Is There A Link Between Chronic Pain And Mental Health

Written on 11/07/2023
Sophie Kirk

This might sound a little strange, but often pain can be a good thing. It’s your body’s way of telling you to stop what you’re doing and check for damage, because something isn’t working the way it should. It prevents you from making injuries worse, and signals that you need help to recover. 

But pain isn’t meant to last. Once the injury or illness has been treated, pain subsides away and you should be able to get back to your normal activities, pain-free. When pain persists and doesn’t go away, it’s known as ‘chronic pain’, and it’s not just your physical health that suffers, but your mental health too.


What Is Chronic Pain?

Chronic pain is the catch-all term for pain that doesn’t really go away. It could be constant pain or pain that goes away and comes back. To be considered chronic it has to last longer than 3-6 months and interfere with your daily life. At the moment around 15.5 million people in England have chronic pain – that’s 34% of the population! So it’s not exactly a rare or unknown issue. It can be caused by a number of things, from health conditions like fibromyalgia, osteoarthritis and rheumatoid arthritis, to injury or migraines, back pain and pelvic pain. It can range from localised pain in one area to widespread pain, and while some of the conditions that can cause it are treatable, many are not, or are difficult to diagnose. It’s actually one of the most common reasons adults seek medical help in the UK.


How Does Chronic Pain Affect Your Mental Health?

Chronic pain is far more than just sore muscles and aching bones. It’s a whole-body condition that doesn’t subside, and it can take quite the toll on your emotions, leading to some significant mental health challenges in the long term. For example, with chronic pain you can often see:

Depression & Anxiety: Being in pain all of the time is draining for your physical and emotional well-being. It can significantly impact your mood and emotions, particularly because when your body is in pain it triggers your brain to release stress hormones and neurotransmitters. This makes regulating your own moods much more difficult 

Addiction: When you’re in pain all the time, finding relief from that pain becomes one of your life’s priorities. Often this means turning to prescription painkillers or opioids, which are used to treat severe or persistent pain. While they may be effective, they are also very addictive, and around 29% of chronic pain patients will misuse them at some point. When it feels like your only relief is pain medication, it’s easy to become addicted to the solution, and potentially spiral into other addictive substances.

Lack of focus: If you’ve ever had a stomach ache or a mild headache, you know that when you don’t feel your best, it can be all-consuming. This is amplified when you have severe or widespread chronic pain, making focusing on work, family, and your other responsibilities a real challenge. This can drain the joy out of life and make it very difficult to complete day-to-day tasks.


The Neurological Link

In fact, researchers have found that pain shares some biological mechanisms with anxiety and depression, which may be why it is so common for these conditions to exist alongside chronic pain. One of the big indicators of this is the fact that both pain and depression share anatomy within the brain. For example:

·  The sensory cortex - which is the part of the brain that interprets sensation

·  The amygdala, hypothalamus and anterior cingulate gyrus – all the bits that regulate emotions and stress response

·  Two neurotransmitters (serotonin and norepinephrine) – these contribute to pain signalling in the brain and nervous system

All of these parts of the brain are used in both the response to physical pain and the feelings of anxiety and depression, meaning the conditions are very deeply linked. This also means that treatment and management can be incredibly difficult – focusing on the pain can mask the psychiatric symptoms from both doctors and patients, and even when both conditions are diagnosed it can be difficult to effectively treat.


Is There Any Way To Help?

For a long time, doctors and psychologists have been looking for ways to manage the psychiatric symptoms that can come with chronic pain. That same study we mentioned earlier (this one) also explored how to treat and manage these overlapping conditions. They found that there were three main ways people can improve their quality of life when dealing with chronic pain and the mental health challenges that came with it.

CBT: CBT is a well-established treatment for depression and anxiety, and the approach it takes makes it uniquely helpful for treating chronic pain at the same time. Since the therapy is based on the idea that thoughts, feelings and sensations are all related, CBT practises can help people with chronic pain learn coping skills so that they can manage their pain, rather than become a victim to it. It’s the most well-studied therapy for treating chronic pain, so it’s an essential tool here.

Relaxation Training: There are various relaxation techniques that have been proven to help people relax and reduce their stress response, which exacerbates pain as well as stress, anxiety and depression. Progressive muscle relaxation, mindfulness, yoga, hypnotherapy and more are all great ways to improve your overall wellbeing. 

Medication: Researchers found that some antidepressants or anticonvulsant medications could alleviate pain and help treat mental health issues at the same time. However, these medications needed to be carefully monitored to make sure there were no interactions. So if you feel this might be a helpful course for you, make sure you speak to your doctor about your options and what will work best for your situation.


It’s important to note here that while there is a wealth of research on the positive effects of exercise on mental health, there is much less evidence about its impacts on pain, which is why exercise doesn’t appear on that list.


At MELP CO we understand just how difficult it can be to manage both mental health problems and chronic pain. That’s one of the reasons we designed the MELP app. It’s like having your own therapist in your pocket and gives you access to a wide variety of relaxation training methods (like yoga, breathing exercises, hypnosis and more), counselling tools and even some CBT techniques that you can browse through whenever it suits you. It provides a convenient way to manage and support your mental health while coping with chronic pain, If you’d like to know more, you can click here, or download the MELP app from the Apple and Google Play store.