Today I want to address a topic that sits in all of our minds but is rarely spoken about aloud. Trigeminal neuralgia — in all its forms — also carries a second, deeply unfortunate name that some of you have encountered in doctor's offices. Fortunately, that never happened to me personally, but I came across it while reading one of the first articles about neuralgia online.
As an author publishing on new platforms, I need to be careful with wording. Still, I want this article to reach everyone dealing not only with chronic pain, but also with all the consequences of living with a physically demanding discomfort that affects the mind as well.
Body and mind are one
For many years, medicine treated pain and psyche as two separate worlds. On one side was the body — nerves, receptors, muscles, skin — assessed through test results, MRIs, and reports. On the other was the psyche — emotions, mood, anxiety, depression, and coping.
Patients entered the first world, and the system often forgot about the second. Today, more researchers — particularly neurobiologists — speak clearly: this division makes little sense. Body and psyche do not function in isolation from each other.
Yet I have the impression this shift in thinking hasn't reached all medical offices. Especially those where a patient with chronic pain appears — pain that is not simply pain lasting longer. It's not a mere extension of acute pain after an injury or procedure. It's a far more complex phenomenon that researchers worldwide increasingly describe not just as a symptom, but as a state affecting the functioning of the entire organism.
What chronic pain actually takes
At some point, we stop fighting only the pain. We begin fighting exhaustion and insomnia. Fear of another day. Constant self-monitoring. Questions that return regularly: "Will today hurt badly?", "Will I be able to leave the house?", "Will it ever stop?"
People who have never experienced chronic pain often imagine it as a more intense version of ordinary pain: it hurts, you take a pill, it passes. But life with pain looks different. There is no "painkiller" that switches off neuropathic pain. Not everyone can count on a procedure that alleviates the intensity. At some point, the adversary is no longer just the pain itself — it becomes the life that step by step begins adapting to it.
Chronic pain can take a surprising amount away. First spontaneity, then the sense of safety, then the ability to plan. Eventually it can even take the sense of being yourself.
A slow process
It doesn't happen suddenly. There's no single threshold where a person says: "From today, I'm not coping psychologically." It's rather a slow process like water wearing away rock. Every individual day seems survivable. The problem is that there become a hundred, two hundred, a thousand such days...
That's precisely why research has shown for years a strong connection between chronic pain and low mood, anxiety disorders, and depression. Not because people in pain are psychologically weaker — the reason is simple: the body was not designed for constant functioning in alarm mode.
Pain is a warning signal meant to relay information to the brain: "something is wrong, react." The problem arises when that alarm doesn't switch off for months or years.
Thoughts that frighten us
This is where a topic arises that is very rarely discussed, though it probably runs through the minds of many people living with chronic pain. There are moments when the problem is no longer the pain itself, but exhaustion from daily life with it. Thoughts begin appearing that we don't always control: "I don't want to exist in this state anymore," "I could just not wake up," "I'm tired of this life."
Many people fear such thoughts. They view them as something shameful or dangerous. But they are more a story about the limits of human endurance than about a desire for death. None of us wants to stop living... we simply — humanly — very often want to stop suffering.
Paradoxically, patients learn about all this least often. After diagnosis they hear what medications to take, what tests to run, when to return for follow-up. They rarely hear: "This can be very difficult psychologically." Even more rarely: "If you feel emotionally shattered, it doesn't mean something abnormal is happening." I believe that sentence should be said more often.
There is no single solution
No single pill solves the problem. Just as there is no one solution for everyone. The path to recovering balance rarely follows a single track. Sometimes standard treatment helps, sometimes therapy support, sometimes movement if the body allows it, and sometimes simply the presence of people who stay beside you — or a place where you feel truly understood for the first time.
Support groups have a hidden side
Although vital for everyone living with pain, people most often appear in support groups when things are bad. When pain becomes unbearable, when fear and helplessness arise. We rarely see those who over time regained balance, because when improvement comes, many simply return to life.
This can create a very misleading picture of reality — an impression that chronic pain is a road leading in only one direction, that everything only gets harder over time. But reality is far more complex. Life with chronic pain rarely looks like a straight line. More often it resembles a road full of turns, worse moments, and moments where a person relearns themselves and their limits.
Remember you are not alone
Even if chronic pain sometimes convinces you that you've been left completely alone with all of this — it's not true. I am here to support you. There are people going through similar experiences, online support groups, forums, and communities where you can meet people who truly understand life with pain.
But there are also places you can turn to when it's simply too heavy and you need to talk, need support, or need help right now.
Crisis resources:
- 988 Suicide and Crisis Lifeline (US) — call or text 988, available 24/7
- Crisis Text Line — text HOME to 741741
- Samaritans (UK) — 116 123, available 24/7
- International Association for Suicide Prevention — https://www.iasp.info/resources/Crisis_Centres/
Sometimes it turns out that the hardest thing isn't the fight with pain itself, but taking the first step and saying: "I need help." And asking for help is not a sign of weakness — it's a sign of enormous strength.
Natalia — since 2014 I've been living with trigeminal nerve pain. I write in plain language, based on reliable sources and personal experience. Read my story →
Frequently Asked Questions
What is trigeminal neuralgia?
Trigeminal neuralgia is a chronic facial pain condition. It manifests as sudden, severe, usually one-sided pain attacks — often described as an electric shock. A single attack typically lasts from a few seconds to about two minutes.
What is the difference between neuralgia and neuropathy?
In simple terms: neuralgia primarily involves paroxysmal pain along a nerve, usually without loss of sensation. Neuropathy involves nerve damage that more often causes constant pain along with numbness and sensory loss.
Do regular painkillers help with neuropathic pain?
Usually not. Neuropathic pain responds poorly to paracetamol or anti-inflammatory drugs. Instead, medications that act on nerves are used, such as anticonvulsants like carbamazepine.
Why is an MRI performed?
MRI helps detect neurovascular conflict and rule out other causes of pain, such as tumors or multiple sclerosis. The diagnosis of neuralgia itself is primarily clinical.
Does alpha-lipoic acid (ALA) help with neuropathy?
Some people use ALA as a supportive supplement, but evidence is limited and comes mainly from studies on diabetic neuropathy. It is considered a supplement, not a proven therapy. Always consult your doctor.
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