Signs may include sad mood on most days, loss of interest in activities that were once pleasurable, change in weight (gain or loss of 5 percent or more within a month), sleep disturbance, fatigue, difficulty concentrating and feelings of hopelessness.

Although all of the symptoms of depression are significant, let’s focus on hopelessness. Even if you are not depressed, you may find that your chronic pain sometimes triggers hopelessness. I have often heard people with chronic pain express feelings of hopelessness, such as:

“My chronic pain has lasted for ten years, and the treatments don’t work very well. How can I be hopeful?”

“Since my injury, I’ve lost my ability to do most of the things I love. I don’t think life can ever be good again.”

“It’s hard to play with my kids when I’m worried about my back. I feel like I have lost the ability to be their dad.”

“I can’t do my job anymore. I feel worthless.”

Loss of hope is common and often may seem a reasonable response to your situation—but anyone who closes the door against the possibility of a better future may miss opportunities for life to improve. It is important to note that hope is not the same as wishful thinking. Hope is based on real possibilities for something better. Often, the “something better” has to be created or discovered.

Setting small, attainable goals may help you to believe that life can improve even though you live with chronic pain. The best type of hope is attached to a plan. But before talking about a plan, let’s look at the areas of life where you may rediscover hope:

• Social – Friends
• Social – Family
• Relationships with Intimate Partner
• Work
• Activity Level
• Exercise
• Emotional
• Leisure
• Personal Growth/Learning
• Household
• Parenting
• Self-Care
• Spiritual/Religious

Notice that “Curing My Pain” is not on the list. Even if pain is unavoidable, hope in other areas of life can be found. Your life can improve, despite your pain.

1. Look at each area of life and think about your goals. (See worksheet.) This doesn’t mean you have to work on goals in all areas, it is just a way to get started. For example, as a general goal in the category of “Social – Family,” you might write, “I want to spend more time with my grandkids, Emma and Josh.”

2. List one or two that address each general goal. For example, you might list “Attend Josh’s basketball games every other Thursday night” and “Invite Emma to come over on Sunday afternoon at 3:00.” In our example, if you are missing your grandchildren and feeling sad and hopeless, planning specific activities will provide hope.

Here’s another example. Suppose your general goal for “Self-Care” is “Take better care of my health.” Two specific activities may be “Cook plant-based meals on Monday and Wednesday nights; select recipes and grocery shop on Sunday morning” and “Do a 15-minute relaxation meditation every evening at 9:30; do a YouTube search to find a variety of relaxation sessions.” As you begin to see results of your new self-care routines, you will feel more hopeful that you can care for yourself.

3. It is important that your specific activities are small and manageable and contain details such as who, what, when and where. Schedule any tasks related to your specific activities onto your calendar and send yourself a reminder if the calendar is electronic. You may want to invite others to join you.

4. Select a day/time each week to review goals/activities you have pursued during the week. Think about which of the activities helped you to rediscover hope. Continue those that were useful, and create additional plans for new activities. Allow yourself to experiment without judgment or criticism. There is no right or wrong goal. When you are planning, you are taking control…and that is what matters. The best hope is attached to a plan.

About the Author. Dr. Linda Ruehlman is a social/health psychologist and researcher, co-founder of Goalistics, and director of the Chronic Pain Management Program, an interactive site that helps people with chronic pain to manage their pain and live richer, more effective lives as well as Think Clearly about Depression, a self-management program for depression.

DISCLAIMER: This blog is provided as an educational and informational resource only. It is not intended nor implied to be a substitute for professional psychological or medical advice.