There are a variety of ways in which chronic illness, chronic pain and other disability can detrimentally affect mental health. Chronic conditions affect everyone differently and no two experiences will be identical, but there are some commonalities that many may share. Here are just 5 ways chronic pain can impact mental health.
Chronic Pain & Mental Health : A Painful Relationship
Chronic pain is a physical experience, but it’s also a mental battle. It’s important to note the difference between acute pain that is short-lived and temporary, and chronic pain that is regular and ongoing for a prolonged period of time. Nobody wants to live with any time of pain for any duration, but chronic pain requires a different level of management and involves wider-ranging ramifications.
Mental health and physical health have a two way relationship, with each able to affect the other. The majority of people who report chronic pain will have genuine, physically-induced pain, whether there’s a definitive cause that can be tested for or not. A small minority may have pain that’s the result of mental health in some way.
Chronic pain comes in different shapes and sizes, from limited-time episodes that occur on a regular basis, to continuous pain that never ends. The level of pain and what it feels like will also vary, as will how each individual experiences it and handles it. Each person has a unique experience of living with pain. There are so many variables that affect the overall experience, meaning no two people should ever be compared in how they’re dealing with pain, nor is there any ‘right’ way to do so.
Living with pain can be an ongoing learning curve. Practice can be required for pacing their daily lives and activities, and trial and error is typically needed for finding ways to manage or treat pain. It can require a lot of patience and a good dose of hope to keep going.
Chronic pain can be so invasive that it splinters lives and causes cracks in our mental health. This can be through biology, hormones and neurological changes from pain and/or illness, or it could be a result of how hideous putting up with pain is, or it could be through the knock-on effects to our lives, relationships and work. Pain can hinder our abilities and put restrictions on what we can do. The stark contrast between how our lives used to be or could have been, compared to what they are now with chronic pain, can be incredibly hard to accept.
It’s perhaps no surprise that chronic pain can be so harmful to our mental health and wellbeing generally. For the friends, colleagues, partners and families of those with pain, having some grasp of the impact can be very helpful. For those with pain, it’s good to know you’re not alone in how you’re feeling because it’s par for the course with so many pain sufferers going through similar struggles.
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5 Detrimental Effects Of Chronic Pain On Mental Health
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1. Chronic Pain Can Make Us Agitated
Chronic pain is ongoing and continual. It’s not acute and temporary, so we can’t tell ourselves it’ll be over soon because it won’t. Chronic pain may be constant or it may wane, and the level of intensity can likewise change over time or flare up with certain triggers. I live with chronic pain from nerve damage which is the most debilitating, alongside chronic migraines, widespread inflammation and fibromyalgia. Pain is constant, every second of every day since my first surgery in 2015.
Not having a break from it means it is relentlessly insistent. It’s like someone poking you in the eye with a ballpoint pen, over and over again nonstop for years. It drives you mad. It makes you irritable, highly agitated, frustrated, annoyed, at your wit’s end. It can be all-consuming, but of course you still have things to do so you keep going. You keep doing the chores, attending appointments, doing the shopping. You can’t make the pain stop, you can only try to manage it and distract yourself however possible.
2. It Makes Us Feel Unheard & Disbelieved
Chronic pain is, for the most part, an invisible condition. What does “sick” look like? What does being in pain look like? You may use a mobility aid or allow a grimace to flash across your face, but otherwise, it’s likely a person living with chronic pain will look “fine” and “normal”. They’re also likely to be well practiced and skilled at putting up with pain and getting on with things as best they can in public, trying to hide it and put on a smile to show the world a veneer. Underneath that is pain so intense and debilitating, with mental health that is cracking and creaking under the pressure.
Looking fine while living with an invisible illness or other hidden conditions means there are likely going to be instances where others don’t believe you or don’t take you seriously, whether that’s in your family, wider society or with medical professionals. For some, these instances are many and varied. When you need medical support, you’re forced to rely on medical professionals and you can only hope that they will be open-minded, aware of the implications of chronic pain, and compassionate. Unfortunately there’s still a lot of ignorance, stigma and judgement around chronic pain, just as there is around age and gender when it comes to illness. If you’re not being heard and believed by those who are there to care for you, it means you can’t get the healthcare support you need and that is both angering and heartbreaking.
