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In addition to a desire to live, not everyone views suffering as the worst possible thing. If I had to be in serious pain every day but could keep doing many t

In addition to a desire to live, not everyone views suffering as the worst possible thing. If I had to be in serious pain every day but could keep doing many things I would rather keep living with the pain. The loss in experience is worse than any level of pain. For the obvious counterpoint: I say that from experience not naivete. I've had a nerve in my hand accidentally sliced lengthwise (for a significant length) by a surgeon. The pain was so excruciating they had to put me under before I had a heart attack (heart rate+blood pressure both went off the charts, 290bpm) However, before that happened I was much more interested in what was going on and how unique this level of pain was. It was fascinating. Prior to that I didn't really know how much pain it was possible to feel. Anyway the point is, not everyone is afraid of pain and suffering. Especially not to the point that suicide would even be considered.

kdamken 10y ago
Out of curiosity - was the pain fixed when you woke back up? Because brief, intense pain like that is one thing, but experiencing pain all day, everyday is a very different beast. Even if it's a tenth of the pain that you felt, that kind of thing really wears on you, especially after years and years and no help from doctors.
- Bartweiss 10y ago
  This, I think, is relevant to the idea that suicide is very strongly tied to exhaustion and hopelessness. Pain and grief, even when they are absolutely horrible, don't appear to be strongly correlated with suicide. Inescapable problems, even when they are not so severe, absolutely do. Broadly, people seem to turn to suicide either when their circumstances seem unimprovable (chronic pain, inescapable debt, irreparable loss) or when they lose the ability to imagine recovery (acute depression, various forms of psychosis). I think that when considering suicide, experiences like "I've been in that much pain" are basically irrelevant - the operant part is the permanence, not the severity.
  - Practicality 10y ago
    I strongly agree! I think part of the reason I (and probably many others) don't see pain as something that would lead to suicide is because I would (and do) simply accept it as a fact and I no longer see it as a problem. Kind of like being short, or not as smart as the next guy. It's just the way it is. No point worrying about it. However, if you viewed it as a serious problem and when is it going to be fixed and then... never... yeah, that would be very different.
    - Bartweiss 10y ago
      Notably, a lot of the people I know who report depression-inducing pain have distracting, breakthrough pain. Even with chronic pain, it's probably not the end of the world when it's "an ache in my knee when I move in this direction" or even "a mild ache in my knee always". But if it's "at random, frequent times, my back hurts too badly to stand or function", that's super hard to ignore or get used to, and I can see being incredibly upset by it. Cluster headaches come to mind as following this sporadic + devastating pattern, and indeed they do cause a fair bit of suicide. "Can't escape it" and "can't get used to it" are an ugly combination.
    - deleted 10y ago
      [deleted]
- Practicality 10y ago
  I've also torn three ligaments (complete separation) in my ankle and they hurt more than 1/10th of that every day. Honestly I really don't care about the pain. It bothers people around me much more that I limp severely than it bothers me that I hurt. It's not something I care to think about because when I do then I feel self-pity.
  - klibertp 10y ago
    One additional note from my side: if you're able to think about anything else than the pain without the painkillers, then my post above does not relate to you at all.
- Practicality 10y ago
  Oh and to answer the direct question, I was given strict orders from the doctor to not go off of serious pain meds (something schedule 2, I don't remember what) for 2 weeks out of the heart attack danger. I took them for about a week before forgetting about it. It was down to just like broken bone painful then so I decided to just deal with it so I could learn how to tolerate severe pain (I was 14 at the time), I figured it would be a useful skill. My parents were a little shocked that I decided to deal with it. I passed the time reading c++ books. The pain did make me take a lot of breaks and sleep to bring my willpower back. I still feel it now, but it's more like the feeling of a minor cut on your finger. Honestly, I think I have the opposite problem. Pain hasn't been sufficient for me to avoid injury. I probably could have avoided many issues if I listened to it a little.
bluehazed 10y ago
Chronic pain is an entirely different beast from acute pain.
- ethanbond 10y ago
