Psychological Effects of Chronic Pain

Eric H. Williams MD
Specializing in reconstructive surgery and pain relief in the Greater Baltimore area.

Chronic pain is terrible.

Sure, the pain itself is an obvious problem—symptoms like burning, tingling, and pins and needles sensations make for absolutely miserable experiences. But this only delves into the physical side of things. The fact of the matter is this:

Chronic pain can also affect your psyche.

For this reason, it is best to seek a multidisciplinary approach that potentially can include mental health professionals, pain management specialists, and possibly even a peripheral nerve surgeon. Assembling a team like this allows you to receive mental health support and—when appropriate—surgical intervention that may take away the pain and help your situation.

Chronic Pain

Chronic Pain and Mental Health

There are, of course, various types of chronic pain. That should be expected given the complexity of the human body. You can have long-term pain from conditions like arthritis or following physically traumatic accidents.

A source of chronic pain that is of particular concern at our office is neurogenic pain—which is pain generated from a problem with a nerve in your peripheral nervous system (outside the scope of your brain and spinal column). This happens when nerves are injured, compressed, trapped, or damaged in some manner and cause painful symptoms like the ones we had just noted.

If you are experiencing pain related to your peripheral nervous system—and not caused by or found within your central nervous system (brain and spinal column)—we would love the opportunity to determine if one of our techniques might provide the relief you need. After all, physical pain—and especially when it’s chronic (long-lasting)—is extremely frustrating. If we could take away that frustration for you, it would be our pleasure to do so.

Now, given how frustrating the physical symptoms can be, it’s quite easy to look past mental and emotional elements.

Sadly, that can be a big mistake.

There’s a greater connection between our physical, mental, and emotional states than we often realize. Because of this, the potential exists for psychological effects of pain to be a major problem.

However, when we look at the stats, we see this isn’t just a matter of “potential”:

Psychological Effects of Chronic Pain

With this mind, let’s take a closer look at issues like depression, insomnia, and anxiety:

Depression. It’s only natural to feel down when you can’t sleep, socialize, work, etc. That’s concerning enough in and of itself, but some people who endure chronic pain also experience major depressive disorder. Symptoms of this include persistent feelings of sadness, tendencies to isolate, inability to concentrate, loss of interest in favorite activities and pastimes, low sense of self-worth, appetite changes, and sleep disturbances.

Chronic pain is able to trigger depressive episodes even in those who had previously never struggled with depression. In part, this can stem from insomnia—more on this in a moment—and the related fatigue it causes. Additionally, pain issues may cause you to withdraw from activities and social events, thereby isolating you from loved ones.

Insomnia. Perhaps one of the more easily understood consequences of chronic pain is the fact that it can make sleeping quite difficult. This can often be attributed to the pain itself, but it might also be related to side effects from any pain medication you might be on.

This is a major problem. Put simply, you need quality sleep to function at optimal levels. When you don’t receive enough—and adults should get between seven to nine hours of sleep every night—it affects hormonal balances and impedes your body’s ability to restore itself naturally. More specifically, lack of sleep can lead to issues with concentration, memory, fitness, and digestion. On top of that, insomnia can exacerbate psychological issues like depression and anxiety.

Anxiety. Anxiety is a psychological disorder that can be characterized by excessive worry. In the case of chronic pain, things you might worry about include:

  • Why you’re in pain and what it means for your physical health
  • Getting to doctor’s appointments, or being able to get in soon when the pain is especially severe
  • Whether you can keep your job if you have to take days off because of the pain

And that is only a snapshot of the worries that can come with long-term pain issues. In all likelihood, you will come up with even more when the pain keeps you up at night—including the fact that pain is keeping you up at night!

This leads to an obsession of negative, “what if” scenarios and a fear that the pain will never go away (or that it’s symptomatic of another serious illness). In turn, this can make you start to second-guess yourself and wonder if you’re overreacting or your pain is actually psychosomatic (which is possible, but it’s more probable that the problem isn’t simply “in your mind”).

Perhaps unsurprisingly, all of this means that chronic pain can definitely cause anxiety and even panic attacks in some cases.

Fatigue. It’s best to start discussing this issue with a clarification—fatigue is not the same thing as simply being tired. The distinction here is that feeling tired is something that can be fixed with proper rest; fatigue doesn’t go away with a reasonable amount of rest. (If anything, rest might exacerbate the feeling of fatigue.)

With fatigue, even an otherwise easy stroll around the block can feel as though you are running a marathon.

So where does this fatigue come from? Usually, the core issue is that an affected individual will become so focused on anxiety-causing matters—and we’ve just seen that these can be plentiful—that they become mentally exhausted.

Guilt. This is yet another psychological effect of pain that is generally easy to understand when you stop to think about it. It’s natural to feel guilty on accord of being unable to handle normal tasks and obligations when you suffer from a chronic condition. You might not be able to work for more than only a few hours a day or find yourself unable to play with your toddler—which are obviously things that can contribute to depression and/or anxiety.

On its own, guilt isn’t technically a disorder, but it is something that can definitely overwhelm a person. And this makes it one of the more overlooked, yet insidious side effects of chronic pain.

Beyond being overwhelming, guilt may cause you to start feeling angry at yourself or place unwarranted blame on yourself for not being able to engage with the world and do the things you are used to doing. It can also keep you from activities and events you might normally take for granted, such as exercising, work, and socializing.

Anger/Frustration. Chronic pain has a way of changing one’s emotional state. For example, you may have developed a tendency to loser your temper more easily or frequently due to being frustrated by you “lot in life” or having your previous abilities to participate in life activities taken away. Sometimes, the anger becomes directed at your spouse or other family members, when this previously hadn’t been an issue.

You might also become quite angry towards the person or thing that had caused your chronic pain (such as if you were in an automobile accident, had one of your hand’s nerves damaged while using a certain machine at work, etc.)

Whereas these feelings are certainly understandable, it’s important that you work through and address them with the help of a trained, mental health professional.

Talking to Doctor

Don’t Suffer—Physically, Emotionally, or Mentally—If You Don’t Have To!

If you have developed these kinds of symptoms as a result of chronic, neurogenic pain, it is critical that you tell your primary care physician or pain management team—along with seeking professional mental health help.

You might find that cognitive therapy—either in group or 1-on-1 sessions—can help you to work through psychological issues that are holding you back. In some cases, you may benefit from prescription medications in treating these symptoms while your search for the treatable cause of the chronic pain continues.

Perhaps you might even find proper support through other social or religious groups and/or activities. Sometimes exercise can be the answer (although, we certainly understand this may be difficult if you have physical pain or severe fatigue).

We encourage our patients to explore all these different avenues. In doing so, you actually might have better results from treatment for chronic pain.

(Even when medical professionals are able to identify and treat chronic pain, it can be more difficult when a patient is also suffering from depression or anxiety.)

As such, it’s best to reach out to others and determine what helps you the most before embarking upon invasive treatment options. And to achieve that, we hope you can keep this in mind:

Complete treatment is best achieved through a group effort that may require a multi-discipline approach.

Again, our area of specialty is in treating peripheral nerves (the ones that exist outside your central nervous system). If you have peripheral nerve entrapment, compression, injury, or other damage in your trunk or any of your limbs, there may be a possibility that we can help.

For more information about our services and what kinds of issues we have been able to treat for patients, please feel free to explore our website.

If you’ve checked out our services and learned more about us (and what we do) and feel as though we might be able to help you, simply give us a call at (410) 709-3868 and speak with one of our team members.

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