Pain: It’s not in your head, but it might impact your mental health
If you’re reading this right now, chances are that you are more than familiar with chronic pain and the impact it has on your body. What you might not know (but chances are that you do and that is why you clicked on this post) is that pain can have an impact on all aspects of your life including your mental health.
I think it is important to stress as strongly as possible that just because you might be struggling to cope with chronic pain or illness does not mean that the pain is in your head. Your pain is real. It doesn’t matter if other people can understand it, or if medical providers have been able to find the right label or diagnosis for it- it’s real and it’s having a real impact on you. I’ve had countless clients over the years tell me that they were referred to mental health or specifically to pain psychology “because the doctor thinks it’s all in my head”. Sometimes, this may very well be the case; I know from experience that there are people out there who may explain the pain away as “stress” or “depression”, and there is a large amount of scientific research that shows that women who have pain are more likely to be prescribed antidepressants or referred to mental health services (Hirsch et al, 2014). When this happens, it is easy to feel dismissed and to assume that “it’s all in the head” and this is both frustrating and disheartening for both you as the patient and me as a pain psychologist. So let’s say it one more time for the people in the back: the pain is not all in your head, it’s real and it’s having a real impact on you.
While it’s easy and completely understandable to assume that a suggestion to see a mental health provider means that your pain is not being team seriously, let me play devil’s advocate for a moment and say that sometimes it might actually the opposite. It might be possible that your doctor or your family notice the significant impact that the pain is having on you, the whole you, and they want to help you.
The Impact on YOU
Pain can have a tremendous impact on your life. In the beginning of your chronic pain journey pain may have only limited your physical activities. If you are dealing with a degenerative pain condition maybe you noticed that little by little you had a harder time exercising or completing day to day tasks around the house like cooking, cleaning, getting dressed, getting out of bed, etc. If you are dealing with pain that came on suddenly (perhaps from an accident or other similar event), all of your physical activities may have come to a crashing halt, but you likely assumed it would get better- and then it didn’t. However you got here, it probably started with physical pain limiting your physical abilities.
Pain CAN negatively impact:
Your job
Your performance in school
Your finances
Your ability to interact with friend and family in the way you want
Your relationships
Your mood
Your sleep
Your sense of self (the way you think about yourself)
Over time, when pain gets in the way of being able to do the things you love and make you feel like you, it can be easy to slowly feel like you’re losing yourself. I know that’s how it feels for many of the people I’ve worked with in therapy.
Stress, anxiety, and depression are extremely common among people with chronic pain. I believe that this is completely understandable and human. It’s simple: when we cannot live our lives in the way that makes us feel fulfilled, happy, and fully ourselves because pain is getting in the way, of course it’s going to impact your mental health in some way.
The Pain Cycle
Have you ever had a day where you wake up and you are feeling pretty good and you think to yourself “maybe today won’t be so bad”, but then something makes you stressed or angry and before you know it your pain is sky-high? There is a scientific reason for this phenomenon; stress and other strong uncomfortable emotions make pain worse- crazy but it’s true! When we experience stress, anger, anxiety, or depression our bodies release chemicals to help us respond, but these chemicals also enhance pain processing. In other words, these emotions turn up the volume on our pain. For more information on the science behind this, stay tuned for upcoming posts.
To recap:
1. Pain can understandably have a negative impact on our mental health and lead to uncomfortable emotions like depression, anxiety, and anger.
2. Emotions like depression, anxiety, and anger can increase the amount of pain you experience and make pain worse.
These experiences feed off each other and it can be easy to get caught in a never ending vicious cycle of physical and emotional pain- that’s the pain cycle.
Breaking the Pain Cycle
Although it may feel as though it’s impossible to break the pain cycle, there are ways to do so. That’s why I became a health psychologist and that’s why I wanted to specialize in helping people with chronic pain. I knew that from my own experiences and by watching the experiences of my family that there had to be a better way- there had to be a way out of the cycle. And there is.
If you find yourself stuck in the pain cycle, know that you’re not alone and that it doesn’t have to be this way forever. Pain psychology or chronic pain therapy can be a game-changer when it comes to breaking the pain cycle. Check out the “therapy services” page here to see if pain psychology/pain-focused therapy might be right for you.
Additional Resources
The American Chronic Pain Association
https://www.theacpa.org/
References
Hirsh, A. T., Hollingshead, N. A., Matthias, M. S., Bair, M. J., & Kroenke, K. (2014). The influence of patient sex, provider sex, and sexist attitudes on pain treatment decisions. The journal of pain, 15(5), 551-559.