  Totally agreed. I woke up once with severe arthralgia throughout my entire body, went to the ER and was asked to rate my pain level. Despite being the worst pain I've ever felt (woke up in tears due to the weight of the blanket on my toes), I answered a 7/10. Acute pain – not really a big deal. Unfortunately, whatever caused the arthralgia was (and still is) a complete mystery, and by day 5 of having top pediatricians explaining "nothing is out of the ordinary" I pragmatically, unemotionally contemplated suicide for the first time in my life. Somehow the ailment completely disappeared over the following weeks and hasn't returned, but it's quite something to feel that pain will truly and honestly never stop. It's not even that your brain goes into panic mode. It's a different mode of existence altogether – I can't even imagine people suffering through years of pain even 1/100th of the intensity of what I had.
  - spdustin 10y ago
    I watched my father live with the pain caused by ankylosing spondylitis [0] for decades before he died. I myself live with the pain of psoriatic arthritis[1], and occasional uveitis [2], both related conditions I knew I was genetically predisposed to (HLA-B27 [3]). It isn't easy. The pharmacological therapies I know would be most effective are too expensive. And so I have to choose how to avoid suffering from my pain, every day. I choose work, music, my family, antidepressant and anti-anxiety medication, and participating in communities (like this one) where I may find peers. [0]: https://en.m.wikipedia.org/wiki/Ankylosing_spondylitis https://en.m.wikipedia.org/wiki/Ankylosing_spondylitis [1]: https://en.m.wikipedia.org/wiki/Psoriatic_arthritis https://en.m.wikipedia.org/wiki/Psoriatic_arthritis [2]: https://en.m.wikipedia.org/wiki/Anterior_uveitis https://en.m.wikipedia.org/wiki/Anterior_uveitis [3]: https://en.m.wikipedia.org/wiki/HLA-B27 https://en.m.wikipedia.org/wiki/HLA-B27
  - guard-of-terra 10y ago
    I think we humans for some reason have ridiculously wide pain gauge. I can only theorize that we've got super pain sensitivity along with super brain. Humans are very often disabled by pain alone, with neligible body damage. That's clearly evolutionary disadvantageous. Makes torture possible, etc. Relevant xkcd: http://xkcd.com/883/ http://xkcd.com/883/
klibertp 10y ago
> If I had to be in serious pain every day but could keep doing many things I would rather keep living with the pain. Scratch that: ~~~No, you (most probably) wouldn't.~~~ EDIT: this post is about severe chronic pain. Think cancer, or a serious toothache which lasts for years. And it's not meant to discuss the specific situation of the parent! I'm talking in general. I also agree that not 100% patients with severe chronic pain will consider suicide, however the percentage of people considering suicide in such group is much higher than in the rest of the population. You may believe so right now, but that's totally irrelevant: just as you were unable to imagine "how much pain it was possible to feel" before your experience, you are unable to imagine what a serious, chronic pain can do to you. Chronic pain is a lot like depression: there's no relief, no hope, nothing you can do to ever feel any better. Assuming that you'd be able to do anything - and that doing that would even make you happy - is... well, very improbable, to say the least. > Anyway the point is, not everyone is afraid of pain and suffering. Especially not to the point that suicide would even be considered. Sure, it's easy to be brave in the face of the unknown. It's a lot harder to be brave once you see what "chronic pain" really means. And there is no notion of being brave (or not) once it actually happens to you - there's only despair and suffering. Really, only that. Nothing else, at all. We have a lot of pain management methods at our disposal now and, in many cases, it's possible to reduce the symptoms and make the patient feel "well enough". Without such help, however, it's only a matter of time before (most of) the patient considers suicide - no matter how brave and "suffering accepting" he was before.
- DominikR 10y ago
  I heavily dislike such absolute statements, especially if they are unfounded. It is merely your opinion that he wouldn't keep going with chronic pain, he has a different opinion. There's no way for us to verify yours or his claim.
  - klibertp 10y ago
    Sorry, but that patients with chronic pain are much more likely to consider suicide is an easily googlable fact. That chronic pain links with depression, which further reduces probability of "would rather keep living" is, too. Also, the "(most probably)" part of that sentence in my previous comment is there specifically to show that I'm not making absolute statements...
abandonliberty 10y ago
