The Psychiatric Impact of Chronic Pain

Chronic pain and mental health disorders often occur together. One explanation is that experiencing pain can exacerbate mental health risk factors, such as stress and sleep problems. But brain imaging research also shows that the two types of conditions can share biological mechanisms that contribute to one another. In this blog post, we’re taking a deeper look at some of the established connections between psychiatric and chronic pain disorders.

Arthritis & Mood and Anxiety Disorders

Arthritis is inflammation of one or more of the joints that causes pain and stiffness. There are more than 100 different types, osteoarthritis being the most common - typically affecting the hands, knees, hip, and spine but having the ability to cause chronic disability in any joint. 

Mood and anxiety disorders are more common in people with arthritis than those without it. Pain and impairment of the joints can limit the ability to accomplish and participate in daily and social activities — leading to the development of conditions like anxiety and depression.

Fibromyalgia & OCD

Fibromyalgia is a chronic condition that manifests itself in various symptoms like pain and tenderness.

Fibromyalgia is often accompanied by fatigue, sleep problems, and mood changes that result in reduced energy and social functioning. The risk of anxiety disorders, and OCD in particular, has been found to be up to five times higher in people with fibromyalgia than in the general population.

Multiple Sclerosis (MS) & Depression and Pseudobulbar Affect (PBA)

Multiple sclerosis is a central nervous system disease where nerve damage disrupts communication between the brain and body. This can result in vision loss, pain, fatigue, and impaired coordination.

People with MS are almost twice as likely to suffer from Major Depressive Disorder than people without MS. Anxiety, panic disorder, and OCD are also common among MS patients.

People with MS also may experience Pseudbulbar Affect, also known as “pathological laughing and crying.” It’s described as sudden, uncontrollable expressions of laughter or crying in situations without an appropriate trigger. This neurologic effect occurs in about 10% of people with MS.

Endometriosis and Uterine Fibroids & Depression and Anxiety

Endometriosis is characterized by endometrium-like tissue growing outside of the uterus, and uterine fibroids are noncancerous growths on the uterine wall. Both conditions cause symptoms including severe pelvic pain or cramping, fatigue, and heavy bleeding. The pain is often invalidated and dismissed as normal period pain.

Because of this, people with endometriosis or uterine fibroids experience higher levels of emotional distress leading to depression and anxiety. Feelings of hopelessness, loss of control, and lowered quality of life are common among these patients.

These are just a few of the observed connections between chronic conditions and mental health disorders, and acknowledging them helps identify at-risk individuals who can benefit from early intervention. Proactively initiating conversations, prioritizing patient-centric care, and introducing peer support resources are just some of the preventative measures that can be taken for someone who may be at higher risk for developing a chronic or mental condition.