Each year, in the month of May the U.S. celebrates Mental Health Awareness month. Research has shown the deep connection between mental and emotional health and chronic pain. Read on to learn more about how the two are connected and strategies individuals can use to manage both mental health conditions — like chronic stress, anxiety, and depression — as well as pain.

How are Chronic Pain and Mental Health Related?

Chronic pain and mental health are so intertwined, it can sometimes be difficult to figure out which comes first. Much like the chicken or the egg problem, does the isolation, fear, and worry that comes with experiencing pain regularly lead to anxiety disorders and depression? Or do mental health conditions like anxiety and depression actually result in sensations of pain.

The answer is not so straightforward. We know from research that:

  • Individuals living with chronic pain in multiple areas are 3-5 times more likely to experience depression than people without chronic pain1.
  • The prevalence of pain in individuals living with depression is 65%1.
  • 60% of those living with chronic pain have a diagnosed anxiety disorder2.

Studies also found that when chronic pain and depression appeared together, there was greater health care use, which translated to more clinic visits, hospitalizations, and greater total medical care costs1. Therefore, it’s important to understand and recognize that mood disorders and chronic pain often coexist; recognition earlier may help clinicians to develop more targeted treatment plans and perhaps decrease overall health care costs.

Researchers studying mental health and chronic pain continue to discover new and novel things about how these conditions work. So, while this chicken and the egg problem hasn’t been solved quite yet, we have learned from this research that both conditions stem from and are deeply rooted in the functions of the brain and the nervous system3.

Strategies to manage chronic pain and anxiety

If both pain and mental health are linked to the brain and nervous system, it makes sense that the approaches to treat and manage anxiety have a lot of overlap with techniques that are proven to better manage chronic pain. A few of those include:

  • Cognitive behavioral therapy (CBT): A therapeutic approach that identifies and challenges a person’s negative thoughts about themselves and the world around them. Despite the fact that mental health conditions and chronic pain often occur together, only 8% of those who experience chronic pain receive CBT.
  • Movement: Whether simply walking to the mailbox or engaging in physical exercise, moving each day can significantly reduce symptoms of anxiety and to reducing pain intensity.
  • Sleep: A good night’s rest built on healthy sleep behaviors can be useful in reducing both anxiety and pain. Simple things like
  • Nutrition: Symptoms of anxiety and pain can be triggered or exacerbated by different types of food, for instance, caffeine, alcohol, sugar, and dairy. By understanding how food can be a trigger, individuals can pay attention to and log how their body reacts to what they eat.

Clearly, both mental health and chronic pain can impact someone’s ability to live how they want – from their sleep and nutrition to how they interact with family and friends, to how they show up at work. And while awareness of how mental health and chronic pain are connected, it’s equally important to know what can be done to help.

Fern Health understands the deep connection between mental and emotional health and chronic pain. Beyond addressing the physical aspects of pain, the Fern chronic pain program addresses the emotional and social factors that may be contributing to their pain experience.

Sources:

  1. Bair MJ, Robinson RL, Katon W, Kroenke K. Depression and Pain Comorbidity: A Literature Review. Arch Intern Med. 2003;163(20):2433–2445. doi:10.1001/archinte.163.20.2433
  2. Cosio D, Meshreki L. Anxiety and Pain. Pract Pain Manag. 2017;17(3).
  3. Harvard Health. 2010. The pain-anxiety-depression connection – Harvard Health. [online] Available at: <https://www.health.harvard.edu/healthbeat/the-pain-anxiety-depression-connection> [Accessed 24 May 2022].
  4. Adda.org. 2022. Chronic Pain | Anxiety and Depression Association of America, ADAA. [online] Available at: <https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/chronic-pain> [Accessed 26 May 2022].
  5. Jo Nijs, Olivier Mairesse, Daniel Neu, Laurence Leysen, Lieven Danneels, Barbara Cagnie, Mira Meeus, Maarten Moens, Kelly Ickmans, Dorien Goubert, Sleep Disturbances in Chronic Pain: Neurobiology, Assessment, and Treatment in Physical Therapist Practice, Physical Therapy, Volume 98, Issue 5, May 2018, Pages 325–335, https://doi.org/10.1093/ptj/pzy020

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