15 years ago I may have said something similar. I'm going to try to shed a little light on how chronic pain and disability is a bit different than acute. I've lived with chronic pain for over 10 years. As a registered person with disabilities, college resources helped me get by - but these did not exist in the real world for someone like me. It prevented me from working in my field of study and preference and severely limited my freedom and willingness to take risks. I encouraged friends and peers to chase my dreams; they have succeeded where I could not. On the spectrum of pain and disability I'm relatively lucky. My condition cannot kill me. At worst, it can only prevent me from doing what I want and deny my dreams. I have managed, and am somewhere in the top 20%. My old friends are in the top 5%. I burn my life doing irrelevant work because my employer has a good benefits package that has my back if I take a turn for the worse. Now, with age, my body and mind is starting to deteriorate, and with it the dream of figuring a way to truly overcome my challenges rather than just get by. I have it pretty good. Anyway, I'm off to an experimental treatment where they'll stab me 20-30 times with a needle. Unfortunately my condition causes hypersensitivity. Acute pain doesn't really matter though. They claim to have improvement in 70% of patients but the published, controlled, literature is less encouraging. This is the best outlook and most hope I've had in years. Maybe if I keep calm, remain positive, and make myself more susceptible to placebo I can get my life back. Or maybe I'll just be one of the lucky ones.
- colmvp 10y ago
  You nailed it. Chronic pain can be really, really, debilitating. Think about what you are going to do in a few hours. Maybe you'll hop on public transit to meetup with someone. Or maybe bike somewhere. Or take a shower. Or make a sandwich. Or make love. Now imagine if you had a really bad joint (ankle, knee) or back. Suddenly, taking public transit has additional complexities, like does the station have a lot of stairs and a lengthy distance to the train? Will I be able to get a seat? Or if I'm biking, is my commute going to flare up my joint/back? If I take a shower, I can't stand too long lest a joint start to get painful. Besides, I have to 'save' my pain threshold for situations that are a bit less controlled like walking to the bank or returning an item. Whereas most people can spend 100% concentration on their surroundings, I have to expend mental energy thinking "Where's the next seat? How long am I standing up for? Am I causing damage to myself?" When science and medicine can't do much, and quality of life drops dramatically, it's hard not to think about alternatives. Death is permanent but it does have one advantage: it's silent. There's no more pain.
beachstartup 10y ago
> However, before that happened I was much more interested in what was going on and how unique this level of pain was your post brought back a memory of mine. i crushed my finger once while doing something mechanical. the bone was crushed into pieces. it hurt so bad i started laughing. i had to be driven to the hospital because i couldn't even see straight. that level of pain is something else, for sure. it hurts so bad, but you can detach yourself from it, somehow.
frosting 10y ago
I get myself into interesting positions quite often by arguing this exact thing. Suffering is a bit of information about the state of your body/mind etc. I can imagine the best life possible, with the most contribution to society, being a huge source of pain and suffering. Generally speaking, of course, that's not a safe bet. Suffering tends to be associated with damage and psychological stress, which are rarely good things. I'd take 8/10 pain every day for the next 40 years though over something like dimentia or advanced alzheimers. That said, I'd also take pain over severe depression. That shit sucks.
BariumBlue 10y ago
Sounds like the importance of pleasure and enjoyment is greater than the importance of pain and suffering. I wonder if you could model the "suicide critical point" as the point at which the importance of pain is greater than the importance of pleasure. Somebody suffering and in pain but hopeful is not likely to commit suicide. Someone with a good, stable life and/or future but fixated on negative aspects or thinkings may be more inclined for suicide.
ohnomrbill 10y ago
There is a big difference between pain you can reasonably expect to go away and pain you cannot reasonably expect to go away. Suicidal ideation is due to the latter, not the former.
greggman 10y ago
Or it's possible we're talking about differing amount of pain or different ways we experience pain. My back gave out once and for about a week nearly every movement was excruciating. Getting out of bed was a 10 minute ordeal. Trying to sit down on the toilet or stand up was excruciating. Trying to sit down anywhere or lie back down on the a bed sent daggers of pain through my back. Turning in a chair or in the bed was just as bad. If a doctor had said "the rest of your life will be like this" I would have seriously considered ending it. I've also had bad experience with bungled root canal and a resulting toothache that required 600-800mg of ibuprofen every 2.5 hours for 4 weeks while I waited for an appointment with the dentist to fix it. If the ibuprofen had not worked and had to live with that pain I would have unquestionably ended it. Had a fingernail pulled out by a doctor once with no pain killers (well, he tried 3 injections of whatever over about 20 minutes but couldn't get the area around the nail to go numb). There's a reason denailing was used as torture. It causes extreme pain. Whether others experience similar amounts of pain or I'm just a whimp I have no idea but of course I only have my experience to go on and I have a hard time believing if people experienced the same amount of pain every day they could truly live with it.

