We all know the dip we experience in our mood when we suffer from a minor injury, say, a fall that leads to scuffed knees and palms. This might be a brief bad mood, but what about when an injury or condition leads to chronic pain? It makes sense that this type of pain would also affect our mood, but how are chronic pain and mental health related, and what can we do to treat both?
How does chronic pain affect mental health?
Chronic pain and mental health syndromes are considered bi-directional, that is, either can lead to the other. It can be difficult to pinpoint which condition causes which, but each certainly increases the intensity of both.
Consider this: a car accident leaves a previously healthy, active person with lingering lower back pain. This lower back pain does not go away, worsening and transitioning from acute to chronic pain when it lasts longer than three months. The pain becomes so intense that the person has difficulty sleeping, going to work, and generally participating in daily life including leisure activities. It follows that a person’s mental health would suffer under these conditions, especially if treatments for pain are ineffective or come with side effects.
Or the other side of the coin: a major depressive episode leaves another person unable to motivate themselves to do the things they normally love, like see friends, go for walks, or play with their dog. As they become more sedentary, the person’s body begins to ache and stiffen. Perhaps this leads to an injury due to exertion, and then chronic pain makes itself known.
Whether the pain comes before the mood disorder, or the mood disorder worsens the pain, we know that these two conditions are linked, serious, and require a multi-pronged treatment approach.
Chronic pain and mental health statistics
Unfortunately, exact chronic pain and mental health statistics can be difficult to come by. This is due to the sometimes-hidden nature of mental health conditions, as well as inconsistencies with patient reporting.
Regardless, here are some chronic pain and mental health statistics that are important to know.
Who suffers from depression, anxiety, PTSD, and chronic pain
Just over 7% of the U.S. population suffers from major depressive disorder, with women twice as likely to develop depression than men. Anxiety is the most common mood disorder in the U.S., with an estimated 40 million people over 18 suffering from this condition. Of those, fewer than 40% receive treatment. Around half of those suffering from depression also have an anxiety diagnosis.
Post-traumatic stress disorder, once considered a “soldier’s disease” is also widespread in the U.S. An estimated 7-8% of people in the U.S. suffer from PTSD after a traumatic event, with women more likely to suffer than men.
Bringing it all together is chronic pain. Estimates vary, but most agree that approximately 20% of people in the U.S. have chronic pain at any given time. People living in poverty, with a high school diploma or less, and those with public health insurance are more likely to experience chronic pain.
Troubling studies are also bringing together a racial component to who suffers from chronic pain and mental health challenges. Black people in the U.S. are more likely than white people to suffer from depression, PTSD, and chronic pain. These are all compounded by more issues with sleep and higher levels of comorbid conditions.
The latest research on chronic pain and mental health
A variety of studies further illuminate the connection between chronic pain and mental health. If you’re interested in learning more of the research behind this connection, we invite you to click any of the following links to read specific studies.
- Depression is the leading cause of disability worldwide
- An average of 65% of depressed people also have chronic pain
- Between 30 and 50% of chronic pain patients experience depression
- People with chronic pain were almost twice as likely to be diagnosed with depression, and two and a half times as likely to be prescribed an opioid
- Pain treatments take longer to work in patients with depression
- Pain can cause anxiety, which makes people more sensitive to pain
- Anxiety increases the risk of chronic pain
- Focusing only on pain treatment and ignoring symptoms of anxiety can make pain treatment less effective
- Pain is one of the most frequently reported symptoms of PTSD
- An estimated 10% or more of people receiving treatment for chronic pain also have PTSD
- Depression is often a symptom of PTSD, and both make chronic pain more difficult to treat
Other studies of note connect chronic pain and anxiety to increased inflammation in the body. Researchers have also discovered a molecular link between chronic pain and depression. This link may lead in the future to treatment for both chronic pain and depression.
How to manage chronic pain and mental health conditions
Much of the latest research on chronic pain and mental health include expanded treatment options that bring the mind and body together to address aspects of both.
The most successful treatments for chronic pain and mental health treat both conditions simultaneously. Since chronic pain takes longer to improve in those with mood disorders, and mood disorders increase the likelihood that acute pain becomes chronic, this approach makes sense.
Here are treatment options that treat the entire individual, not just the disorder.
Diagnosis of chronic pain (and treatment)
One of the first steps to successfully treating chronic pain and mental health conditions is to properly diagnose and begin to treat the chronic pain where possible. Mental health and pain management are so connected that simply treating the mood disorders is not enough and vice versa.
In some cases, a conclusive diagnosis is not possible. And, if you have a diagnosis, generating a comprehensive management plan for pain is just the beginning.
Cognitive behavioral therapy (CBT)
Cognitive behavioral therapy for chronic pain and depression can have mixed results when it comes to the research, but it is incredibly helpful non-invasive option for some patients. This type of therapy helps patients look at how they are changing or distorting their experience. Reframing the run