How is Chronic Pain & Mental Health Connected?

Chronic pain is a widespread issue that can affect people of all ages and backgrounds. In fact, research suggests that more than 25 percent of all US citizens are affected by some degree of chronic pain.

Living with chronic pain can be challenging. Even mild or moderate pain can have a significant impact on your quality of life, including by reducing your ability to engage in physical activity.

Many cases of chronic pain are caused by injuries and illnesses, from slips and falls to strained muscles, diseases, infections and complications following surgery. 

However, there’s also a link between chronic pain and mental health. Not only can pain have a significant effect on your mental wellbeing, but some forms of mental illness may also cause or contribute to persistent pain and discomfort.

Below, we’ve discussed what chronic pain is, as well as what it can be like to live with a chronic pain condition.

We’ve also covered the link between chronic pain and mental health and shared proven treatment options that you may want to consider if you’re affected by a form of persistent or constant pain, a mental health disorder or both. 

Chronic pain is pain that doesn’t go away. Clinically, it’s defined as any type of pain that lasts for more than three months.

It’s normal to develop physical pain after a specific event, such as an injury or surgery. This type of pain is referred to as “acute pain,” and it tends to become less severe as your body heals from the specific injury or procedure that caused the pain to develop.

Chronic pain, on the other hand, often doesn’t get better. Many people affected by chronic pain have pain that may occur on a daily basis or “come and go” over the course of a few months, years or even decades.

As a health problem, chronic pain is incredibly common. In fact, in the United States, more money is spent every year on healthcare related to managing pain and its complications than the entire amount spent on heart disease, cancer and diabetes.

Chronic pain can vary significantly in type and severity. It can also affect many different parts of your body, from your joints, bones and muscle tissue to your organs and central and peripheral nervous systems.

Common types of chronic pain include:

• Headaches

• Neck pain

• Lower back pain

• Joint pain from arthritis

• Cancer-related pain, such as from tumors

• Musculoskeletal pain, such as fibromyalgia

• Neurogenic pain, which is pain from nerve damage

Chronic pain can involve a range of different sensations, including aching, joint and/or muscle stiffness, stinging, throbbing pain or burning sensations that occur in certain areas of your body. 

Many people with pain that’s chronic in nature have two or more health conditions that cause or contribute to their symptoms. 

These are often chronic medical conditions that, in addition to causing long-term pain, can place other limits on the affected person’s daily life. 

Chronic conditions that cause pain can have a serious impact on your mental health, including your risk of developing a mental illness. 

The mental and emotional impact of chronic pain may be particularly significant if your levels of pain are so high that your symptoms interfere with your ability to take part in daily activities and maintain an active social life. You might experience depression after surgery, for example, if there were complications or if your healing process is painful or long-term.

Research shows that there’s a significant link between chronic pain and mental health disorders like anxiety and depression. Approximately two-thirds of all people with chronic pain also have a mental health disorder of some type.

People with chronic pain also have a higher risk of developing suicidal thoughts or attempting to die by suicide than the general public. 

Interestingly, research also suggests that this relationship is bidirectional, meaning that not only can chronic pain have a negative effect on your mental health, but your mental health could contribute to your risk of developing chronic pain.

When chronic pain is linked to a mental health issue rather than a physical injury, it’s referred to as “psychogenic pain.” 

You may be more at risk of developing psychogenic pain if you have an anxiety disorder, severe stress or clinical depression. Other psychological and behavioral factors are also thought to play a role in this type of pain.

Chronic pain can’t be cured, but there are effective treatments available to lower the severity of your pain and make living a normal life easier.

Currently, the most widely-used medical treatments for chronic pain are analgesics (painkillers, or pain relief medications), anticonvulsants and antidepressants.

For some types of pain, such as stiffness and discomfort from muscle cramps, drugs like muscle relaxers are also sometimes used.

Treating chronic pain is difficult, and it often involves finding a medication that’s effective for you, then gradually adjusting the dosage you're prescribed until your pain becomes easier to manage without any significant or bothersome side effects.

Sometimes, it also involves treating any mental health conditions that develop at the same time as your ongoing pain. 