kdamken 10y ago

Out of curiosity - was the pain fixed when you woke back up? Because brief, intense pain like that is one thing, but experiencing pain all day, everyday is a very different beast. Even if it's a tenth of the pain that you felt, that kind of thing really wears on you, especially after years and years and no help from doctors.

Bartweiss 10y ago
This, I think, is relevant to the idea that suicide is very strongly tied to exhaustion and hopelessness. Pain and grief, even when they are absolutely horrible, don't appear to be strongly correlated with suicide. Inescapable problems, even when they are not so severe, absolutely do. Broadly, people seem to turn to suicide either when their circumstances seem unimprovable (chronic pain, inescapable debt, irreparable loss) or when they lose the ability to imagine recovery (acute depression, various forms of psychosis). I think that when considering suicide, experiences like "I've been in that much pain" are basically irrelevant - the operant part is the permanence, not the severity.
- Practicality 10y ago
  I strongly agree! I think part of the reason I (and probably many others) don't see pain as something that would lead to suicide is because I would (and do) simply accept it as a fact and I no longer see it as a problem. Kind of like being short, or not as smart as the next guy. It's just the way it is. No point worrying about it. However, if you viewed it as a serious problem and when is it going to be fixed and then... never... yeah, that would be very different.
  - Bartweiss 10y ago
    Notably, a lot of the people I know who report depression-inducing pain have distracting, breakthrough pain. Even with chronic pain, it's probably not the end of the world when it's "an ache in my knee when I move in this direction" or even "a mild ache in my knee always". But if it's "at random, frequent times, my back hurts too badly to stand or function", that's super hard to ignore or get used to, and I can see being incredibly upset by it. Cluster headaches come to mind as following this sporadic + devastating pattern, and indeed they do cause a fair bit of suicide. "Can't escape it" and "can't get used to it" are an ugly combination.
  - deleted 10y ago
    [deleted]
Practicality 10y ago
I've also torn three ligaments (complete separation) in my ankle and they hurt more than 1/10th of that every day. Honestly I really don't care about the pain. It bothers people around me much more that I limp severely than it bothers me that I hurt. It's not something I care to think about because when I do then I feel self-pity.
- klibertp 10y ago
  One additional note from my side: if you're able to think about anything else than the pain without the painkillers, then my post above does not relate to you at all.
Practicality 10y ago
Oh and to answer the direct question, I was given strict orders from the doctor to not go off of serious pain meds (something schedule 2, I don't remember what) for 2 weeks out of the heart attack danger. I took them for about a week before forgetting about it. It was down to just like broken bone painful then so I decided to just deal with it so I could learn how to tolerate severe pain (I was 14 at the time), I figured it would be a useful skill. My parents were a little shocked that I decided to deal with it. I passed the time reading c++ books. The pain did make me take a lot of breaks and sleep to bring my willpower back. I still feel it now, but it's more like the feeling of a minor cut on your finger. Honestly, I think I have the opposite problem. Pain hasn't been sufficient for me to avoid injury. I probably could have avoided many issues if I listened to it a little.

bluehazed 10y ago

Chronic pain is an entirely different beast from acute pain.

