Loneliness casts a shadow of depression and erodes self-esteem. The feeling of being alone is even more poignant for those wrestling with chronic pain and loneliness. This combination amplifies suffering and intensifies mental and physical burdens.

Throughout my life, I have navigated loneliness with a set of personal tools: faith, attention-diversion, yoga breathing, stoicism, positive self-talk, hypervigilance, problem-solving skills, active listening, body-awareness, and resilience, naming a few. These strategies, while proven effective, have been dramatically challenged as chronic pain deepened my isolation and self-identity.

My life has been saturated with loneliness, a byproduct of a childhood marred by a deep sense of unworthiness caused by relentless physical and psychological abuse. I survived by learning to see my self-worth and not depend upon others for validation. I also learned to be stoic. I avoided conflict. I stayed busy. I read voraciously (teaching myself self-confidence, faith, yoga, and how to deal with others), explored forests, and worked on the farm.

It was in the farm’s openness that my faith blossomed. I felt God walking beside me, listening as I talked about my problems. The Lord offered solace, companionship, and strength. I could develop a concept of self-worth that allowed me to be who I was and to recognize that I had intrinsic worth.

My college days continued the patterns of my youth. Loneliness remained a constant while I struggled without friends. I always wanted friends but grew accustomed to not having them. Every time I tried to incorporate friends into my life, life became too complicated, so I held people at arm’s length.

When I started my USAF career, after college, I found sanctuary and peace in working. Work became my sole focus. I buried myself in learning my job, fulfilling work responsibilities, working long hours, while avoiding anything close to a social life. I learned to project self-confidence through my professional achievements. While I had colleagues, genuine friendships eluded me. I was a success professionally and gained promotions easily; I just had no life outside work.

The stress of constantly working took a toll. At thirty-five, I developed testicular cancer. The cancer, subsequent surgery and radiation treatment dramatically decreased my stamina and energy. It impaired my ability to work and introduced a new level of loneliness into my life. I was shunned at work, as being different, less than a man.

Between cancer surgery and the onset of chronic pain, I experienced what I can only describe as divine intervention: Marianne walked through my front door.

She was a revelation, a vibrant oasis in the desolation of my existence. Marianne embodied strength, independence, intelligence, and beauty, distinguishing herself profoundly from anyone I had ever known. I fell deeply in love with her.

For the first time in my life, I had someone to talk with who wanted to listen. Our conversations weren’t just dialogue; they were lifelines, sustaining me as the foundations of my life crumbled. Her love, companionship, support, and our shared faith were gifts, enabling me to persevere through the unraveling of everything I had once relied upon.

The aftermath of radiation treatment for the cancer brought chronic pain into my life, further limiting my physical capabilities, and caused the military to reassign me to less physically demanding roles. As I faced medical retirement, the assertion that I could no longer do anything worthwhile marked a profoundly low point, challenging my identity and sense of purpose.

I do not know how I would have managed chronic pain and loneliness without Marianne’s love and support. Even though I had the same tools that had helped me to survive, just existing from day-to-day became more difficult. Marianne was there to talk to me about my fears and my life. With her encouragement and support, I found purpose in my existence.

We have actively pursued medical treatment and tried everything to contain the pain. We tried every known treatment for chronic pain: acupuncture, epidurals, magnets, massage, electricity, heat/cold, faith healing, remote healing, exercise, drugs—you name it, and I tried it.

I did everything I could to manage the pain. I focused on my faith and tried to recover my self-esteem. I did therapy for about eight years to put the past to rest. I became a peer-led support group facilitator by joining a national chronic pain association. I ran an After-School program in our neighborhood for at-risk children for five years. I volunteered at our church. I flooded my days with activities.

Even with these diversions, I hit rock bottom emotionally. When the pain worsened, I became bedridden. The pain level increased daily. My depression and anxiety rose with the pain level, and I became more isolated.

