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Physical pain is a common occurrence in the daily lives of millions of people across the world. This pain is the body’s way to let a person know that there is something wrong inside that requires attention and treatment. In addition to the physical element, pain also possesses a psychological aspect that, unfortunately, not many people pay attention to. Pain, especially when it becomes long-term or chronic, can raise a person’s risk of developing anxiety and mood disorders.
Persistent or chronic pain can easily make anyone feel hopeless and depressed, forcing them to experience high anxiety as they continue ruminating over their condition. Some people end up developing addiction to painkillers, which, in the long run, only exacerbate the pain they are struggling with. Chronic pain and mental health share a direct connection with any increase in the former leading to a decline in the latter. Understanding the effects of chronic pain on mental health and learning how to overcome them best can, however, make a huge difference.
How Does Chronic Pain Affect Mental Health?
To understand the relationship between chronic pain and mental health, the following are some examples of chronic diseases and how they affect one’s emotions:
Arthritis is a disease that involves inflammation of one or more joints of the body, which results in disabling pain. With more than 100 different types of arthritis, the condition can lead to severe deformity and long-term disability. According to statistics, the prevalence of specific anxiety and mood disorders can occur at high rates among people living with arthritis. 
Due to limited movements, pain, and impaired joints, arthritis can significantly reduce an individual’s abilities to go by their daily life and may hinder their social life as well. The frustration related to these impairments, in addition to social isolation, may put people with arthritis at increased risk of developing mental health conditions, such as depression.
This chronic pain condition involves multiple symptoms as the brain and spinal cord process pain signals differently than in a normal person. For people living with fibromyalgia, a certain movement or touch that does not cause any pain to others may feel extremely painful. The condition can lead to widespread pain in bones and muscles in addition to generalized fatigue. The condition can make a person withdraw from social and professional lives in addition to draining their physical and mental energies. Consequently, such people are often at high risk of developing mental health issues, such as anxiety and obsessive-compulsive disorder.
Also known as MS, the condition is a consequence of nerve damage that disturbs the communication between the brain and the rest of the body. As one of the most common disabling conditions, this long-term condition particularly affects young adults. Because of its direct impact on every aspect of the body, people with multiple sclerosis are at a particularly high risk of experiencing mental health issues, such as depression, generalized anxiety disorder, and panic disorder. Research suggests that obsessive-compulsive disorder (OCD) is also more prevalent in people with multiple sclerosis. Up to 36 percent of people with this chronic condition are likely to experience a form of anxiety at some point in life.
In addition to the mood disorders mentioned above, some people with diagnosed multiple sclerosis end up experiencing a phenomenon known as pathological laughing and crying. This phenomenon includes excessive laughing or crying in inappropriate situations, for example, any event that others may not deem sad or funny. Also known as pseudobulbar affect, this phenomenon occurs in up to 10 percent of the people living with multiple sclerosis.
Pain in the neck and back are some of the most common forms of chronic pain. It may begin with mild aches coming from muscle strain, lifting heavy objects, or sleeping in uncomfortable positions. In some cases, such pains may be a sign of more serious issues, such as cancer or meningitis. Studies have found that mental health issues are more prevalent in populations struggling with these types of pain. The risk of major depression was particularly high in people with neck and back pain. Additionally, depressive symptoms have also been found to last longer in such people.
Migraines that occur for 15 days or more in a month for at least three months or more are termed chronic. Such migraines often co-exist with other mental health issues, such as anxiety, major depressive disorder, etc.  Increasing evidence also suggests that people with underlying migraines and mental health issues face poorer health-related outcomes, such as in terms of restriction of activities, disability, and excessive utilization of mental health care services.
While some amount of pain is normal to experience during periods, having certain conditions, such as uterine fibroids and endometriosis, can make it more intense. Endometriosis is a problem in which tissue similar to the one lining the uterus in females grows outside of this body part. Uterine fibroids, on the other hand, refer to non-cancerous growths often on the uterine walls that appear in women during childbearing years.
Up to 80 percent of people diagnosed with endometriosis experience severe pelvic pain along with very high levels of emotional stress. Those with uterine fibroids are also at risk of developing anxiety and depression due to the feeling of helplessness and loss of control over their fibroids. Both conditions are also known to lower the overall quality of life and can make some people bedridden. Such people may start declining social invites due to the fear of not having bathroom access or the embarrassment associated with the unavailability of sanitary products when needed. All these factors merge to collectively have a negative impact on a person’s mental health.
