Topic 6: Challenging Thoughts, Emotions and Pain

Chronic pain can be one of the most debilitating conditions in daily life. Chronic pain goes beyond the pain itself. The mental stress and biopsychosocial effects of pain can be just as severe as the pain itself. In fact, people with chronic pain are three times more likely to develop depression. If you’re suffering from chronic pain and have noticed an increase in irritability, mood fluctuations, and other psychological issues, you’re not crazy.

Pain is inextricably linked to emotions. In fact, physical pain and emotional pain exist on almost the same circuitry of the nervous system, with common brain systems involved. For this reason, it’s not surprising that the presence of chronic pain is often associated with emotional changes. Anxiety associated with chronic pain is real. As a stressor, the natural response is to escape or flee the pain. However, with chronic pain, this is often not possible. Even in times where the pain is not present, chronic pain sufferers may experience anxiety surrounding the return of the pain. This anxiety can be crippling and detrimental to the quality of life. The link between chronic pain and depression is strong, but it’s not well understood by psychologists.

Some researchers believe this depression as a result of pain may be programmed into our wiring evolutionally. Contextually, it makes sense. Withdrawing from society provides the body with a peaceful environment that is needed to heal. It also creates a “safe place” away from stressors and possible threats. However, chronic pain makes this difficult because the threat is internal, not external. The result can be chronic, nagging depression that seemingly has no end. Depression-like symptoms may also evolve as a perception of loss of control. This is called adjustment disorder and results when an individual fails to adapt or cope with a perceived stressor like chronic pain. However, depression is not necessarily a guaranteed progression in chronic pain. It is impacted by a number of factors, including genetics.


Credits: Joyce McSwan – PainWISE Pty Ltd.

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