Chronic pain can adversely affect mental health, and, depending on one’s pain threshold, it could lead to anxiety, irritability, interpersonal conflicts and depression
Written By Neha Jain
With Quotes from Dr Darshan Angadi (orthopedic surgeon), Dr Prashant Bhimani (psychologist)
It’s crucial to focus on mental health to manage pains that are rooted in one’s mind.
The threshold for pain varies from person to person, as it’s subjective and perceptive. While a few might be sensitive to a certain type of pain, there would be many who can easily tolerate it. The same is the case for chronic pain, which can negatively impact one’s mental health.
The variance in pain threshold and perception means that its mental impact would be significant for some while absent for others, making it hard to address. Experts explain the relationship between pain and mental health, highlighting the need to address both simultaneously.
How does chronic pain impact mental health?
“Chronic pain can lead to depression, anxiety, irritability and interpersonal conflicts because one’s coping mechanism becomes fragile and weak while the levels of neurotransmitters like serotonin and other happy hormones go down,” says Dr Prashant Bhimani, a senior consultant psychologist from Ahmedabad.
Pain is broadly classified as acute or chronic. However, there are many who endure both together. For instance, those with rheumatoid arthritis (RA) deal with chronic pain and bouts of acute pain. These typically correspond to flare ups of RA symptoms.
These flare-ups can affect mental health, shares Dr Darshan Angadi, consultant orthopedic surgeon, Altius Hospitals, Bangalore. “The brain knows that the joint or the specific part of the body is painful and that there is a trigger element, which can be an injury or inflammation. However, once the threshold is breached and there is a new level of pain, it directly impacts the mood or the mental well-being of the individual,” he explains.
A disrupted mental state can contribute to chronic pain
The mood and mental state of an individual can contribute to chronic pain as well. When people feel low on energy or their mood dips, they invariably feel some odd aches and pains; they may also be fatigued and worn out. The trigger here may not be an injury. This is just the brain perceiving pain in response to mental triggers.
“There are different factors that cause chronic pain, and we try to identify the predominant one. To name some, they can be mental triggers related to mood, injuries, certain infections, some form of cancer and neurogenic or neurological pain,” says Dr Angadi.
Managing chronic pain: Mental health must be the primary focus
To address chronic pain, the primary focus should be on mental health, say experts. This will help deal with the pains that are psychosomatic in nature, where the cause of the pain or its perception is in the mind, not the body. “The pain from unknown or specific causes, including body pain, headache, migraine, rheumatoid arthritis pain and joint pains, might result from stress. It is not something that originates from the body. Sometimes, it is rooted in the mind, and then it affects the body,” says Dr Bhimani. It’s a vicious cycle, and the mind needs to be treated first before addressing the bodily issues.
If the individual is in a good mental space, i.e., they’re at peace or relaxed, the pain is easily manageable. In addition, being cautious of movements, diet and sleep can also help manage chronic pain.
Ways to cope with mental health issues
People with chronic pain are exposed to various forms and intensities of pain, with some experiencing chronic fatigue syndrome. These issues can be addressed through counseling and psychotherapy. One should talk about the pain with a caregiver or relative, which can help them deal with the situation effectively.
“Self-help techniques like yoga, meditation, walking and regular exercise help keep the body and mind intact. Additionally, socializing, especially with like-minded people, is a kind of therapy that can ease the pain,” advises Dr Bhimani.
Treating chronic pain
Mental health issues and a low mood can trigger a small episode of pain (acute pain) in some, which can turn chronic. There is a complex interplay here. For them, the diagnosis and treatment approach must be decided in a structured way by a multidisciplinary team of doctors. “The treatment depends on the cause of chronic pain. If it’s from an injury, then a surgeon, rehabilitation specialists and pain specialists are to be sought. To treat mental health issues that flare up while dealing with chronic pain, counseling and therapy sessions with a physiatrist or psychologist will help,” says Dr Angadi.
Certain chronic pains will never go away, and those affected must accept that they have to deal with this throughout their lives; they shouldn’t be in denial. People must manage the pain through relaxation techniques, listening to music or engaging in activities they enjoy, which will elevate their mood and help them deal with the pain. “This way, the perception of pain becomes a lot less, as it shifts their focus from constantly thinking about it. This kind of positive approach and attitude towards life can help reduce the pain to a significant extent,” concludes Dr Angadi.
Takeaways
- Chronic pain can give rise to mental health issues like depression, anxiety, irritability and interpersonal conflicts since the coping mechanisms of those affected become weak.
- Factors contributing to chronic pain are widespread, including mental triggers, a low mood, injuries, certain infections, some forms of cancer and neurogenic or neurological pain.
- To treat chronic pain, it’s paramount to address the mind before the physical aspect. It requires a multidisciplinary approach.
