The relationship between chronic pain and mental health is a strong one. Sometimes it is difficult for individuals who experience chronic pain to acknowledge the mental health factor because they simply do not want their experience of pain to be chalked-up to “being in their head” or “not real”. When a doctor refers a chronic pain patient to a therapist, such as myself, the first thought could be “why, you don’t believe my pain is physical?”. This is a very valid concern and I am here to say that your pain IS real. Pain is pain and it is felt for various reasons. It is often the case, though, that a factor contributing to the pain is anxiety, depression, trauma, denial, ect. It is also true that one’s mental health can suffer due to their chronic pain. Those who experience chronic pain are more likely to have anxiety and/or depression. Many patients with chronic pain will isolate themselves and develop anxiety about going out with friends or doing activities out in public because they are afraid about their pain increasing during that time. They simply do not want others to see their pain and they do not want to feel ‘trapped’ in a place where they are unable to cater to their pain. While this is a very valid thought process, it can also lead to depressive symptoms such as low mood, loss of interest in activities, and isolating behaviors. It can also lead to anxiety symptoms due to “what if” thinking and panic symptoms while ruminating about the possibility of an increase in pain.
I am also here to tell you that you CAN still socialize and go out and do things despite your pain. There is a process to gaining back your independence and control over your body. It is the case in many instances where an individual feels they have no control over their body or their pain. They feel helpless and therefore they feel stuck to live this way forever. This is where a pain therapist, such as myself, can be a very useful tool to utilize in your pain treatment. In the pain therapy setting individuals with chronic pain will learn how to set boundaries in regard to their pain, re-develop their identity to distance themselves from being a “pain patient”, learn how to manage their anxiety and/or depression, develop better coping skills to manage their pain, cultivate an awareness of their body in order to better manage their functioning, and re-gain their sense of self and independence.
Living with chronic pain can be frustrating and overwhelming. It alters the way in which individuals function on a daily basis, it interrupts relationships, disrupts work and activities. The goal is to learn how to adjust to this new way of functioning and to learn how to live a fulfilling life despite the pain. Through this process individuals may find that their pain experience decreases and becomes more manageable. So, how do we do this? The mind-body approach.
The mind and the body are very much interconnected. This is why some people may develop a stomachache when their anxiety is high or feel fatigued when depressed. Clients need to be considered as a whole and complete being and treatment must encompass the same. Combination treatment is shown to yield the most rewarding results, when the mind and the body are treated together. Therapies such as Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) are shown to benefit individuals with chronic pain by increasing their overall quality of life and decreasing anxiety, depression, and even experience of pain. In my own practice I utilize both CBT and ACT with clients to help them adjust and cope with their pain experience. I also utilize Thermal biofeedback. Biofeedback is a great tool that helps individuals cultivate more awareness of their body and when they are and are not in a relaxed state. Tension often exacerbates pain, and being in a more relaxed state helps to decrease pain and improve functioning. Thermal biofeedback works by measuring skin temperature of the hand. When the temperature rises, blood vessels are opening up and allowing blood to flow to the peripherals. This is a more relaxed state. When temperature decreases it means the blood vessels are restricted and the body is tense, not allowing for blood flow to reach the peripherals.
Chronic pain is a difficult adjustment that can have a large impact on life in various ways. Counseling can help in many different ways. If you experience chronic pain and feel you could benefit from therapeutic services, please reach out today! Wellness is possible!
Sources:
https://www.health.harvard.edu/healthbeat/the-pain-anxiety-depression-connection
http://www.instituteforchronicpain.org/understanding-chronic-pain/complications/anxiety
https://link.springer.com/article/10.1007/s10865-015-9628-3
https://www.sciencedirect.com/science/article/abs/pii/S0025619616301823