Furthermore, those who need or are taking painkillers like opioids find themselves between a rock and a hard place. For many people, such medications are a last-ditch route; they don’t “get rid” of pain by a long shot, but they might just help to take the edge off it and keep us mobile and somewhat function to get through our days. We don’t want to be on them but we need them if we’re going to get the basics done, and yet many patients have to fight to keep these very treatments that are keeping them alive. There are misunderstandings and prejudice caused by the so-called “opioid crisis”, where opioid use by those without pain is confused and tallied alongside opioid use by those with chronic pain. They’re very different. When that difference isn’t acknowledged, it’s the chronic pain patients that suffer that ignorance.
Related Reading : Invisible Disabilities : How Docs, Patients & Public Can Help
3. Chronic Pain Can Be Lonely
It’s hard to find someone who truly wants to hear about our experiences, especially when we’re struggling, and we don’t want to feel like we’re moaning or being negative. It’s harder still to find someone who really understands. You can’t entirely “get’ what chronic pain is like in its full scope unless you’ve experienced it for yourself, but you can of course empathise and learn. Not having someone who “gets” it or wants to try to understand means you feel very much on your own.
Living with chronic illness may mean we can’t do the things we used to, and you might find you can’t socialise or keep the friendships and relationships you once did. Loss of those social contacts further isolates a person with chronic pain and makes loneliness feel all the more poignant.
When you feel that you’re missing out on things others are doing, or that you’re behind in life because your path is completely different as a result of your health, you can feel detached from your peers and the world at large.
When you’re around others who don’t live with a chronic condition, the difference between “you” and “them” becomes apparent. You might feel like you owe reasons, excuses or explanations for why you are the way you are, for the things you can’t do, or for the lifestyle you lead. Nobody should feel like they owe such explanations, but in such situations it can feel like that explanation is regularly needed. We might feel paranoid, perhaps rightly so in some cases, about what others think of us.
There’s also the issue of personal boundaries and how these can weaken or blur, leaving us more vulnerable. We can learn to be more independent, to feel more confident in ourself, to speak up for our needs, and to assert self-respecting boundaries.
We already feel bad enough about the situation, but many of us add the concern of what others are thinking and how they see us. We might worry they think we’re being melodramatic, that we’re frauds or that we’re lazy. There’s all the same ignorant insults our inner critics might throw at us. And so the sense of isolation deepens.
4. Chronic Pain & A Vicious Cycle Of Poor Sleep
When you think of going to bed and catching some Zzzs, you think of getting comfortable, snuggling up and calmly dozing off. With pain driving you up the wall and finding you can’t get comfortable in any position, it can be hard to get to sleep. Some may go through periods of insomnia (or “painsomnia“), much like I did for a number of years. Some may wake up regularly or not be able to get back to sleep.
There are different ways in which pain can mess up sleep patterns but the outcome is often the same. This can include too little sleep, too much sleep, broken sleep, waking too early, not getting back to sleep, nightmares, etc. Poor, disturbed sleep (too little or too much) leads to more exhaustion and more agitation, making it harder still to get to sleep the next time or function enough with the pain, putting a strain on our mental and physical health. Cognition, concentration and focus can suffer, and relationships can come under increased tension. and so the cycle continues continues as we start to fall behind on to-do lists, feel resentment at having no time for pacing or enjoyment, and wear ourselves even more ragged.
There’s no quick fix and for many people living with pain it’ll be a case of trying to go with the flow and get by as best you can. Pacing yourself during the day is important, as is looking after yourself and prioritising self-care. Getting a little better at managing the pain, having a nighttime routine and finding ways to get more comfortable when you’re in bed may help make sleep more appealing and successful.
5. Chronic Pain Can Lead To Or Worsen Anxiety & Depression
Chronic pain & mental health are intricately interwoven. Any chronic condition can be a catalyst for creating or worsening the likes of anxiety and depression. Pain already chips away at mental health day to day through its continual nature. A person with chronic pain can start to feel the weight of it on their shoulders and the sense of despair at not being able to reduce their pain enough, let alone get rid of it. The future can feel disheartening with no end to pain in sight. Research suggests that those living with chronic pain are 4x more likely to suffer with anxiety and depression than those without pain.
There’s increased stress and frustration having to continually fight for your health with medical professionals. If you’ve lost work through your condition, that’s another layer of guilt, financial pressure, feelings of loss, feelings of not being useful or good enough. Chronic conditions can lead to people losing many things in addition to work and career intentions, like friends and social life, family, hobbies, and their whole lifestyle. This is all on top of disturbed sleep, changes to appetite, feelings of loneliness and so on. It all adds up.
How many chronic pain patients are heard? How many can even get a smidge of the help they need for their mental health or with some of the issues adding undue stress? Not enough. Not nearly enough.
If you live with chronic pain, in what ways has it affected your mental health?