The Science Between Physical Pain & Mental Disorders

Introduction

Have you ever questioned how feeling mentally numb started after your physical pain? Ever feel that the intensity of your pain has increased when you’re in a state of sadness are despair? Do you feel confused and alone while physical pain and mental depression are occurring? Don’t fret; you’re not alone. In fact, research has shown that 30-50% of individuals suffering from chronic pain also have a behavior disorder where depression and anxiety were shown to be the two most significant behavior disorders. There is no doubt an association between chronic pain and mood disorders so let’s explore this connection and how consulting and strategizing with your doctor can go about treating these symptoms.

Acute Vs. Chronic Pain

Pain can be defined as either being acute or chronic based on the length that the pain has persisted. Any injury associated with pain that persists for three months or longer means that the normal healing process is irregular. Thus pain associated with this injury is identified as chronic. There is some disagreement within the medical community as to what identifies acute or chronic pain; nonetheless of physicians are beginning to consider chronic pain as an underlying factor that may contribute to mental illness.

Chronic Pain and Mental Disorders; Which Came First?

This is a question of which came first, the chicken or the egg? However, concerning chronic pain and mental illness, it can work both ways. Pain can cause depression and anxiety. Depression and anxiety can also cause pain. It can create a cycle where one continually worsens the other. For example, someone in pain from an injury may cut back on their activity because they are reluctant to exacerbate their injury.

Let’s look at another example. Chronic pain may be causing someone sleep problems. Lack of sleep has been shown to create the thought of anxiety, helplessness, and worthlessness. A continuation of these feelings may lead to someone to a diagnosis of mental illness.

Treatment Options

A comprehensive approach to treatment involves a thorough evaluation to determine what might be contributing to both the pain and the mood disorder. If it’s something physical, like arthritis contributing to pain, treating the pain may improve the depression. Treatment may involve medication, physical therapy or other treatments, such as nerve blocks. For other cases, it is important to address the psychological aspects of counseling or with drugs that may help improve both pain and depression.

Other options for treating both pain and depression include:

  1. Education. This is essential for both the one with the ailments as well as for their family. Talk to you doctor, ask questions, and absorb as much information as you can.
  2. Self-help Groups. These can be helpful because it will allow you to understand that you are not alone in your battle. Talking with others is not only therapeutic, but it can also begin changing your mental affect, which in turn may reduce your pain symptoms.5, 8, 9
  3. Cognitive Behavioral Therapy. This for of therapy may help you develop coping skills so that you can manage your pain as well as your mental thoughts.2, 3
  4. Hypnosis. This sort of treatment has been shown to help patients reach a relaxed state that may allow for positive suggestions.6, 11
  5. Exercise. Exercise has numerous health benefits. One being that it can boost your mood as well as reduce pain symptoms.1, 6, 10
  6. Meditation. This practice has been shown to contribute to reducing the stress response that often worsens pain and increases the symptoms of depression and anxiety.4, 7

It’s important for people to treat their pain and depression, and to take part in activities. Rather than focusing on what they cannot do, it is important that patients realize what they can do.

Did any of these alternative treatment options work for you? Let us know!

Tags: anxiety, chronic back pain, chronic conditions, chronic knee pain, chronic neck pain, chronic pain, depression

References:

  1. Abenhaim L, Rossignol M, Valat JP, Nordin M, Avouac B, Blotman F, et al. The role of activity in the therapeutic management of back pain. Report of the International Paris Task Force on Back Pain. Spine 2000; 25: 1 S–33S.
  2. Ayen I, Hautzinger M. [Cognitive behavior therapy for depression in menopausal women: a controlled, randomized treatment study] Zeitschrift fur Klinische Psychologie und Psychotherapie. 2004;33:290–299.
  3. Cuijpers P, Smit F, Bohlmeijer E, Hollon SD, Andersson G. Efficacy of cognitive-behavioural therapy and other psychological treatments for adult depression: meta-analytic study of publication bias. Br J Psychiatry. 196:173–178
  4. Felipe A. Jain, Roger N. Walsh, Stuart J. Eisendrath, Scott Christensen, B. Rael Cahn, Critical Analysis of the Efficacy of Meditation Therapies for Acute and Subacute Phase Treatment of Depressive Disorders: A Systematic Review, Psychosomatics, 2015, 56, 2, 140
  5. Gilbody S, Bower P, Fletcher J, Richards D, Sutton AJ. Collaborative care for depression – A cumulative meta-analysis and review of longer-term outcomes. Arch Intern Med. 2006;166:2314–2321.
  6. Maren Nyer, James Doorley, Kelley Durham, Albert S. Yeung, Marlene P. Freeman, David Mischoulon, What is the Role of Alternative Treatments in Late-life Depression?, Psychiatric Clinics of North America, 2013, 36, 4, 577
  7. Michael de Manincor, Alan Bensoussan, Caroline Smith, Paul Fahey, Suzanne Bourchier, Establishing key components of yoga interventions for reducing depression and anxiety, and improving well-being: a Delphi method study, BMC Complementary and Alternative Medicine, 2015, 15,
  8. Paul N. Pfeiffer, M.D. Efficacy of Peer Support Interventions for Depression: A Meta-Analysis. Gen Hosp Psychiatry. 2011 Jan–Feb; 33(1): 29–36
  9. Rush AJ, Trivedi MH, Wisniewski SR, Nierenberg AA, Stewart JW, Warden D, Niederehe G, Thase ME, Lavori PW, Lebowitz BD, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: A STAR*D report. Am J Psychiat. 2006;163:1905–1917.
  10. Skouen JS, Grasdal AL, Haldorsen EM, Ursin H. Relative cost effectiveness of extensive and light multidisciplinary treatment programs versus treatment as usual for patients with chronic low back pain on long-term sick leave: randomized controlled study. Spine 2002; 27: 901–910.
  11. Tomonori Adachi, Haruo Fujino, Aya Nakae, Takashi Mashimo, Jun Sasaki, A Meta-Analysis of Hypnosis for Chronic Pain Problems:A Comparison Between Hypnosis, Standard Care, and Other Psychological Interventions, International Journal of Clinical and Experimental Hypnosis, 2014, 62, 1, 1
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