Chronic Pain and Mental Health

Chronic pain affects every aspect of your life, including your mental health. Sometimes patients are so focused on alleviating their physical aches that they neglect to address the psychological effects of their chronic pain.

Ignoring the toll chronic pain has on the mind can be a major mistake. Your mental state can exacerbate your physical pain, making it even more difficult to manage.

In a 2006 study, 77% of people who suffered from chronic pain reported feeling depressed. Over 85% of chronic pain patients said that they had difficulty sleeping.

Let’s discuss some common psychological effects of chronic pain, and how to cope:

Depression
You can’t sleep, you can’t socialize, you can’t work — of course you would feel down. However, some people who endure chronic pain also experience major depressive disorder: symptoms include persistent feelings of sadness, loss of interest, inability to concentrate, sleep disturbances, appetite changes, self-isolation, low self-worth, and more.

Long-term pain can trigger a depressive episode, even for individuals who have never before been diagnosed with depression before. The insomnia caused by chronic pain (more on that below) wreaks havoc on your moods and prompts you to nap frequently instead of engaging with others. Pain issues also cause you to withdraw from activities, thus isolating yourself from your loved ones. Depression is shockingly common among individuals suffering from chronic pain.

Insomnia
While a symptom of many mental and physical disorders, insomnia is also a separate diagnosis in its own right. You need quality sleep to function. Even though getting a good night’s sleep is sometimes inconvenient and often difficult in today’s hectic world, adults still require seven to nine hours of sleep every night.

Chronic pain makes sleeping difficult. This can be due in part to the pain itself, as well as any medication side effects you may need to cope with the pain. Insomnia adversely impacts every aspect of your life: concentration, digestion, memory, fitness, relationships, etc. Worse, insomnia can exacerbate psychological disorders like depression or anxiety.

Anxiety
You worry, and most of your worries are connected to your chronic pain: you worry about why you’re in pain, how you’ll pay your bills, when you’ll see your doctor, if you’ll keep your job. Your pain keeps you up at night, and you find yourself obsessing over what-if scenarios. You become fearful, wondering if the pain will ever go away or if it is actually a symptom of another serious illness.

People sometimes even second guess themselves, wondering if they are overreacting or if their pain is psychosomatic. For all these reasons and more, chronic pain can cause anxiety and even panic attacks.

Fatigue
Fatigue is different from simply being tired. Feeling tired can be fixed by resting; feeling fatigued can’t be relieved by resting and if anything, resting might worsen the feeling. Walking around the block feels like running a marathon. You are so focused on appearing “normal” that you mentally exhaust yourself.

Studies indicate that arthritis can physically increase fatigue; the body fights the inflammation by releasing chemicals, which can in turn cause fatigue.

Guilt
Feelings of guilt may stem from everyday occurrences, such as being unable to play with your toddler, or work for more than a few hours a day. While not a disorder by itself, feelings of guilt can overwhelm a person.

Chronic pain prevents you from participating in activities that most people take for granted like socializing, working and exercising. You might feel angry at yourself and blame yourself for no longer being able to engage with the world. Guilt is one of the most insidious mental side effects of chronic pain.

Tips for Coping with the Mental Effects of Chronic Pain

• Educate yourself about your condition to reduce fear of the unknown.
• Practice meditation.
• Exercise (only as much as you are able, and with your pain medicine clinician’s permission!)
• Consider seeing a mental health counselor for talk therapy.
• Some people might need medication to treat insomnia, depression, or anxiety.
• Practice mindfulness: focus on the here and now.
• Do not fall into self-medication! Using substances might temporarily alleviate physical or emotional pain, but this is never a good long-term solution.