ethanbond 10y ago
Totally agreed. I woke up once with severe arthralgia throughout my entire body, went to the ER and was asked to rate my pain level. Despite being the worst pain I've ever felt (woke up in tears due to the weight of the blanket on my toes), I answered a 7/10. Acute pain – not really a big deal. Unfortunately, whatever caused the arthralgia was (and still is) a complete mystery, and by day 5 of having top pediatricians explaining "nothing is out of the ordinary" I pragmatically, unemotionally contemplated suicide for the first time in my life. Somehow the ailment completely disappeared over the following weeks and hasn't returned, but it's quite something to feel that pain will truly and honestly never stop. It's not even that your brain goes into panic mode. It's a different mode of existence altogether – I can't even imagine people suffering through years of pain even 1/100th of the intensity of what I had.
- spdustin 10y ago
  I watched my father live with the pain caused by ankylosing spondylitis [0] for decades before he died. I myself live with the pain of psoriatic arthritis[1], and occasional uveitis [2], both related conditions I knew I was genetically predisposed to (HLA-B27 [3]). It isn't easy. The pharmacological therapies I know would be most effective are too expensive. And so I have to choose how to avoid suffering from my pain, every day. I choose work, music, my family, antidepressant and anti-anxiety medication, and participating in communities (like this one) where I may find peers. [0]: https://en.m.wikipedia.org/wiki/Ankylosing_spondylitis https://en.m.wikipedia.org/wiki/Ankylosing_spondylitis [1]: https://en.m.wikipedia.org/wiki/Psoriatic_arthritis https://en.m.wikipedia.org/wiki/Psoriatic_arthritis [2]: https://en.m.wikipedia.org/wiki/Anterior_uveitis https://en.m.wikipedia.org/wiki/Anterior_uveitis [3]: https://en.m.wikipedia.org/wiki/HLA-B27 https://en.m.wikipedia.org/wiki/HLA-B27
- guard-of-terra 10y ago
  I think we humans for some reason have ridiculously wide pain gauge. I can only theorize that we've got super pain sensitivity along with super brain. Humans are very often disabled by pain alone, with neligible body damage. That's clearly evolutionary disadvantageous. Makes torture possible, etc. Relevant xkcd: http://xkcd.com/883/ http://xkcd.com/883/

klibertp 10y ago

> If I had to be in serious pain every day but could keep doing many things I would rather keep living with the pain. Scratch that: ~~~No, you (most probably) wouldn't.~~~ EDIT: this post is about severe chronic pain. Think cancer, or a serious toothache which lasts for years. And it's not meant to discuss the specific situation of the parent! I'm talking in general. I also agree that not 100% patients with severe chronic pain will consider suicide, however the percentage of people considering suicide in such group is much higher than in the rest of the population. You may believe so right now, but that's totally irrelevant: just as you were unable to imagine "how much pain it was possible to feel" before your experience, you are unable to imagine what a serious, chronic pain can do to you. Chronic pain is a lot like depression: there's no relief, no hope, nothing you can do to ever feel any better. Assuming that you'd be able to do anything - and that doing that would even make you happy - is... well, very improbable, to say the least. > Anyway the point is, not everyone is afraid of pain and suffering. Especially not to the point that suicide would even be considered. Sure, it's easy to be brave in the face of the unknown. It's a lot harder to be brave once you see what "chronic pain" really means. And there is no notion of being brave (or not) once it actually happens to you - there's only despair and suffering. Really, only that. Nothing else, at all. We have a lot of pain management methods at our disposal now and, in many cases, it's possible to reduce the symptoms and make the patient feel "well enough". Without such help, however, it's only a matter of time before (most of) the patient considers suicide - no matter how brave and "suffering accepting" he was before.

DominikR 10y ago
I heavily dislike such absolute statements, especially if they are unfounded. It is merely your opinion that he wouldn't keep going with chronic pain, he has a different opinion. There's no way for us to verify yours or his claim.
- klibertp 10y ago
  Sorry, but that patients with chronic pain are much more likely to consider suicide is an easily googlable fact. That chronic pain links with depression, which further reduces probability of "would rather keep living" is, too. Also, the "(most probably)" part of that sentence in my previous comment is there specifically to show that I'm not making absolute statements...

