On bad days, I don’t know where the anxiety stops and the chronic pain begins. The tightening in my chest could be a warning of a panic attack or of a fibromyalgia flare that will spread across my chest, down my arms, and into my hands, rendering me unable to write — both my work and my passion — or to hug my loved ones. The need to lie down in a quiet, darkened room could be because of sensory overload that triggers my chronic fatigue, or a trauma trigger that means I need the safety of my bed and the darkness that is by turns both comforting and lonely. The resulting pain and depression seem to roll into one.

Am I depressed because I am in pain, or in pain because I’m depressed?

I was diagnosed with PTSD and accompanying anxiety and depression in 2010, after fleeing a violent relationship. While PTSD can become less acute over time, particularly with the right care and support, trauma leaves a mark. In my case, both neural pathways in my brain and scars upon my body. But six years on, after a lot of therapy, rebuilding of my life, and a new, loving relationship where I do not fear for my life on a daily basis, I was healing. I was less anxious and less prone to bouts of depression, and bad days were getting further apart.

Then it came back, and with it, new diagnoses that affected my body as well as my mind (if the two can even be said to be fully separate.)

I gave birth to my third child in 2016 after traumatic three-day labor which hit all of my trauma triggers and sent me into a state of extreme disassociation that my newly-qualified midwife had no idea how to handle. My husband was fantastic, but the fear on his face started to mirror my own.

For days afterward I couldn’t let go of my son without being plunged into acute terror. The only thing that soothed me was the soft warmth of his little body and the sound of his heartbeat. The psychiatric nurse diagnosed me with PTSD, again, and gave me medication that meant I couldn’t breastfeed. A relief, because the sensation was suddenly triggering, and now I had an excuse to switch to bottles without feeling like a failure.

All of a sudden, the world was a dangerous place again. Monsters lurked in every shadow, and nightmares prowled my sleep, making rest impossible.

Then the pain started.

Chronic pain and fatigue are often correlated with trauma-related mental health disorders, and at first, I assumed they would go away as my mental health improved. Which it did, slowly, especially when my son got older and more robust and I stopped compulsively waking him up to check that he was still breathing. But instead, as my head cleared, my body just hurt more, and after a while, all my symptoms started to blur together.

My doctor made noises about psychosomatic disorders and suggested the psychiatrist again, while I cried and begged for painkillers. It was a relief when I was finally referred to the endocrinologist and diagnosed with both fibromyalgia and ME, although that relief wore off when I was told they were ‘not curable, but treatable’ and I would potentially spend the rest of my life managing them, just as I would my anxiety.

A few years on, time is measured in moments, not days.

I make no pretense of how I feel about the ‘self-improvement’ approach to both anxiety disorders and chronic pain as if we could think our way out of over-thinking or feel our way out of extreme physical sensitivity, but I do like gratitude lists. When the sun bursts through my window and my youngest laughs at the dust dancing in the air, turned golden by the light, I am suddenly reminded that I am, in spite of it all, glad to be here. On some days when getting out of bed is a feat beyond me, the tree across the road becomes my companion. This may sound trite to those who have been accustomed to taking such things for granted, but there are days when the beauty of the sky can move me to tears, and I find a feeling of safety — that too often eludes me — in such moments.

I try to remind myself that I am not alone.

Even if it feels like it, and even if there are days when I want to be. It is not uncommon, for those with mental health disorders to also experience chronic illness in other forms. I am not unique, trapped in my own cage of fear and pain. And there are others, I’m sure, who cry at the sunset too, just because there are too many nights when bedroom ceilings, or the walls of institutions, have been all we can see.

I have to try not to get angry. At my old abuser. A medical system that too often dismisses, stigmatizes, and marginalizes us, and shows such a lack of understanding of how childbirth can and does affect trauma survivors. In an economic system that means I am only ever one client away from poverty, and so when my hands seize up, the fear is not of the past but of the future. Some days it is hard, and on other days the anger is not a bad thing. It is better than the numbness. It is better than pain, gnawing relentlessly at my joints like a hungry dog on a bone.

My favorite days, of course, are the ones when all this fades into the background, the sunlight dances like golden dust in the air, and my son laughs, coaxing a smile reserved for such moments. I string these memories together like beads on a rosary, points of solidity in an otherwise never-ending loop.

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Kelly Palmer

Kelly Palmer is a neurodivergent psychotherapist and counsellor from the Midlands in the UK, a Senior Accredited Member of the ACCPH, and an Advanced Practitioner with the Federation of Drug and Alcohol Practitioners. She also works as a doula and birth coach and is the bestselling author (writing as Michelle Kelly) of commercial fiction. She has also written for The Telegraph, the Fix, and Sojourners.