Pain signals come from the body, but the perception of pain originates in the head – and how our brain works can change how we feel and conceive pain. We already know that certain moods and mental states reduce or even aggravate pain sensitivity, weakening or strengthening a person’s threshold for pain. For example, being happy and continuously doing things that help improve your mood – exercise, comedy, certain kinds of musical arousal, acupuncture, and sex – can reduce how much pain you’re feeling by releasing endorphins and other feel-good brain chemicals. However, this logic also works inversely – negative thoughts and poor mood can drastically worsen even minor aches and pains.
Your mindset can prolong and intensify your suffering. But it isn’t just about pain resilience and moment-to-moment interpretations of your body’s pain signals. New research shows that the long-term effects of chronic pain on the mind and body can affect a person’s mental resilience and their likelihood to struggle with mental health issues such as anxiety and depressive thinking – meaning dealing with pain for months or years at a time can negatively affect your mental health, which in turn can make your pain worse. That relationship is often neglected in treating chronic pain. More research on the topic can give us a greater insight into the effectiveness of mental health therapies for pain relief and symptom management.
When Chronic Pain and Anxiety Overlap
Chronic pain can be disabling, and with that disability can come a lot of resentment and regret. These negative emotions can contribute to a person’s worldview and mindset and exacerbate existing issues, such as depressive thoughts or suicidal ideation. Yet despite the more obvious link between pain and depression, there is also a statistically significant link between pain and anxiety.
Patients with chronic pain issues are more likely than the average population to struggle with PTSD and panic disorder specifically. Patients with more than one co-occurring mental health issue were also far more likely to experience not just pain-related disability but increased disability than their chronic pain peers. Yet it’s more than just a situation of cyclical symptoms. More research has pointed out a potential genetic link between the pathology of pain and anxiety.
Meaning people with certain anxiety disorders are also more likely to experience chronic pain problems and vice versa. These studies indicate that understanding the neurobiology and exploring cellular biology behind the genetic link between anxiety disorders, depressive disorders, and chronic pain conditions may lead to better treatments. As such, patients with chronic pain issues should be aware of the increased risk of mental health issues and vice versa – and how to cope.
Types of Chronic Pain
Chronic pain is usually diagnosed when patients complain of a consistent pain issue for about six months. Some types of chronic pain are more straightforward than others, such as recurring injuries or post-surgical healing problems. In many cases, however, chronic pain is more difficult to pinpoint and treat. This can result in frustration, especially as a patient is bounced around from specialist to specialist. Some pain is nociceptive, while some pain is neuropathic.
Nociceptive pain is pain caused by the correct signaling of nociceptive nerves, which are meant to transmit pain signals. For example, chronic inflammation can make your wrists and joints tender and painful to touch and cause pain during everyday activities. Many forms of arthritis involve chronic nociceptive pain. Some nociceptive pain is visceral, which is tied to the perception of pain from your internal organs, such as irritable bowel syndrome, bladder pain, and endometriosis.
Neuropathic pain, on the other hand, is felt when there is a neural dysfunction. Nerve damage, corroded myelin sheathing, and misfiring nerves can be causes of neuropathic pain through conditions like diabetes, post-surgical nerve pain, and sciatica. Sometimes, pain can be made worse or even originate through psychological health issues – people with anxiety or depression can experience headaches, stomach pains, and increased pain sensitivity without any known physical or nerve-related cause. This is called psychogenic pain, and in some cases, it can develop into a chronic problem.
Not all chronic pain can be accurately described or explained. In these cases, a person is experiencing idiopathic pain, which means pain with an unknown or unclear origin.
Types of Anxiety Disorders
We’ve mentioned that the most commonly diagnosed mental health issues associated with long-term pain symptoms include panic disorder and post-traumatic stress disorder (PTSD). But there are other anxiety disorders, all of which can exacerbate chronic pain issues. The most common anxiety disorders include:
- Generalized anxiety disorder (GAD), is characterized by symptoms of worry and fear even when there is nothing to provoke these feelings;
- Obsessive-compulsive disorder (OCD), a debilitating condition revolving around intrusive thoughts and paired compulsive behaviors;
- Social anxiety disorder, wherein a person experiences overwhelming worry and self-consciousness in typical social situations.
Overwhelming feelings of worry in inappropriate or unwarranted circumstances characterize most anxiety disorders. These include phobias involving intense fear of a specific concept or situation.
Managing and Treating Comorbid Chronic Pain and Anxiety
Chronic pain conditions are treated in many ways, depending on a patient’s diagnosis, circumstances, and medical history. Certain chronic pain conditions require particular medication to treat the primary condition, such as autoimmune disorders requiring specific immunosuppressants. Treating a chronic pain condition alongside a mental health issue requires a contemporary approach that considers both and devises a treatment plan that helps patients cope with their mood or anxiety symptoms while managing their pain symptoms.
Too often, people categorize one set of symptoms as more important than the other. Pain is a more immediate concern for most, but simply focusing on pain relief without addressing mental health issues might be futile. Anxiety treatments can involve medication but are often centered around one-on-one talk therapy. Incorporating therapy into your pain management plan can help you address concurrent mental health symptoms and bring more significant relief.