I depended upon Marianne for companionship. When she tried to maintain her own life by spending time with her friends, I felt abandoned and alone. All the ghosts of being lonely and unworthy of love came back and haunted me. Although I never lost my faith or the love I had for Marianne, I thought about suicide. Life with pain and loneliness was just too much for me. I felt hopeless and lost. I was spiraling downward, dealing with pain and loneliness.

Marianne rallied to my side after I told her about my helplessness and frustrations. We realized that as a team we could support each other through all the rough times.

After I finally stopped taking opioids, I had a new lease on life. I still had to deal with growing levels of pain, but now felt I had regained the mental ability to do just that.

Before the Pandemic, I could employ every tool in my toolbox to combat both chronic pain and loneliness. I returned to facilitating a chronic pain support group. I talked one-on-one with others dealing with all the mysteries of chronic pain and loneliness. I used my leadership skills to organize and motivate leaders of other support groups and to advocate for others with chronic pain. I provided the “lived experience” voice with national patient-oriented organizations. I became a chronic pain advocate and spokesperson for patient empowerment and patient engagement through clinical trials of new devices like virtual reality.

Our mutual friends have played a significant role in dealing with loneliness. This small circle of friends is always solicitous and has made me an integral part of our group. We meet monthly to play cards and they often come to our home for parties.

During the Pandemic, I shifted all my advocacy efforts to Zoom and other platforms so I could feel I continued to have a purpose in trying to help others. Marianne and I became wonderfully comfortable with the isolation. We spent more time together, especially around mealtime, when we would share time, making meals, eating, playing cards. (I have yet to win at Gin Rummy!)

After the Pandemic, I increased my advocacy efforts by speaking at conferences and listening to others one-on-one. I cannot say that I made friends that are close, but I have contacted people I can talk to about chronic pain and loneliness.

Life with chronic pain alone is exceedingly difficult; with depression, that life is even more difficult. You can never tell what is going to cause chronic pain to get worse – it could be the weather, what you ate, or even how you slept.

I deal with loneliness now whenever chronic pain flares. Increased pain causes me to doubt my ability to be a productive member of society. I often get caught up in feelings of inadequacy and loss of usefulness. I measure myself against what I used to do, not what I can do. Getting through this type of “funk” takes patience, time, and every tool I have.

Managing chronic pain is a day-to-day, moment-by-moment task. The same can be said with loneliness. I have found the tools for dealing with loneliness and those for managing loneliness are the same. Because everyone is different, something that works for me will not necessarily work for someone else.

I depend on my faith (and self-concept), the love Marianne and I have for each other, the occasional use of epidurals, the lessons I have from support groups, and my general “damn the torpedoes” attitude to keep me focused and moving forward each day. Sure, there are those days when nothing but bedrest works. Through all my experiences, I have learned to accept that there are always going to be days when I can do nothing but take care of myself. Even then, I try to make the best of the time “off,” sure knowing that I can always try to work my magic tomorrow or the next day.

Living with chronic pain is rough! Living with chronic pain and loneliness is even harder. I believe each of us has a choice to make–rail against suffering or learn to live with it. If you live with it, you can have true quality of life.

Onward and upward!

*****

As I drafted this article, I was reminded just how often chronic pain and loneliness can affect one’s life. As I wrote about my past, my posttraumatic stress disorder was triggered; I spent the last month depressed and unmotivated. It was a struggle to even sit down at the computer to write, much less be as active as I have been in the last year. In the last week, the pain reached a new, sustained level of intensity. The daily pain increased beyond my ability to manage. My back, abdomen, and hips were wracked with pain every time I moved. I found myself unable to walk. At the height of the pain, all the feelings of loneliness (depression and loss of self-esteem) were the focus of my mind for days.

By actively employing all the tools I have at my disposal, I have been able to come close to my baseline (that level of pain that I have experience managing) and get back to my advocacy work.

The bottom line: Never give up! We never know what we can manage.