Migraine, Chronic Pain, and Your Mental Health

September 23, 2016

shutterstock_198592244“Hurting bodies and suffering minds often require the same treatment.”

So begins an article from the Harvard Health website. This seems to say quite a lot about the relationship between chronic pain and psychological pain; they seem to be very intimately linked. I am inclined to state that there isn’t one without the other, albeit a non-scientific observation.

Relationship Between Physical Pain and Mental Pain
Let’s read further on, “Pain is depressing, and depression causes and intensifies pain. People with chronic pain have three times the average risk of developing psychiatric symptoms — usually mood or anxiety disorders — and depressed patients have three times the average risk of developing chronic pain.”

To put it in laymen’s terms, when one experiences chronic physical pain, depression can easily set in. But the other way around – mental health and pain – still has societal stigmas attached to it. If one is depressed,perhaps chronically depressed, this can show up in the body by causing physical pain. 

Because of this, it may help to understand a bit about the way our “brain pathways” work, to get a better sense of the connection between the two.

Our Brain and Body: A Two-Lane Expressway
Depression and pain are hardwired in the circuits of our nervous system. When there is pain, the communication between our body and brain go both ways. When one experiences “normal,” pain, our brain shuttles away signals of physical discomfort so we can cope with them. This is our brain’s way of helping us concentrate on things other than our pain.  However, when this mechanism is impaired or isn’t working efficiently, physical sensations like pain are more likely to become the center of our attention, affecting our mood, well-being, and mental health.

Brain pathways use some of the same “neurotransmitters” involved in our ability to control mood (antidepressant medication is prescribed to address this). Interior mechanism failure can both intensify pain, as well as feelings of sadness, hopelessness, and anxiety.

Don’t Rule Out One or The Other
Chronic pain, as with chronic depression, can alter the way our the nervous system functions. Depression can greatly contribute to physical symptoms like headaches, backaches, or arthritis. Even though this is true, there is evidence to support that people get treated for physical pain rather than mental pain. Some estimate that more than 50% of patients who visit general practitioners and complain of physical symptoms that include pain may have a high rate of mental pain as well. Some studies suggest if physicians tested pain patients for depression, evidence shows that up to 60% of pain patients are experiencing depression, left untreated.

Referring back to the article, “pain and depression feed on themselves.” Often, when depression is treated, our physical pain lessens. When the pain goes away physically, a lot of the suffering that causes depression may too.

Given this complex back-and-forth between physical and psychic pain, how can it be treated?

Treatment and Understanding the Connection
Many pain rehabilitation centers understand this mental/physical connection and thus treat both. They use many methods besides medication such as muscle relaxation, hypnosis, and meditation. Medication is its own complex system. In America, for example, many treated for depression undergo a trial-and-error method of finding the right medication, the combination of medications, and the proper dosage. While often arduous, this is the most common way psychiatrists determine which medication helps that individual. We all are unique in biological make-up. Medication, then, depends on the person.

It’s important to be aware and in tune with our bodies. Though not always the case, if you are experiencing one or the other, it’s important to address both. If you are experiencing either, be sure you recognize the relationship and get checked out for both.

Our body is not separate from our mind. The mind is, in fact, an important part of the body. If somebody tells you, then, that the pain is “only in your head,” they don’t quite understand that what their creating is a dichotomy:  

Where there is none.


  1. ‘Depression and Pain – Harvard Health’. May 20, 2015. Accessed August 30, 2016. http://www.health.harvard.edu/mind-and-mood/depression_and_pain.
  2. Kiefer, Dale and George Krucik MD (Medically Reviewed). ‘The Link between Chronic Migraine and Depression’. April 15, 2014. Accessed August 30, 2016. http://www.healthline.com/health/migraine/link-between-chronic-migraine-and-depression
  3. NYT Consultants. ‘Can Migraines Cause Mood Swings?’. The New York Times (Consults Blog), August 4, 2010. http://consults.blogs.nytimes.com/2010/08/04/can-migraines-cause-mood-swings/?_r=0.

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