The Inter-relationship Between Chronic Pain and Mental Pain

September 16, 2016

shutterstock_472752325“Hurting bodies and suffering minds often require the same treatment.”

So begins an article from the Harvard Health website. This statement seems to say quite a lot about the relationship between chronic pain and psychological pain. 

Relationship Between Physical Pain and Mental Pain
But 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.”

It seems, then, one affects the other almost casually. To put it in laymen’s terms, when one experiences chronic physical pain, depression can easily set in. But the other way around is true as well. Unfortunately, psychological pain that causes physical pain still has societal stigmas attached to it, “it’s all in your head,” for example.

But if one is depressed – perhaps chronically depressed – evidence supports that this shows up in the body through physical pain. There is an intimate connection between physical pain and mental pain. 

As both mental and medical doctors work to find a way to address both of these problems simultaneously, it may help to understand a bit about the way our “brain pathways” work to get a better sense of this connection.

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 both the body and brain go both ways. When one experiences pain “normally,” our brain shuttles away those signals of physical discomfort. This is our brain’s way of helping us concentrate on things other than our pain.

However, when this mechanism is impaired, physical sensations like pain are more likely to become the center of our attention. Brain pathways use some of the same “neurotransmitters” involved in our ability to control our mood (for more information on this, it may be helpful to research what antidepressants treat). But when this mechanism fails, both the pain is intensified, as are 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 contribute to such physical symptoms as headaches, backaches, or arthritis. However, people tend to get treated not for mental health, but for physical pain, which may be caused by a depression they are not recognizing. Some experts estimate that more than 50% patients who visit general practitioners complain of physical symptoms that include pain. Other studies suggest if physicians tested pain patients for depression, they might discover up to 60% are experiencing undetected depression.

According to the Harvard article, “pain and depression feed on themselves.” Often, when depression is treated, physical pain is no longer becomes the center of our attention. And when physical pain goes away, a lot of the suffering that causes depression may, too.

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

Treatment and Understanding the Connection
Recognizing this connection, many pain rehabilitation centers treat both at the same time. They use techniques such as progressive muscle relaxation, hypnosis, and meditation, among other modulations that address psychic pain. Medication is also used, although finding the right kind of psychological medication is quite an endeavor.

It’s important for us to be in tune with our bodies. No. Physical pain and mental pain – though not always the case – are intimately linked to each other. If you are experiencing either, be sure you seek treatment for both, even if you feel it unnecessary. Our body is not separate from our mind.

And if somebody tells you that something is “only in your head,” well: they just don’t get it.


  1. ‘Depression and Pain – Harvard Health’. May 20, 2015. Accessed August 30, 2016.
  2. Kiefer, Dale and George Krucik MD (Medically Reviewed). ‘The Link between Chronic Migraine and Depression’. April 15, 2014. Accessed August 30, 2016.

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