Chronic Pain and its Impact on Mental Health
by: Jacob Higman
What is chronic pain?
Chronic pain is typically defined as pain that persists or recurs for at least 3 months. It can have many causes such as injury, illness, or idiopathic causes- meaning a cause has not been identified or understood. Chronic pain can impact nearly every aspect of someone’s life, such as work, hobbies, relationships, sleep, mental health, and even their identity. Chronic pain can decrease quality of life, limit one’s ability to function, have a profound impact on mood, decrease independence, and change one’s relationship dynamics.
How does chronic pain impact one’s mental health?
People who live with chronic pain experience higher rates of mental health challenges such as depression, anxiety, and substance use disorders. Chronic pain and emotional distress can influence each other. Historically, the biomedical model of pain has emphasized that pain is primarily a result of physical damage or injury. However, pain is far more complex than tissue damage alone. We now know that two people with the same injury can experience different levels of pain and people can experience chronic pain even when imaging or medical tests do not show a clear source of tissue damage.
The relationship between pain, stress, and the nervous system
Some of the same brain networks involved in processing emotions, stress, and threats also influence how the brain interprets and responds to pain. This helps explain why emotional distress, stress, and fear can increase the intensity of pain, and why improving emotional well-being can be an important part of pain management. Importantly, this does not mean pain is “just psychological,” rather, emotions and the nervous system are part of the complex way the brain processes pain.
Pain professionals now often view pain through models such as the biopsychosocial model, which explains that pain is influenced by a combination of the body, the mind, and a person’s life experiences or environment. This means that things like an injury, stress, emotions, relationships, and daily life can all affect how much pain someone feels. Because pain has many causes, the best treatment often addresses both the physical and emotional aspects of pain rather than focusing only on the injury.
What can talk therapy/psychotherapy do for chronic pain:
● Develop coping skills to manage pain
● Educate on the connections between pain, emotions, and the nervous system
● Process grief and life changes
● Challenge and reframe unhelpful thoughts about chronic pain
● Address internalized ableism and beliefs about productivity, independence, and worth
● Identify systems and structures that impact quality of care
● Build self-advocacy skills
● Communicate needs and concerns effectively with healthcare providers
● Navigate and process medical trauma
● Explore ways to increase quality of life, meaning, independence, and functioning
(Important note: Mental health services are not a replacement for other medical care and can play an important role in pain management.)
References:
Hassett, A. L. (2023). Chronic pain reset: 30 days of activities, practices, and skills to help you thrive. Countryman Press.
Trachsel, L. A. (2023). Pain theory. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK545194/
Vadivelu, N., Kai, A. M., Kodumudi, G., Babayan, K., Fontes, M., & Burg, M. M. (2017). Pain and psychology—A reciprocal relationship. Ochsner Journal, 17(2), 173–180. https://pmc.ncbi.nlm.nih.gov/articles/PMC5472077/