Chronic pain, a debilitating condition affecting millions of individuals, is often accompanied by a silent companion that frequently goes unnoticed: mental health struggles.
We spoke with Samantha Kluger, PsyD, a CU Medicine psychologist with a background in pain psychology, about the often misunderstood connection between
mental health and chronic pain.
“Pain and emotions can trigger each other,” explains Dr. Kluger. “Pain can mess with our mood and having strong emotions can mess with our pain.”
Screening individuals with chronic pain for mental health issues is imperative for promoting healthy outcomes, considering that an estimated 35% to 45% of people with chronic pain also experience depression1.
Understanding chronic pain
Pain lasting longer than 3 months is called chronic pain. The pain may come and go or be constant. Chronic pain can happen anywhere in your body.
According to Dr. Kluger, “If everyone is assuring you that you're fine or if an injury has healed but you are still experiencing pain, that’s an indicator your pain could have transitioned into a chronic condition."
The chronic pain and mental health connection
Chronic pain and mental health are intricately intertwined, with each influencing and even exacerbating the other.
“Pain is 100% produced by the brain. The body receives information from the environment – a cut on your arm for instance – and sends the information up the spinal cord to the brain. The brain then interprets the signal as pain,”
explains Dr. Kluger.
Pain’s influence on mental health: The persistent presence of chronic pain often leads to heightened levels of anxiety, depression and stress. The constant discomfort and the challenges associated with managing pain can significantly impact an individual's
psychological state, affecting their overall mood, cognition and emotional well-being.
Mental health’s influence on pain: Mental health conditions, such as anxiety and depression, can contribute to a phenomenon known as central sensitization. This process involves the amplification of pain signals within the central nervous system,
resulting in heightened pain perception. The presence of untreated or undertreated mental health disorders can intensify the perception of pain, making it more challenging to manage effectively.
Coping and treatment for chronic pain and mental health
Chronic pain and mental health issues can be a vicious cycle. Dr. Kluger recommends a holistic approach. She explains, “Doctors may recommend medicine, procedures, physical therapy and occupational therapy. Psychology can be very helpful as well.”
The key to managing chronic pain-related mental health issues is to break the cycle. Whether that means pain management or mental health help, interrupting the pattern is essential to finding a solution.
Chronic pain and mental health interventions include:
- Cognitive-behavioral therapy (CBT) for pain management
- Mindfulness-based stress reduction (MBSR) and meditation
- Pain medications
- Anti-depressants
- Physical therapy and exercise
- Coping techniques and stress reduction strategies
- Healthy lifestyle choices and pain self-monitoring
Seeking help for chronic pain
"My personal advice is knowing that pain does not have to control you," says Dr. Kluger. In addition, understanding how pain works and that you don’t have to go it alone is the key takeaway Dr. Kluger wants patients to know.
If you think you may be experiencing chronic pain, schedule an appointment with your primary care provider as a first step. CU Medicine offers primary and specialty care with thousands of providers at over 75 locations in the Rocky Mountain region.
If you are experiencing suicidal thoughts or behaviors, please seek help immediately. Assistance can be sought at your nearest emergency room or by contacting Colorado Crisis Services by phone at 1-844-493-TALK (8255) or online at coloradocrisisservices.org.org. The National Suicide and Crisis Lifeline can be accessed by dialing 988.
References
Vadivelu, Nalini, et al. (2017). Pain and Psychology-A Reciprocal Relationship. The Ochsner Journal, 17(2): 173-180.