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The Link between Chronic Pain and Mental Wellness

By Jennifer Thompson

Chronic pain—defined as pain that lasts longer than six months—is surprisingly common, with an estimated 30 million Americans affected by an illness that causes chronic pain. A wide range of health problems can cause this type of pain, including chondritis, fibromyalgia, endometriosis, and irritable bowel syndrome, as well as physical injuries. One way of managing some types of chronic pain is through an exercise program; this can help reduce pain by strengthening muscles, thus putting less pressure on aching joints. Focusing on your mental wellness can also be beneficial, as chronic pain causes considerable psychological stress.

The Cycle of Physical Pain and Mood Changes

Over the long term, pain can have a profound effect on mental wellbeing. Mood changes such as irritability, hopelessness, and fear are common, and these can quickly progress to depression, anxiety, and panic attacks. In addition, fatigue and insomnia often result from these mental changes. Often, the result of all of these changes is more pain—low mood is linked to hormonal imbalances that can heighten the body’s ability to feel pain; as well as this, both low mood and chronic pain are linked to immune system suppression. When you have chronic pain, you are therefore at risk of becoming trapped in a cycle of pain and depressive feelings that is difficult to break.

Just as low mood can make pain worse, an improvement in your mood can help alleviate pain, or at least make it somewhat easier to bear. It’s tempting to rely solely on pain medications to ease physical symptoms, but they don’t necessarily address the psychological effects of the pain, or its cause. Medication does have its place, of course, but in some instances, drugs can make the problem worse in the long term. For example, the overuse of some types of painkillers can lead to drug tolerance and addiction, which is a problem in itself, but can also worsen the psychological effects of pain. Bearing this in mind, it’s helpful to know that there are other ways to manage chronic pain that can help minimize the use of these medications, and also address the mood problems that often go along with the pain. Natural drug-free therapies such as acupuncture, for example, are known to facilitate the relief of chronic pain, and there is mounting evidence that this treatment can also help improve symptoms of depression.

Simple Ways to Improve Your Mood

There are many things you can do to help alleviate the stress and low mood that chronic pain causes. For example, deep breathing and meditation can be useful during episodes of breakthrough pain, or flare-ups, which are sudden flashes of pain more intense than that normally felt. Typically these are treated effectively with rapid-onset short-acting painkillers, but breathing and meditation can assist with the emotional reactions that sometimes accompany the pain, and help you feel calmer in the midst of what is often a sense of chaos.

It’s not just pain that causes mood changes. Many people with chronic pain become extremely frustrated because it’s so hard to explain to other people what it’s like to live with it. This is often an important aspect of the depression that can develop: people with chronic pain don’t always look sick or disabled, and this can lead to a variety of problems—family and friends often have difficulty understanding the nature of the illness and the pain, and it’s a very hard thing to explain. One helpful analogy is “spoon theory”, which highlights how people with chronic illnesses have limited physical resources with which to navigate each day. When the people closest to you have a better understanding of how your illness affects your life, it can bring you a little more peace of mind

Many people with chronic illnesses or chronic pain feel as though they’ve lost control over their lives—that the illness or pain is controlling them, instead—adding to feelings of hopelessness and depression. One effective way of helping to manage the mood changes that chronic illness causes is to try and regain some of this control. Tracking pain and other symptoms, for example, can help pinpoint specific activities and treatments that either worsen pain or assist in preventing or alleviating it. This type of tracking can also be useful as a planning tool for times when you have specific activities you need to carry out, and need to be sure that you have the physical resources to manage them.