Coping with chronic pain is never easy. But for some, the day-in, day-out impact of living with pain can lead to a second assault — emotional issues like frustration, anxiety, and eventually depression. And poor emotional health can further exacerbate physical pain, leading to a worsening of physical symptoms.
“What happens in the mind and emotions affects the physical body and vice versa,” says Katherine Puckett, PhD, LCSW, the national director of mind-body medicine for the Cancer Treatment Centers of America.
“Feelings of anger, depression, and anxiety contribute to stress, which in turn has physical effects such as increased muscle tension, increased heart rate, reduced functioning of the digestive system, increased inflammation in the body, and increased activity in the sympathetic nervous system that results in release of stress hormones,” say Puckett. Any or all of these physical effects of stress may in turn increase pain. And increased pain may make a person feel more depressed. It can be a vicious cycle if you don’t interrupt it.
How Pain Impacts Emotional Health
Chronic pain doesn’t necessarily doom you to depression or other emotional problems, but pain does lead to some situations that can make emotional issues more likely, says Scott Gottlieb, MD, of Gramercy Pain Management in New York. “Someone who is in pain stays home, feels frustrated, and can’t do what they used to do,” he says. “This impact of pain on activities of daily living can cycle some patients into a depressive state.”
Anxiety in particular often occurs when there’s uncertainty about what’s causing the chronic pain, adds Dr. Gottlieb. “For example, if someone is having headaches and nothing shows up in any tests or studies, it’s often hard for a patient to accept it’s just nerve pain as a diagnosis,” he says. “They feel pain in their head all day and are anxious that it is something more serious even though other serious causes have been ruled out.”
Managing Chronic Pain Emotions
These strategies can help you break free from the spiral of emotional problems leading to even more pain:
- Try counseling. Even if you don’t feel like you have full-blown depression or anxiety, a visit with a counselor can help stem the tide of pain-related emotions before they get worse. “A good therapist will listen, get to know the person, gain an understanding of what he or she is going through, and offer helpful reflections and suggestions,” says Puckett.
- Exercise more. Puckett says regular exercise is one of the best antidotes to both emotional problems and pain. And it doesn’t have to be an intense exercise that might exacerbate your pain either. If your doctor approves, “taking walks, enjoying nature, or playing with pets are all good choices,” Puckett says.
- Try deep breathing. Philip Wazny, NMD, a naturopathic medical doctor and pain specialist at Integrative Health Care in Scottsdale, Ariz., recommends a simple stress- and anxiety-reducing technique. “For beginners, taking as little as 10 minutes a day to focus on your breathing can be a game changer,” he says. “I recommend that people sit in a quiet space and focus on their breath. It sometimes helps to count to seven while inhaling, hold the breath for two seconds and then exhale for eight seconds. By exhaling for a little longer, patients are forced to use accessory muscles that cause a reflexive inhalation of healing oxygen.”
- Write it down. “Patients may benefit from keeping a pain log to chart their symptoms,” says Anand Gandhi, MD, a physician at the Laser Spine Institute. “This allows you to monitor pain over time and objectively compare from one day to the next.”
Above all, keep a positive attitude. It may be difficult at times, but Dr. Gandhi says this is critically important to not falling into the depths of anger, depression, or emotional distress. “Chronic pain causes both emotional and physical changes in many patients,” he says. “It is important that patients maintain a positive attitude and avoid allowing the pain to consume their lives.”