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Pain Management

Overcome the Psychological Impacts of Chronic Pain

depression and chronic pain - treatingpain.com

When it comes to the topic of living with chronic pain, our focus is generally on its impact on the body—the back, the knees or the shoulders. But chronic pain has a significant impact on our mental health as well.

More and more research indicates that pain, especially when dealt with for long periods of time, can lead to a host of psychological effects. This means it can be classified as a neurological condition. Research indicates that nearly half of those dealing with chronic pain face depression at some point.[1] Left untreated, depression related to chronic pain can become more complex and more difficult to overcome.

What are the psychological impacts of chronic pain?

Living with pain can lead to a host of additional mental health problems, including:

  • Depression: One of the most common thoughts expressed by those in chronic pain is, “Will I ever feel better?” Dealing with pain day after day can lead to a sense of hopelessness. If ignored, these feelings can magnify and make physical and emotional recovery more difficult. For many, chronic pain leads to a great loss of enjoyment and functional abilities in everyday life.
  • Anxiety and stress: People living with chronic pain think about the pain often throughout the day. Patients can begin to focus too much energy on their painful symptoms. Concerns over health and well-being begin to overwhelm their coping strategies. They begin to obsess about their reduced function levels, health care burdens, and ultimately on their ability to keep their jobs, pay their bills and support their families.
  • Moodiness and irritability: The challenges of coping with physical pain and anxiety can lead to more erratic or unstable behavior.  A common symptom reported is increased impatience and anger. People around them notice that they have a “short fuse.” These emotions are natural. Living with chronic pain is difficult and makes people feel more on edge, which can have negative impacts on both personal and professional relationships.
  • Decreased cognitive function: Have you ever tried to concentrate when you have a headache? Imagine living with that kind of pain every day. It takes a toll on your ability to focus and remember things.
  • Insomnia and fatigue: Chronic pain can make it difficult to fall asleep and stay asleep. This creates a vicious cycle. Lack of restful sleep impedes your body’s ability to heal and think clearly. The lack of sleep, combined with reduced activity and increased anxiety, often leads to more restless sleep—and increased fatigue.
  • Sexual dysfunction: Chronic pain can make sexual activity difficult in several ways.  Pain increases stress, anxiety, insomnia and depression, all of which reduce sexual drive and cause some people to lose interest in sex all together. Also, for many the physical act of sex can increase pain, so they avoid it. The reduction in libido and reduced sexual activity can have a significant impact, both physical and emotional, on relationships and intimacy.

All of these factors contribute to a decline in quality of life. This can exacerbate the emotional aspects of living with daily pain. For example, when we a miss a family event because of pain, we become depressed, angry and irritable. So it is critical to address the psychological effects of pain in coordination with treating the physical aspects of it.

Addressing the Psychological Effects of Chronic Pain

Chronic pain is exhausting, both physically and mentally. The body expends a great deal of energy trying to heal, while the brain works overtime trying to process the pain signals. Your interventional pain specialist can address the physical injuries that are causing chronic pain. But if you are suffering from depression, anxiety, insomnia, reduced libido, or other concerns in your emotional life, you should communicate them to your doctor. He or she will likely recommend a number of mental health interventions, including:

  • Biofeedback: This technique helps you learn how to control your body’s reactions to pain and stress. By learning how to relax tight muscles and breathe deeply you can refocus your brain and gain greater control over your body’s reaction to pain.
  • Cognitive therapy: Working with a mental health professional, you will have the opportunity to talk about your feelings and fears. The goal is to raise your awareness of inaccurate or negative thinking so you can reframe those ideas and emotions to deal with them in a more positive and healthy way.
  • Exercise: Although it is often difficult to think of exercising while in pain, gentle body movement can be helpful and lead to the release of endorphins, the body’s “feel good” hormones. Non-impact exercise, such as swimming, yoga, Pilates and stretching can be beneficial to the body and mind.
  • Massage therapy: A soothing massage offers both physical and psychological benefits. It relieves muscle tension and stiffness and increases blood flow to encourage healing of injured tissues. It also stimulates the release of endorphins to reduce stress and anxiety.
  • Medications: In some cases, prescription antidepressants, sleep medications or anxiety medications may be appropriate. This is something you should discuss with your pain specialist, who may work with an outside specialist or your primary care doctor to address your symptoms with medications.

Early Diagnosis is Key

As is the case with all medical conditions, it is important to recognize and diagnose the psychological effects of chronic pain early. This begins when both patient and physician agree that there is an issue with mood that needs to be addressed—in addition to pain. A plan can be established to treat you as a whole person, treating both the physical and the mental aspects of chronic pain.

Suicide

Studies indicate that suicide rates are higher in patients with chronic pain. If you have thoughts of hurting yourself, please share this with your primary care physician, mental health specialist and/or pain specialist. If you are contemplating suicide, especially if you have thought about a plan of how to end your life, report to an emergency room immediately or call the National Suicide Prevention Lifeline (800-273-8255).

Remember, if you are suffering from chronic pain, there is hope! It is possible to overcome the psychological impacts of this pain. Be honest with your pain management specialist. We are very familiar with all of the consequences of dealing with pain and will develop a plan to support your entire well-being, from head to toe.

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