Understanding The Complicated Relationship Between Chronic Pain and Mental Illness

Not only does chronic pain come with physical issues, but it can also result in some serious emotional turbulence. People living with chronic pain are 4x more likely to experience mental illness than their pain-free counterparts. Living with both chronic pain and mental illness can be frustrating for both individuals and their loved ones.

One condition can affect and exacerbate the other condition’s symptoms. Likewise, the dual impact of both issues can dramatically compromise one’s livelihood and overall functioning.

Let’s unpack more of what you need to know about these challenging relationships.

Chronic Pain and Depression

Depression is the leading cause of disability around the world. Research estimates that over 16 million Americans experience at least one major depressive episode in the last year.

Depression and chronic pain, unfortunately, can go hand-in-hand. Depression is encapsulated by thoughts and feelings related to shame, guilt, worthlessness, and low self-esteem. Depression can impact all areas of one’s functioning including sleep, appetite, cognition, and mood. It can make daily tasks feel unsurmountable, and many people find themselves isolating from loved ones and typical pleasant activities due to the sadness or apathy they experience.

Just like chronic pain, depression can strike at any age. However, many people with chronic pain struggle with depressed thoughts and feelings. Depending on the pain condition, your semblance of “normal” can change dramatically. Your relationships may change; your career may face complications; your finances may suffer.

Any of these changes (or anticipated changes) can be undoubtedly challenging. You may struggle with disproportionate feelings of shame or guilt. You may feel angry or resentful towards other people- or even towards yourself. You may worry that the quality of your life will never improve, and that can trigger a deep depression for even the most resilient person.

Chronic Pain and Anxiety

Like depression, many people also struggle with anxiety disorders. Anxiety can happen to anyone, and certain life circumstances can intensify anxiety symptoms.

Chronic pain often entails many unknown variables. What kind of recovery can you expect? How long does treatment take? Is there hope for improvement? Is there a qualified diagnosis, or are the doctors still running tests and evaluations?

These variables can ramp up anxiety levels. You may struggle with racing thoughts, nightmares, or hypervigilance. You may feel like your mind is constantly in the future- and not in a good way. Instead of feeling excited and optimistic about what potentially lies ahead, the future seems dreadful or even terrifying.

If you experienced a trauma resulting in physical injuries, you might experience PTSD. PTSD is an anxiety disorder resulting from trauma. The symptoms may include cognitive impairments, avoidance tendencies, hyperarousal, and mood disruptions. People who suffer from chronic pain due to a traumatic injury may feel resentful, depressed, and enraged over what happened to them.

Extreme levels of anxiety can worsen your condition. Because we carry stress in our bodies, excess tension can worsen inflammation, which can exacerbate the pain.

Chronic Pain and Substance Use Disorders

Approximately 21-29% of patients receiving opioids for chronic pain misuse their medication. Around 10% of those individuals develop an opioid use disorder, and an overwhelming number of heroin users didn’t start with heroin- they started with prescription medication.

The relationship between chronic pain and substance use disorders is a difficult one. Many people need medication to relieve their symptoms. However, all narcotic medications carry the risk of dependence and misuse. As a result, many people turn to self-medicating their symptoms via drugs or alcohol to “numb” the pain they feel.

The problem is insidious. People may be fearful of stopping their medication because they worry about distressing withdrawal effects. Or, they may believe that they will not be able to function without the substances.

Treating Both Chronic Pain And Mental Illness

Unfortunately, many people only focus on the physical pain component when addressing their chronic pain issues. They don’t address the co-occurring mental illness, and the symptoms often worsen- possibly without warning.

That is why it is so crucial to treat both chronic pain and mental illness simultaneously. Doing this provides you with faster relief, and it also offers you the best chance for recovery.

Therapy can treat both conditions, and it can help you learn how to manage your symptoms in a way that feels realistic and feasible. Therapy also gives you emotional support and encouragement, even when you feel scared and alone. Are you ready to take the first step towards change? Contact me today to learn more!



4601 Spicewood Springs Road Building 3, Suite 200
Austin, TX 78759

kara@hartzellcounseling.com
(512) 988-3363

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