Emotional Impact of Pain

Emotional Impact of Pain | Pain Management & Understanding | Arthritis.org

Although it may feel like it’s coming from your joints, pain – particularly the chronic pain common to arthritis – is also an expression of your state of mind.

If you’re depressed or anxious, you’ll very likely hurt more than when your mood is lighter or more balanced.

The crucial distinction is that depression or anxiety will only worsen *pre-existing* pain, not create new pain.

The fact that pain itself is depressing and worrying only makes the problem worse. 

Chronic pain and emotions are so intertwined, in fact, says psychiatrist and palliative medicine physician David Buxton, MD, that’s it’s often hard to tell where one ends and the other begins.

People with depression, for example, have about three times the risk of those without it of developing chronic pain. And, those with chronic pain have about the same increase in risk for winding up with clinical depression.

Depression and anxiety can intensify feelings, including pain, hopelessness and sadness, he says. “Mentally, emotionally and physically, everything sensory, including pain, ratchets up.”

Yes, intensify feelings, but not start them. As with pain, depression and anxiety don’t create or cause the painful symptom, but they will certainly magnify the misery.

Multiple studies of osteoarthritis, rheumatoid arthritis, lupus and fibromyalgia show that people who experience more negative emotions also report more pain.

Not surprisingly, people with these conditions also have substantially higher rates of depression and other mood problems compared with those without arthritis and related conditions.

So pain and depression are fully bi-directional, each enhancing the other.

It’s not difficult to imagine a person becoming trapped in a  state of pain leading to depression leading to more pain and so on until they are suicidal.

Pain and the Brain

“Pain-related signals reach the brain through multiple pathways, but pain is constructed in the brain,” explains Tor Wager, PhD, director of the Cognitive and Affective Neuroscience Lab at the University of Colorado at Boulder.

All of the regions targeted by pain-related signaling from the body have other functions – some help regulate blood pressure and other aspects of physiology, others participate in creating strong emotional responses, and yet others help you learn what to do and not do in the future.

So, pain-related signals interface with other brain processes in many ways,” he says.

This is probably why chronic pain, even at fairly moderate levels, is so disruptive. So many other brain processes are affected that even if we can ignore the sensation for a while, we can’t escape the effects pain has on our brain functions.

The way people interpret and cope with their emotions and pain, for example, drive the patterns created by the brain. These patterns shape how we remember our pain, and those memories, in turn, strongly influence what we feel in the present, says Dr. Buxton.

5 thoughts on “Emotional Impact of Pain

  1. lawhern

    I personally approach an article like this from two perspectives. Without a doubt, we need to understand the neuroscience behind connections between chronic pain and depression. But we also need to understand and take action to CHANGE the current practical impact of physician misunderstandings of these connections.

    In practical terms, a diagnosis of “psychogenic” pain in addition to any serious underlying disorder, may directly increase the risk of patient suicide by 250%. The mechanism for this risk elevation is essentially social in character. When a mental health related diagnostic code appears in a patient medical record, altogether too many ill-trained physicians will interpret this code informally as “the pain is mostly in the patient’s head. They are catastrophizing, or perhaps even malingering for the attention”. Physicians who harbor such attitudes regularly resist the expense and time needed to more thoroughly investigate the patient’s un-diagnosed medical symptoms. The doctor’s dismissal of the patient’s reports is tantamount to discrediting the patient as an observer in their own life. And such dismissal very commonly leads to further social isolation and deeper depression… and in some cases to iatrogenic suicide.

    Thanks for your ongoing work to illuminate the many dimensions of chkronic pain.

    Liked by 1 person

    1. Zyp Czyk Post author

      Yes, you’ve captured the experience perfectly: “discrediting the patient as an observer in their own life”.

      That’s exactly how I felt when a Stanford doctor from their “pain clinic” told me that opioids weren’t effective for the pain I had been treating successfully – with exactly that drug! Because I had arrived at their clinic with such high hopes and expectations, I was prepared to submit completely to their purported expertise, so that statement momentarily left me stunned. (But not too stunned to leave.)


  2. Renee Bosler

    Get real!!!! MRIs, X-rays, Labs and
    Objective Criteria refute your analysis, I agree Neurotransmitters due play an important part…but if that is addressed and the pain persists what then???

    Liked by 1 person

    1. Zyp Czyk Post author

      Medical folks seem to think that depression leads to pain, while most pain patients know that pain leads to depression. So what happens when a doctor suffers chronic pain? Do they then “see the light”?

      I assume that everyone who actually *has* pain knows how this works, but doctors keep insisting the contrary.


  3. Renee Bosler

    Get real!!!! I agree Neurotransmitters play an important part; but MRIs, X-rays, Labs and Objective Criteria refute your analysis




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