Chronic Pain and Mental Health

What is chronic pain? 

Chronic pain is classified as persistent pain that lasts for longer than 3 months despite taking any medication or treatment. The pain can be felt all the time or may come and go, and it can occur anywhere on the body. It can affect a person’s daily life and make it difficult for them to live a normal routine, leading to depression or anxiety. 

Chronic Pain and Mental Health 

The association between chronic pain and health conditions like depression and anxiety can result in a low quality of life for one’s health. The stress of living with chronic pain can change levels of stress hormones and neurochemicals in the brain and nervous system. These changes can affect one’s mood and behaviour. Research on chronic pain has shown that persons with chronic pain are four times more likely to have depression or anxiety compared to those who are pain-free.1 

Chronic Pain Conditions and Mental Health 

Arthritis 

Arthritis is a condition where there is inflammation in the joints, causing disabling pain. Evidence indicates that persons with arthritis have higher rates of mood disorders and anxiety compared to those without arthritis.2 The pain caused by arthritis can limit a person’s abilities to do certain daily activities and prevent them from joining social activities, this can cause frustration and lead to a person developing depression as a result. 

Fibromyalgia 

Fibromyalgia is a health condition where the brain and spinal cord process pain signals differently resulting in multiple symptoms. It can cause a person to feel pain from touch or movement that others who do not have the condition would not find painful. A person’s mental health, social functioning, and general health can be affected. The risk of anxiety disorders in women with fibromyalgia is five times higher than in women in the general population.3 

Multiple Sclerosis 

Multiple sclerosis (MS) is when there is nerve damage that impacts the connection between the brain and the body. It is a disabling nervous system disease. Depression, anxiety, and pseudobulbar affect are the three common mental health concerns associated with MS.4 It has been noted that Generalized Anxiety Disorder is the most common anxiety disorder among persons with MS. Instances of uncontrollable laughing or crying in response to feelings or situations,  also known as pseudobulbar affect, are common in persons with MS. 

Treatment for Chronic Pain

In order to treat chronic pain, healthcare professionals attempt to identify the cause to treat it. If it is not possible to identify the cause, the focus is shifted to treating the pain. The approach to treating the pain depends on the type of pain a person has, the cause of the pain, and the age and overall health of the person. A variety of strategies can be used, such as medication, therapies, and lifestyle changes. It is recommended that mental health treatment is sought apart from treatment for chronic pain if the person is experiencing mental health difficulties as this can make the pain worse.

Medical treatments

Certain medications can be recommended by a doctor to treat chronic pain. Muscle relaxers, anti-inflammatory drugs, and topical products are some of the medical treatments used. Sometimes antidepressants and sedatives are given to treat any symptoms of depression or anxiety that arise. Opioids are also used to treat pain, but due to how addictive they can be, doctors will recommend other treatments before prescribing opioids. 

Side effects of treatments

Every medical treatment has a risk of side effects. This should be discussed with healthcare providers when coming up with a treatment plan. Mood changes are one side effect that can occur when receiving medical treatment for chronic pain. These mood changes can affect a person’s mental health, which is why it is important for people with chronic pain to seek mental health treatment alongside physical treatment. The risk of opioid addiction is another concern when it comes to medical treatment. Developing a dependency on opioids would also require seeking out mental health treatment.

Therapy for chronic pain

Different therapies can be used to manage chronic pain. For the mental health aspect, a person can receive Cognitive Behavioral Therapy (CBT) or regular talk therapy. CBT is useful for changing the way one thinks about pain and modifying behaviours in order to cope with chronic pain. Talk therapy is also useful for managing pain as it can help with psychogenic pain, which is pain caused by psychological factors. Other therapies for chronic pain include occupational therapy and physical therapy. These can help a person with chronic pain manage their pain through learning how to change everyday tasks to improve their quality of life and use stretching and exercise to reduce symptoms of pain. 

Coping with chronic pain

Chronic pain is stressful both psychologically and physically, making it important to figure out ways to cope with the pain. Managing stress is an essential part of coping as emotional and physical pain are related. Dealing with stress in healthy ways can lead to better management of pain. Positive thinking is another tool for coping. Focusing on improvements can affect your perceived comfort level and help you feel better about the pain you are feeling. Becoming active and engaged can serve as a distraction from the pain and help shift the focus to more positive factors in a person’s life. Avoiding isolation will prevent a negative effect and reduce the perception of pain. It is better to reach out and seek the help of others so that a person does not have to deal with the struggle of pain alone. Feeling understood by others can make a step in the right direction of coping with pain. This also can include seeking the help of mental health professionals if a person feels overwhelmed. 

Summary 

Chronic pain is a constant long-term pain that persists despite medication and treatment. This can be felt anywhere on the body and can make it difficult for a person to lead a normal life. Due to how much strain chronic pain can put on the body people with chronic pain are likely to experience mental health difficulties as a result. Different health conditions can cause chronic pain, leading to different mental health outcomes. It is important to seek professional help to treat chronic pain as there are different treatment options out there to help individuals manage their pain. Dealing with chronic pain can be stressful, and there are several ways that a person can cope with it. In cases where chronic pain can be extremely overbearing and stressful, it is best that the individual seeks mental health treatment to deal with the mental health difficulties. 

References

  1. Chronic pain and mental health [Internet]. Mental Health America. [cited 2022 Aug 22]. Available from: https://www.mhanational.org/chronic-pain-and-mental-health
  2. Sambamoorthi U, Shah D, Zhao X. Healthcare burden of depression in adults with arthritis. Expert Rev Pharmacoecon Outcomes Res [Internet]. 2017 Feb [cited 2022 Aug 22];17(1):53–65. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5512931/
  3. Galvez-Sánchez CM, Duschek S, Reyes del Paso GA. Psychological impact of fibromyalgia: current perspectives. Psychol Res Behav Manag [Internet]. 2019 Feb 13 [cited 2022 Aug 22];12:117–27. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6386210/
  4. Multiple sclerosis and mental health: 3 common challenges [Internet]. 2022 [cited 2022 Aug 22]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/multiple-sclerosis-ms/multiple-sclerosis-and-mental-health-3-common-challenges
This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Carla Alvarez

Master of Science - MS, Global Mental Health, University of Glasgow, Scotland
Carla is a Psychology Intern and a Medical Writer.

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