Coping with Psychological Effects of Chronic Pain
While chronic pain can significantly damage one’s mental health, it is possible to reduce these side effects through simple lifestyle modifications. Some of these lifestyle tips include the following:
Being active can significantly benefit both mental and physical health. Exercise boosts the release of dopamine and endorphins that boost mood while reducing pain and mitigating inflammation.  These effects, when combined, can act as a strong counter to the vicious cycle of chronic pain and mental health issues.
Mindfulness focuses on helping people live in the present while adopting a non-judgmental mindset. It also supports them in accepting their chronic pain and changing their perception of its severity. In simpler words, mindfulness can help make pain less intense to people. Many experts also recommend mindfulness practices to improve emotional experiences and control depression and anxiety arising from chronic pain in a better way.
Try Anti-Inflammatory Diet
Chronic pain is often linked to chronic inflammation, such as arthritis, where joint swellings put pressure on nerves and generate pain. Choosing a diet pattern that involves plenty of natural anti-inflammatory foods can help bring down this long-term inflammation. Consider adding the following foods to your diet for this purpose:
- Fibrous whole grains
- Nuts and nut butter
- Vegetables, such as dark, leafy greens
- Fruits, such as oranges and berries
- Legumes, including lentils and beans
- Coffee and tea
- Fish, including sardines and salmons
Consider cutting down the use of the following foods simultaneously as they increase inflammation and chronic pain and may consequently worsen mood:
- Fried foods, such as fried pickles and French fries
- Refined carbohydrates, such as white bread and rice
- Sweetened drinks and sodas
- Processed meats
Adopt Better Sleep Habits
Sleep is essential for healing and recovery. Living with sleep deprivation can significantly increase a person’s sensitivity to pain and consequently worsen mood. The problem is particularly troublesome in people with certain chronic pain conditions, like fibromyalgia, which stops them from having enough sleep every night. This sleep deprivation, in turn, worsens their pain and mood. To break this vicious cycle, consider adopting healthy sleeping habits, such as the following:
- Invest in a comfortable mattress and bedding
- Keep the bedroom environment cold and dark
- Use earplugs to cancel out noise
- Avoid using any electronic gadgets close to bedtime
- Cut back on alcohol and caffeine close to bedtime
Emotional support is a cornerstone for every physical and mental ailment. Having loved ones around you who understand your struggles and are there to support you can greatly make a difference in your mental and physical health. Try to involve your friends, family members, and other loved ones in your affairs, and do not hesitate to ask for help whenever you feel low.
Professional Treatment Options For Chronic Pain and Poor Mental Health
For people who cannot benefit from lifestyle modifications, different professional treatment options are available to keep their chronic pain and mental health in check. These treatments generally involve using pain relief medications and psychotherapy, but a combination works best for most people.
Opioids are strong pain relief drugs that experts prescribe to manage pain. However, the biggest downside of using these medications for chronic pain is their risk of causing addiction and potentially fatal overdose. Hence, an expert may switch to non-opioid drugs when it comes to managing long-term pain. Some examples may include gabapentin and pregabalin. Cortisone shots may also be used to relieve inflammation in certain body parts and provide pain relief.
Psychotherapy for chronic pain has minimal side effects and risks when compared to medication use. Some experts combine it with drug use to achieve better outcomes. Acceptance and commitment therapy (ACT) and cognitive behavioral therapy (CBT) are the two most common types of behavioral therapies to help people with chronic pain improve their mental health. CBT emphasizes changing unhealthy behaviors and negative thinking while altering a person’s pain perception. It also helps them build new coping strategies to combat stress.
Can psychotherapy help control the psychological effects of chronic pain?
It is possible to keep both chronic pain and mental health under control through the following types of psychotherapy:
Cognitive behavioral therapy
Operant behavioral approaches
When should I seek help from a mental health professional for my underlying chronic pain?
There are no clear-cut guidelines about when to involve mental health input if you are suffering from the extended effects of chronic pain. In general, if you feel like your chronic pain is causing severe stress on your mental well-being, consider seeking support. Some symptoms of this phenomenon may include excessive crying, feeling persistently low, losing interest in daily activities, or behaving unusually differently.
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2 Peterlin BL, Katsnelson MJ, Calhoun AH. The associations between migraine, unipolar psychiatric comorbidities, and stress-related disorders and the role of estrogen. Current pain and headache reports. 2009 Oct;13:404-12.
3 Geneen LJ, Moore RA, Clarke C, Martin D, Colvin LA, Smith BH. Physical activity and exercise for chronic pain in adults: an overview of Cochrane Reviews. Cochrane Database of Systematic Reviews. 2017(4).