abandonliberty 10y ago

15 years ago I may have said something similar. I'm going to try to shed a little light on how chronic pain and disability is a bit different than acute. I've lived with chronic pain for over 10 years. As a registered person with disabilities, college resources helped me get by - but these did not exist in the real world for someone like me. It prevented me from working in my field of study and preference and severely limited my freedom and willingness to take risks. I encouraged friends and peers to chase my dreams; they have succeeded where I could not. On the spectrum of pain and disability I'm relatively lucky. My condition cannot kill me. At worst, it can only prevent me from doing what I want and deny my dreams. I have managed, and am somewhere in the top 20%. My old friends are in the top 5%. I burn my life doing irrelevant work because my employer has a good benefits package that has my back if I take a turn for the worse. Now, with age, my body and mind is starting to deteriorate, and with it the dream of figuring a way to truly overcome my challenges rather than just get by. I have it pretty good. Anyway, I'm off to an experimental treatment where they'll stab me 20-30 times with a needle. Unfortunately my condition causes hypersensitivity. Acute pain doesn't really matter though. They claim to have improvement in 70% of patients but the published, controlled, literature is less encouraging. This is the best outlook and most hope I've had in years. Maybe if I keep calm, remain positive, and make myself more susceptible to placebo I can get my life back. Or maybe I'll just be one of the lucky ones.

colmvp 10y ago
You nailed it. Chronic pain can be really, really, debilitating. Think about what you are going to do in a few hours. Maybe you'll hop on public transit to meetup with someone. Or maybe bike somewhere. Or take a shower. Or make a sandwich. Or make love. Now imagine if you had a really bad joint (ankle, knee) or back. Suddenly, taking public transit has additional complexities, like does the station have a lot of stairs and a lengthy distance to the train? Will I be able to get a seat? Or if I'm biking, is my commute going to flare up my joint/back? If I take a shower, I can't stand too long lest a joint start to get painful. Besides, I have to 'save' my pain threshold for situations that are a bit less controlled like walking to the bank or returning an item. Whereas most people can spend 100% concentration on their surroundings, I have to expend mental energy thinking "Where's the next seat? How long am I standing up for? Am I causing damage to myself?" When science and medicine can't do much, and quality of life drops dramatically, it's hard not to think about alternatives. Death is permanent but it does have one advantage: it's silent. There's no more pain.

beachstartup 10y ago

> However, before that happened I was much more interested in what was going on and how unique this level of pain was your post brought back a memory of mine. i crushed my finger once while doing something mechanical. the bone was crushed into pieces. it hurt so bad i started laughing. i had to be driven to the hospital because i couldn't even see straight. that level of pain is something else, for sure. it hurts so bad, but you can detach yourself from it, somehow.

frosting 10y ago

I get myself into interesting positions quite often by arguing this exact thing. Suffering is a bit of information about the state of your body/mind etc. I can imagine the best life possible, with the most contribution to society, being a huge source of pain and suffering. Generally speaking, of course, that's not a safe bet. Suffering tends to be associated with damage and psychological stress, which are rarely good things. I'd take 8/10 pain every day for the next 40 years though over something like dimentia or advanced alzheimers. That said, I'd also take pain over severe depression. That shit sucks.

BariumBlue 10y ago

Sounds like the importance of pleasure and enjoyment is greater than the importance of pain and suffering. I wonder if you could model the "suicide critical point" as the point at which the importance of pain is greater than the importance of pleasure. Somebody suffering and in pain but hopeful is not likely to commit suicide. Someone with a good, stable life and/or future but fixated on negative aspects or thinkings may be more inclined for suicide.

ohnomrbill 10y ago

There is a big difference between pain you can reasonably expect to go away and pain you cannot reasonably expect to go away. Suicidal ideation is due to the latter, not the former.

greggman 10y ago

Or it's possible we're talking about differing amount of pain or different ways we experience pain. My back gave out once and for about a week nearly every movement was excruciating. Getting out of bed was a 10 minute ordeal. Trying to sit down on the toilet or stand up was excruciating. Trying to sit down anywhere or lie back down on the a bed sent daggers of pain through my back. Turning in a chair or in the bed was just as bad. If a doctor had said "the rest of your life will be like this" I would have seriously considered ending it. I've also had bad experience with bungled root canal and a resulting toothache that required 600-800mg of ibuprofen every 2.5 hours for 4 weeks while I waited for an appointment with the dentist to fix it. If the ibuprofen had not worked and had to live with that pain I would have unquestionably ended it. Had a fingernail pulled out by a doctor once with no pain killers (well, he tried 3 injections of whatever over about 20 minutes but couldn't get the area around the nail to go numb). There's a reason denailing was used as torture. It causes extreme pain. Whether others experience similar amounts of pain or I'm just a whimp I have no idea but of course I only have my experience to go on and I have a hard time believing if people experienced the same amount of pain every day they could truly live with it.