Before prescribing medication for chronic pain, your healthcare provider will likely talk with you about your symptoms. They might ask:

• How severe your pain is

• Where you feel pain in your body

• How frequently you experience pain

• How your chronic pain affects your daily life

• If you’ve recently experienced a physical injury, illness, or other medical issue

• Whether you’ve recently undergone a surgical procedure 

• If you’ve been diagnosed with a mental health disorder

• If you have any symptoms of anxiety, depression or stress 

They may also use one or several tests to check for damage to your muscles, nervous system, joints or bones, or for the presence of other medical conditions that could cause pain. 

You may need to fill in a questionnaire to help your healthcare provider understand the severity of your pain and how it’s affecting your physical and mental wellbeing.

Medications for Chronic Pain

Several different types of medications are commonly used to treat chronic pain. Your healthcare provider may suggest using one of the following types of medication:

• Nonsteroidal anti-inflammatory drugs (NSAIDs). These medications help to control pain and inflammation. 

• Non-NSAID medications. These medications, such as acetaminophen, are also used for chronic pain treatment. They are better for long-term use in some people than NSAIDs.

• Antidepressants. These medications work by changing the levels of certain chemicals in your brain and body that are involved in modulating pain perception. Antidepressants can also treat depression and anxiety, which often occur with chronic pain.
  Common types of antidepressants used to treat chronic pain conditions include tricyclic antidepressants (TCAs) and serotonin-norepinephrine reuptake inhibitors (SNRIs).

• Topical medications. Some topical creams, gels and solutions may be used to relieve pain that only occurs in specific areas of your body.

• Anticonvulsants. These medications work by changing the way your nervous system functions. Your healthcare provider may prescribe an anticonvulsant medication if you have nerve pain.

• Opioids. These medications help to reduce pain by targeting opioid receptors on your nerve cells. They’re effective at controlling pain, but can cause dependence and aren’t typically used as the first treatment option if you have chronic pain.
  Misuse of opioids is common, and your healthcare provider will likely talk to you about the risks and benefits of this type of medication before prescribing opioids for pain.

Because chronic pain can vary in type, there’s no one-size-fits-all type of medication that your healthcare provider will prescribe. You may need to try several medications before finding one that provides relief from pain without causing unwanted side effects.

Research shows that with ongoing treatment, most people with chronic pain are able to reduce their pain scores (a measure of how severe their pain is), allowing for better everyday function and quality of life. 

Other Options for Improving Chronic Pain

In addition to using medication, making changes to your habits and lifestyle can often make pain easier to deal with. 

Good habits for improving chronic pain include:

• Meditating. Although research is mixed in quality, some studies suggest that meditating can offer benefits for reducing pain and improving quality of life. Meditation is also linked to improvements in the symptoms of stress, depression and anxiety.

• Relaxation techniques. Practicing relaxation techniques at home may make it easier to deal with chronic pain.

• Yoga. Some evidence suggests that yoga may help to reduce the severity of lower back pain, neck pain and other forms of pain, such as osteoarthritis.

• Maintaining a healthy lifestyle. Making other healthy changes, such as cutting back on alcohol, quitting smoking, avoiding illicit drugs and eating a balanced diet may help you if you have chronic pain symptoms.

If you have anxiety, depression or another mental health issue in addition to chronic pain, talking to a therapist can often make dealing with your symptoms easier.

We offer a range of mental health services online, including psychiatry, online individual therapy and anonymous support groups, allowing you to access mental health support from home. 

Chronic pain is a common condition that can have a serious impact on every aspect of your life, including your mental wellbeing.

If you have chronic pain, it’s important to talk to your healthcare provider about what you're experiencing. Many cases of chronic pain can be managed with medication, changes to your lifestyle or a combination of approaches to treatment. 

Over time, you and your healthcare provider may be able to identify an approach that works well for you and provides relief from your symptoms, letting you live a more normal life. 

If you’re worried about anxiety or depression due to chronic pain, you can take part in a mental health consultation online to talk to a licensed provider about your symptoms and access care, including anxiety or depression medication.