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The RSI case of Sanjeev Sabhlok: description of the problem and its treatment.

Section 2. Psychological consequences

Psychologically, the impact of this ever increasing problem can be compared with a drowning person who is desperately trying to keep his head above the water in a storm in the sea. One's head would bob above the water for a moment and then go under. Over the months and years this enormous depressive feeling became as serious as the pain and numbness.  Among the immediate consequences of this psychological impact was strong increase in the intake of alcohol after work. I would literally drown myself in alcohol, which gave temporary respite from both forms of pain. 

The tragedy of this particular disorder is that one looks so normal on the outside that it is only the rarest of individuals that will inquire about your health, even though they may be generally aware that you have significant pain. One looks normal, and one speaks normally: therefore one must (finally!) be normal! No one even barely understands the magnitude of the pain or distress. One might even be asked to help push a table as if one were normal able bodied person.

The only "public" symptom that could possibly give away my internal pain levels away would be an extremely tired voice, with laboured breathing. When chronic pain levels intensify after a day's work, one tends to almost stop breathing. One sounds like a 85 year old man climbing a steep hill. Such a change to the voice would be noticed only by extremely perceptive people, and I did not find even one such  in these five years; not their fault – no one can perceive such a problem.

On top of everything, time gets even more scarce than it normally is. One spends significant amounts of time and energy in somehow trying to fix the pain. Tens of books, innumerable equipment, various nutritional supplements, varieties of therapies, exercises, and desperate attempts to sleep. There is no spare time for true relaxation.  Not being able to get a proper night's sleep is the most significant problem, further squeezing the limited time and creating continuous fatigue.

And one's body gets bloated as food and alcohol is used to somehow drown the pain.

Disconnectedness

One of the very strong mental consequences of this kind of "internal" (ie. publicly not visible) physical problem is the loss of the "sense of embeddedness” in this world that we normally possess without even knowing that it exists.  This sense of disconnectedness is perhaps experienced only by very few people in their lifetime, possibly under extreme psychological distress. It is not something to be lived with on a daily basis for years at a time. Unfortunately, given that one has to survive and earn a living, it is essential to go to work. Were physical symptoms of this problem visible, the problem would rate on par with childbirth, skin burn or serious bleeding, eliciting not only sympathy but virtually being compelled to take time off work.

Under such circumstances, the sense of being different and permanently defeated becomes enormously powerful. I remember completely losing interest in any other human being or event. Apart from my philosophical underpinnings that drive me away from attaching too much value to human endeavour or existence taken as part of an enormously vast cosmos, this was a far more serious psychological disconnection.  It would be something that a fish might feel when taken out of water for years on end.

It is extremely difficult - indeed impossible, to properly describe my state of mind over the past few years with mere words. As someone would pass me by carrying a briefcase, I could imagine my hands screaming in pain with that effort. When experiencing significant pain in the hands or shoulders or chest while travelling to work, I would tend to look at people's hands or shoulders etc., and would find myself completely unable to visualise how it felt for these other people to not have pain. One quickly forgets the sensation of painlessness and wonders – completely confused, what it feels like.

I have come home on many occasions, barely able to sit or lie down. Sheer frustration and helplessness have led to constant contemplation of death as the most welcome solution to this endless problem.  But of course, death does not seem to want to offer itself when most wanted. I would often contemplate various tall buildings or structures with a view to finding painless oblivion. I would not like to dwell here on some other extremely problematic consequences of such thinking.