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By Congressman Adam Smith
People suffering from chronic pain, anxiety, or depression--or, as often is the case, these three nasty afflictions at the same time—can feel overwhelmed and hopeless. But help is available. Unfortunately, our country’s current healthcare system and overall basic approach to these problems makes it mind-numbingly difficult to, first, find any help at all in these areas and, second, even more difficult to find help that will actually make you better.
That’s what I learned when, at the age of 47 and after a lifetime of relatively minor aches and pains and an overly stressed mental state, fell over the edge into debilitating pain and crippling anxiety. I struggled to walk, sit, or stand for any length of time, a sense of existential fear was my constant companion, and I cycled through a series of surgeries and medications that either didn’t begin to solve my problems or made them worse. Over a six-year period, I literally saw more than 100 providers of one kind or another—psychologists, psychiatrists, physical therapists, internists, massage therapists, podiatrists, naturopaths, acupuncturists, chiropractors, personal trainers, osteopathic surgeons, muscle-activation therapists and likely a few other varieties that have been lost somewhere in what was my fogged-over brain.
I quickly learned, as I began to discuss these issues with more and more people I knew or encountered in my life, that my experience was far more the norm than some kind of outlier. And I had a big advantage over many people. I had access. I was and still am a United States Congressman. I know people. I have decent healthcare coverage. Access, however, though part of the problem with our system, isn’t the only problem. Complicated healthcare problems like breakdowns in our neuromusculoskeletal system often get misdiagnosed repeatedly, and the treatments offered miss the mark with equal frequency.
I did, eventually and finally, find relief. I found both a psychologist and a muscle-activation therapist who helped me. They gave me my life back. Anybody suffering from chronic pain or a debilitating mental illness will recognize this terminology: we just want our lives back; to be free of the constant darkness of depression or the constant existential fear of anxiety or the constant inability to live our lives without being severely limited by never-ending physical pain. Millions live with one or more of these realities every day in our country.
I wrote a book about my experiences, Lost and Broken: My Journey Back from Chronic Pain and Crippling Anxiety. I hope my story, and the details around all the struggles, ups and downs, steps forward and back that I went through can help others navigate through their own journey dealing with chronic pain and mental illness. But I also hope it can add to the growing debate and discussion about how to improve all of the systems currently in place for trying to help people, systems that can and should work far better than they do.
I don’t pretend to have all the answers. I’m just absolutely convinced that if we look closely at the details of stories like mine we can learn how to better help people.
The problems getting to these solutions start with stigma and a lack of access. More and more people today are talking openly about their battles with mental illness and chronic pain, and that is a very positive development. But most people still hesitate to admit to what society often perceives as the “weakness” contained in talking openly about being in pain or, in the area where even greater stigma lies, to confessing to depression or anxiety. Then comes the fight to find a provider to help you. People lack access, even after the important improvements made by the Affordable Care Act, to the healthcare they need. They don’t have insurance, don’t have enough insurance and/or simply can’t afford the cost of care.
Even when you have resources, however, and can find providers to help with mental illness or chronic pain, problems remain. Our system pays for the quantity of care, not the quality. Healthcare providers rarely listen to and communicate clearly with their patients, largely because they get paid per visit or per treatment ordered, not for the amount of time spent actually trying to find the right diagnosis and
treatment. Once insurance decides to cover a treatment, odds are that our healthcare system will keep providing it pretty much forever regardless of how much it winds up helping the patient.
My book offers a much more detailed explanation of all of these problems, but they are significant. We can do better, and the staggering number of people needing help with chronic pain and mental illness demands that we do so.
About Adam Smith
Adam Smith is the member of Congress who represents the 9th District of the State of Washington. He was reelected to his 14th term in 2022 and has been the top Democrat on the House Armed Services Committee since 2011. He served as chair of the committee from 2018–2022 when the Democrats controlled the majority in the US House.