Chronic pain and mental health have a complex bidirectional relationship, meaning each can influence and exacerbate the other in both directions. Adults who have chronic pain have a higher incidence of conditions like anxiety and depression. At the same time, mental health symptoms can make perceptions of pain seem worse.
This relationship looks different across various population groups and individuals. Health conditions, life experiences, and approaches to self-care and treatment can shape how someone experiences pain and responds emotionally.
In this article, we’ll explore eight ways chronic pain and mental health are linked.
8 links between chronic pain and mental health
The interplay between chronic pain and mental health is much more than a “chicken or the egg” situation. The way a person develops their pain can have a huge impact on the way they process it mentally and emotionally.
Whether it’s a genetic condition, a product of aging, or an accident or injury, the likely causes of the pain and the person’s experiences at the onset can shape their concept of it and responses to it. People may have underlying mental health conditions that are intensified by chronic pain. Cultural notions about what their life “should” look like can also affect their feelings on a daily basis.
The following are eight links between chronic pain and mental health:
Chronic pain affects cognition and working memory
Physical pain and any emotional discomfort that comes with it can be a powerful distractor. The results are that you have fewer attentional resources and a lower capacity for working memory. If you struggle to manage everyday tasks, this further impacts your mood and emotions.
The emotional response to chronic pain
Emotional discomfort related to chronic pain may be experienced as fear, anxiety, or irritability. These immediate responses can make real difficulties seem even worse than they really are.
Pain catastrophizing is a sense of panic or preoccupation with the possibility of worsening health problems. When it goes untreated, people who catastrophize their pain can experience more acute suffering and have a poorer response to pain treatments.
Chronic pain and mental health conditions
People with chronic pain are more likely to have mental health conditions like anxiety and depression and have a lower quality of life. A study measuring positive mental health markers also found that they’re less likely to flourish. There are a number of factors at play, including emotional reactivity, limited ability to participate in life activities and the perception of limitations.
Cognitive reserve as moderator
Cognitive reserve refers to the brain’s resilience and ability to adapt, which can support mental health in a way similar to how cognitive flexibility and mindfulness contribute to emotional regulation and pain management . It modifies the interaction between pain intensity and mental health, and it’s also a protective factor for conditions like dementia and traumatic brain injury.
That means people with more cognitive reserve have a better ability to “tune out” their pain and process other things.
Lack of exercise
Chronic pain can make people feel less able to exercise. It’s not only about the pain itself, but also emotional factors. For instance, fear of pain might keep people from exercising, as well as a lack of motivation and lack of support or access. In many cases, a lack of exercise can lead to worsening health.
Chronic pain and sleep
Pain and sleep have a reciprocal relationship. Poor sleep can lower the pain threshold, affect a person’s ability to mentally cope with pain, and increase ratings of pain intensity. All of this, in turn, can make it even harder to sleep.
Hypervigilance
When you experience pain often, the nervous system may start to brace itself in anticipation of more pain. Expecting pain can make you more sensitive to feelings that aren’t painful, potentially interrupting your thoughts.
ADHD management
People who have attention-deficit/hyperactivity disorder (ADHD) were found to have lower pain thresholds and pain tolerance than others. However, this was reversed when patients took ADHD medication. Managing ADHD can improve pain symptoms in people who have this condition.
Get help with the mental and emotional impact of chronic pain at Lightfully
Physical pain and emotional difficulties aren’t always obvious to loved ones and care providers. Communication about what the person is feeling and education about mental health topics and treatment can go a long way to improve their quality of life.
People who have chronic pain may have a hard time confiding in their friends and loved ones when they’re not feeling well. This is often because they fear being misunderstood, judged, or seen as complaining. You might need to remind them that it’s OK to talk about how they’re really feeling — and be careful not to invalidate them or tell them what they “should” do.
While friends and family often mean well, those with chronic pain may benefit from having other types of supporters in their support system. Connecting with people who have similar conditions can be a great way to feel seen and accepted. Finding an online community or a support group might be a good start.
A licensed clinician or therapist can provide more structured support and help the person find a more adaptive relationship to their pain. Cognitive behavioral therapy (CBT) can help people change how their brain processes pain and their resilience to it — the ability to pay attention to other things, remember details, and make decisions while experiencing pain
At Lightfully, we see our clients as whole people with complex lives, not a list of symptoms. Our licensed clinicians use a framework called Precision Care Model (PCM) to design personalized treatment plans.
We also make it safe for people to show up to treatment exactly as they are. Our programs combine individual, group and family therapy sessions to help each person strengthen their support network throughout the treatment process.
Is your mental health suffering because of a chronic pain condition, or are you helping a loved one find treatment? Let’s figure out your next steps together. Reach out to our Admissions Concierge Team today.
