How Chronic Pain Can Affect Your Mental Well-Being

Experiencing pain isn’t just physically uncomfortable; it can be psychologically taxing, especially when the pain is chronic. Coping regularly with discomfort can be stressful and exhausting, decreasing your quality of life and even contributing to depression or anxiety.When you wake up every day with chronic pain, instead of feeling calm and refreshed, you might feel cranky and tired because your pain made it hard to sleep restfully. You might develop a reputation for being rude or impatient. You might find it hard to concentrate. Things that brought you joy in the past might not even make you smile.If your chronic pain leads to depression or anxiety, it may heighten your perception of pain, amplifying your discomfort and causing more stress. It can be a vicious cycle.

Physical and emotional pain can be intertwined because areas of the brain that process pain and movement also process thoughts and emotions.Chronic pain may also change the way that your brain responds to discomfort. Think of pain as someone making a 911 call to your brain for help. When they dial 911, the brain acts as the dispatcher, triaging the situation to find out what’s wrong. As the 911 dispatcher, your brain decides to send the equivalent of a fire truck, ambulance or police car to the affected area, depending on the type of pain that led to the alert. The brain, acting as a 911 dispatcher, doesn’t follow the usual protocols when someone experiences chronic pain. Instead of doing triage to figure out which emergency services should be sent, the brain might dispatch every emergency vehicle in town, even if the pain wasn’t that intense. The smallest twinges then cause a huge response, leading to an increased perception of pain. Additionally, your brain may regard pain differently when it is chronic. Your brain might be on constant alert for potential sources of discomfort. If you anticipate that something will cause pain, based on past experiences, you could become afraid to engage in those activities. If those fears make you less physically active, you may become deconditioned, which makes you more likely to injure yourself, increasing your risk of experiencing more pain.

When people experience chronic pain, they often see a Primary Care provider or a specialist for treatment. If medication isn’t effective by itself, the provider sometimes recommends psychological therapy. Therapists offer individualized treatments to patients with chronic pain. Common research-proven treatments for the psychological aspects of pain include:

• Cognitive behavioral therapy. This type of talk therapy helps patients develop skills to think about their pain differently, with the goal of changing their perception of pain. (Our thoughts affect how we feel and behave.) 

During cognitive behavioral therapy, patients learn to let go of negative thoughts related to their pain and adopt coping skills to react differently to their discomfort. This type of flexible thinking can change the way that patients’ brains interpret pain over time. Patients come to realize that pain doesn’t detract as much from their quality of life when they think about it differently. The hope is that they’ll begin doing activities that they had stopped because of the pain, even if the pain itself hasn’t changed.

• Acceptance and commitment therapy. During acceptance and commitment therapy, therapists don’t help patients seek solutions to eliminate their pain. Instead, they help patients learn to recognize and accept their pain and then change the way that they think about it.

Patients learn to focus on the present and detach from the emotional thoughts they have about their pain. Patients also work with their therapist to determine activities that are meaningful to them. Once they recognize their personal values, they choose to engage in the meaningful activities that they enjoy, even if it causes pain flare-ups.These techniques help patients become more engaged in their lives rather than missing out on things they fear could cause pain.

• Mindfulness. Mindfulness has two key components: Being aware of the present moment and practicing acceptance. One common way people focus on the present moment is sitting still and concentrating on their breathing or another bodily sensation, such as muscle relaxation. By focusing on the present, they aren’t thinking about the impact of their pain in the past or the future. 

When you focus on the moment, you notice that your chronic pain is causing discomfort. You then accept the fact that you’re feeling that pain without trying to change it. The process helps you become more emotionally detached from your pain and less judgmental about your feelings toward the pain.Engaging in mindfulness for as little as five or 10 minutes each day has been shown to have positive effects. It helps people become more in tune with their bodies. Some people who regularly engage in mindfulness notice physical cues earlier than they otherwise would have, which helps minimize pain. For example, if you notice that your back is starting to ache, that could be a cue to take a short rest instead of pushing through, which would cause more pain.

If you’re seeing a therapist to manage the psychological aspects of chronic pain, apply what you’ve learned to your everyday life, such as mindfulness or acceptance.Create coping statements or mantras that inspire you in the moment when you’re experiencing pain. Write the words down and hang them somewhere you’ll see them as a reminder.Practice self-care ideas like activity pacing: Recognize that chronic pain flares when you overexert yourself, causing physical and emotional discomfort. Learn to read your body, so that you take breaks from physical activity before overexerting yourself. You should experience less physical and emotional pain that way.Be patient and understanding with yourself. Realize that chronic pain isn’t going to disappear tomorrow. Figure out ways to live with the condition, incorporating as many tools as possible to improve your day-to-day existence. Your efforts may improve your physical functionality and your mental health.Click here to learn more about chronic pain you or your loved one may experience and how it impacts your behavioral health.