Key takeaways:
For a time, the twin stressors of work and home dominated Deborah Pleasant’s life.
To manage her anxiety, she learned to make self-care her priority.
Today, she focuses on activities she enjoys.
In 2004, Deborah Pleasant’s facial pain reached a tipping point. She collapsed in agony — literally, onto the floor at her boss’s party — and had to go to the hospital.
For a month, she had suffered sporadic yet debilitating pain on the left side of her face, and no one could figure out why. But that day in the emergency room, doctors diagnosed her with trigeminal neuralgia (TN), something the Scholarly Journal of Otolaryngology describes as “the most painful condition known to mankind, so much so that it has been described as suicide illness.”
TN is a chronic pain condition, caused by a problem with the trigeminal nerve. According to the National Institutes of Health, TN can occur as a result of aging, multiple sclerosis, brain lesions, or a tumor compressing the trigeminal nerve. Deborah’s doctors — who diagnosed her with anxiety and depression — considered the pain to be the way anxiety manifested in her.
Today, the now-retired U.S. Air Force major is doing much better. The California resident fills her calendar with hikes on the trails near her Redondo Beach home, lunches with friends, and travel to exotic destinations — things she enjoys most, but previously lacked the opportunity to do. “Basically, I got a life and quit waiting for others to have a life with me,” she says.
The physical side of anxiety
Deborah, now 59, recalls the days when the twin stressors of work and home dominated her life. “Workplace dynamics” made her dread going in each day. But she felt trapped because, in the military, her only options were to quit and lose her pension, or tough it out another 18 months or so when she could retire with 20 years of service. At home were her two children, one of whom is on the autism spectrum, and her husband, an avowed workaholic.
“Those were some lonely years,” she says. “I’m a people person, OK? And I need to have a lot of socializing in my life.” Having no friends at work and no one at home to watch the children should she want to go out only worsened her anxiety. “You can only handle so much, and then your body starts reacting.”
While there’s no clear medical evidence that anxiety can make you get TN, Deborah and her doctors said that’s how physical symptoms presented for her. During the month before her collapse, she experienced shooting daggers of pain from above her left ear down through her jaw. Thinking there was something wrong with her teeth, she made several trips to the dentist. X-rays revealed no cavities or infection. Despite that, her dentist replaced a filling and performed two root canals. The pain persisted. At night, Deborah paced the floors of her home, sobbing in pain.
The ‘suicide disease’
According to the National Institute of Neurological Disorders and Stroke, chronic pain from TN is frequently “isolating and depressing” for those who suffer from it. The condition is also rare, with fewer than 15,000 new cases per year in the US. It is often called the “suicide disease.”
TN pain is usually caused by a pressure or irritation in the trigeminal nerve. The trigeminal is responsible for sensation and movement in your face. The nerve has three branches — upper, middle, and lower — that spread from behind the ear on either side of the face across the cheeks, jaw, lips, and nose. A TN attack can last from a few seconds to 2 minutes and be physically and mentally incapacitating. The American Association of Neurological Surgeons notes that while the disorder can occur at any age, it is most common in people over the age of 50.
Deborah was 42 the night of that 2004 party. Between hospital visits, surgery to relieve pressure on the trigeminal nerve, and cocktails of painkillers and anticonvulsant meds, she was often out on sick leave a month at a time. In 2006, she’d reached 20 years of service and retired from the Air Force.
And the pain all but disappeared.
“I was still taking the medicine, and all of a sudden I noticed I didn’t have the pain anymore,” she says. “I still had my anxiety, but it wasn’t about work anymore.”
About a year after retirement, she went off the nerve blockers and painkillers. “Getting rid of that stress eliminated the pain,” she says. What was left was home-related anxiety. Still, “when I went down to just one type of stress, I was able to manage.”
Counseling and coping skills helped
Through counseling, Deborah explored the choices she’d made, acknowledged that some weren’t the best, and learned how to either accept and learn to live with those choices, or walk away.
“In other words, for your own mental health, you cannot just sit here in this anxiety,” she says. “I decided I wasn’t going to walk away, and the way I learned to accept things is if I just started kind of making my own life.”
She began by going back to school for interior architecture. “That created a whole new outlet for me. I started having my own friends and doing stuff that I wanted to do,” she says. “I have my family, I still have my husband, but I’m not looking for them to fill my dance card.”
She has had times when the pain has returned and she has had to go back on nerve blockers, but that hasn’t lasted.
Today, “I don’t take anything for anxiety right now. I walk a lot and spend time with my friends. My husband nicknamed me ‘walkie talkie.’”
She travels a great deal more, often without her husband, but sometimes with her daughter and special-needs son. When she’s away with friends, she hires a caregiver to make sure her son gets to and from school and appointments.
For Deborah, the key to managing anxiety continues to be making the right choices for her mental health. “What was bothering me was that I felt like I was trying to change something that wasn’t changeable,” she says. What she chose to change was making herself her priority.
Physician’s perspective from Dr. Sarah Gupta:
“Though there is no clear evidence at this point that trigeminal neuralgia is caused by anxiety or stress, there’s definitely a link between anxiety and chronic pain. People with neuropathic pain (from nerve damage or injuries) can absolutely benefit from a well-rounded treatment plan that not only addresses their pain directly, but also focuses on improvements in other related areas like sleep, mood, and anxiety.”
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