Experiencing chronic pain is not only physical but it is also often related to one’s mental health. A study conducted by Mental Health America in 2021 confirms that chronic pain is linked to serious mental disorders, including anxiety, depression, and Post Traumatic Stress Disorder (PTSD). Remarkably, about 45% of the chronic pain patients also have symptoms of major depression.
This issue affects more than just the elderly. Veterans, military personnel, and caregivers are some of the hardest hit by this emotional toll. Well, how does chronic pain affect our mental health then?
The Physical and Emotional Toll of Chronic Pain
Pain is not only a physical suffering but invades a person’s emotional life as well, especially when the ache is long lasting. For instance, an arthritis patient may develop worry concerning the future or may become concerned about ability to work. Such prolonged distress adds to the emotional toll, further burdening the individual beyond their physical pain.
- Stress and Anxiety: Pain signals to the stress response and hence brings about an increase in cortisol levels and anxiety. Activities that would normally be completed with ease turn into major challenges, therefore often increasing stress levels.
- Depression: When pain becomes chronic, the individual is likely to lose interest in simple things that he or she used to find enjoyable, and therefore may experience depression symptoms, loneliness or hopelessness. Chronic pain has been known to increase the prevalence of depression with people experiencing the pain being two to three times more likely to experience depression.
- Impact on Daily Functioning: One of the most devastating aspects of chronic pain is that it reduces the quality of the patient’s life, depriving them of the ability to play with their children or the energy to go out with friends.
The Cycle: How Pain and Mental Health Influence Each Other
Many a time, chronic pains are draining and such conditions can worsen the mental health of a patient.
This cycle is often challenging to interrupt, and the pain catastrophizing only aggravates it. This can also increase the sensitivity of an individual to pain and result in poor quality health both physically and mentally. Several studies have established that depression and anxiety can increase pain sensitivity and this worsens the mental state and vice versa.
Adam Km Woo in his paper titled, Depression and Anxiety in Pain (2010) agrees with the argument asserting that pain is physical in so far as it can be felt but includes elements of psychological processes indicating that pain is actually the result of the interaction of physical and psychological factors. The article also reveals ways in which chronic pain leads to depression and anxiety that in turn leads to the enhancement of pain experience. Woo also supports that it is easier to treat pain when the treatment involves acknowledgment of the body and mind of the patient.
Chronic Pain and Common Mental Health Issues
Studies show that chronic pain patients are at a higher risk of developing certain mental disorders. Below are some key examples:
- Depression: About half the patients who present themselves with chronic pain may present with clinical depression. For instance, a patient diagnosed with osteoarthritis is likely to feel sad and with low self-esteem because of loss of mobility and independence.
There is a strong interconnection between chronic pain and psychology, according to the study of Nalini Vadivelu, MD, et al. It is stated that 30-45% of chronic pain patients experience depression compared to 5% of other people. This two-way relationship means that depression causes chronic pain, and conversely, chronic pain causes depression. MRI shows that there are similar mechanisms of neuronal functioning in the two diseases: hope and perception of pain as non-threatening help in the process of adaptation. Nevertheless the relationship between these factors is more complicated and more studies have to be conducted to explain this process.
- Anxiety: Chronic pain patients may be worried about the likelihood of future pains which in turn adds to the levels of stress. For instance, the rheumatoid arthritis patient may spend most of his or her time waiting for the next flare-up meaning that he or she only gets periods of respite occasionally.
- PTSD: The case is similar to patients who experienced a trauma in the past, like in a car accident or on a battlefield; such persons are likely to have constant pain in addition to PTSD. Research evidence reveals that between 40% and 60% of the chronic pain patients have PTSD.
Coping Strategies and Treatment Approaches
Fortunately, there are effective coping strategies to manage chronic pain’s emotional toll. These include:
Therapy and Counseling: Cognitive Behavioural Therapy (CBT) is one of the most evidence-based treatments. CBT can help people to manage the pain related to cognition and also can help to change the cycle of pain and negative affectivity.
Mindfulness and Meditation: Psychological strategies such as mindfulness helps the patients deviate focus away from the pain. For instance, some of the patients who frequently engage in mindfulness exercises reported that they have lesser stress and anxiety over their pain.
Medications: Selective Serotonin Reuptake Inhibitors (SSRIs) are often utilized for managing pain with a coexisting depression or anxiety. In other words, it can be stated that using medication can help to stop this cycle, which allows the sufferers to gain at least partial control over their experiences and feelings. However, it is advised to consult a professional.
Holistic Approaches: The best results usually come from a combination of physical therapy, mental health counseling, medications, and changes in diet and daily habits. This integrated approach acknowledges the emotional toll chronic pain takes and seeks to address both physical and mental health.
Conclusion
Chronic pain is not an isolated issue—it has a profound and far-reaching impact on mental health, causing a significant emotional toll on the individual and sometimes also the people around them. It is critical to pay attention to the correlation between pain and psychopathology.
As Dr. Nalini Vadivelu, noted, “Further research is still required to understand this multifaceted connection. ” However, one can seek help, and as it was stressed, “You are not alone in facing these difficulties. ” With the right combination of treatments and coping strategies, it is possible to find relief and regain control.
References
Vadivelu N, Kai AM, Kodumudi G, Babayan K, Fontes M, Burg MM. Pain and Psychology-A Reciprocal Relationship. Ochsner J. 2017 Summer;17(2):173-180. PMID: 28638291; PMCID: PMC5472077.
Woo AK. Depression and Anxiety in Pain. Rev Pain. 2010 Mar;4(1):8-12. doi: 10.1177/204946371000400103. PMID: 26527193; PMCID: PMC4590059.
