I am at the end of my rope! I have had lower disc and back surgery, and more back problems for years. I have gained a lot of weight and am on several meds for pain and depression and high blood pressure. I want my old life and body back, but my problems are too big for me to handle! I have no energy, sex drive or motivation to go the gym because when I do I end up hurting and my morphine makes me sweat while I swim. I’ts not fun. I am seeing a pain management doctor, a clinical psychologist, and my pastor.

What a mess I am in. I used to be strong and lean and handsome and motivated. Now I am fat, tired, depressed, and in pain all the time. I’m 44 years old, 6′ 5″ 280lbs white male, married 20 years and have 4 children.

Our Clinical Psychologist’s Reply

You are already involved with several professionals, including a clinical psychologist. Your situation would be difficult to manage as multiple problems are present. In such situations, it’s often helpful to focus on one or two areas at a time.

In your situation, it’s going to be easier to get your life back than get your body back. To accomplish this, I’d recommend focusing on depression first. I didn’t see a psychiatrist on your case so the first concern might be the use of an antidepressant medication. Important questions are:

1. Am I taking an effective dose of my antidepressant? Many nonpsychiatrist physicians prescribe antidepressants at a low dose or don’t increase the dose over time to improve effectiveness.
2. Is there a better antidepressant if my current med isn’t working?
3. Is there an antidepressant that works better when chronic pain is involved? “Cymbalta” for example is considered very helpful as an antidepressant and when physical symptoms of ache/pain/neuropathy are present.
4. Am I actively working to improve my mood or am I waiting for the medication to fix it? Antidepressant medications work best when the patient is actively involved in the recovery process.

To get your life back, we then expand our positive activities within the limits of our physical restrictions. If we can no longer play baseball, golf, or tennis — we can coach our children or become involved in volunteer work. Work with your clinical psychologist to develop a treatment plan to improve your quality of life. Millions of adults have physical restrictions and limitations for a variety of reasons. The goal is to have a great life within the boundaries of our existing limitations.