Contributor: Rachael Mattice is the Content Manager for Sovereign Health Group, an addiction, mental health and dual diagnosis treatment provider. Rachael received her bachelor’s degree in journalism and mass communication from Purdue University.
Chronic pain alone affects more Americans than diabetes, heart disease and cancer combined according to the American Academy of Pain Medicine1 . More than 100 million Americans, that’s almost one third of the U.S. population, suffer from chronic pain2 , according to the Institute of Medicine Report from the Committee on Advancing Pain Research, Care, and Education.
Psychological and Social Issues
Chronic pain can be caused from physical injuries that result in musculoskeletal pain such as back pain, hip pain or knee pain, or nerve pain, resulting from nerve injuries or amputations. However, many types of chronic pain do not result from a physical injury and show no signs of damage to the body. These include chronic headaches, fibromyalgia, bone pain from cancer, arthritis and many more.
Chronic pain can persist for weeks, months and even years; causing many psychological and social issues, even leading to personality changes. Patients who live with chronic pain will eventually exhibit pain from stimuli that are not normally painful as well as an increased amount of pain from stimuli that are normally painful, and will be overly sensitive to pain — all abnormalities that do not exist in people who do not live with chronic pain.
Depression and Pain Share Brain Pathways
Depression is the most common emotion associated with chronic pain. The American Chiropractic Association3 estimates that depression is 3 to 4 times more common in people with chronic pain than in the general population.
In addition, 30 to 80 percent of people with chronic pain will have some type of depression, the ACA states.
People with chronic pain and depression suffer dramatic changes in all aspects of their lives. They often find it difficult to sleep, are easily agitated, cannot concentrate, and are often more stressed out.
Affecting The Whole Family
People with chronic pain frequently report a wide range of limitations in family and social roles, such as the inability to perform household chores or workplace tasks, take care of children or engage in leisure activities. In turn, spouses, children, and co-workers often have to take over these responsibilities leading to agitation, resentment, and anger toward the pain patient, which in effect can put stress and strain on the family and other social relationships.
This constellation of disabilities starts a vicious cycle of pain leading to more depression, which leads to more chronic pain. The same neurotransmitters that are involved in depression are also involved in physical pain. This is illustrated by brain pathways which regulate the reception of pain signals. Pain signals are eventually sent to the brain’s limbic system, which is the brain’s emotional center. These pain pathways use some of the same neurotransmitters involved in mood regulation, especially serotonin and norepinephrine.
How Pain Changes Personality
Subtle brain changes in people with chronic pain could cause personality shifts that make them worry more and venture less. These subtle brain changes also result in chronic pain patients to have a more self-centered perspective aimed at maximizing self-gain.
Traumatic injury to the brain from an accident can change one’s personality, the Brain Injury Association of America4 states in its brochure, “Behavioral Challenges After Brain Injury.”
Based on a study5 published in Plos One on Oct. 12, 2011 by researchers in Italy, patients with chronic pain were more passive and withdrawn than the people without chronic pain. These researchers studied 22 people with chronic nerve pain on one side of their face. Using five different brain imaging methods, the researchers compared the chronic pain patients’ brains with those of healthy controls.
Focusing On The Pain
They also assessed the participants’ personalities using a 240-item questionnaire. Within this study, their results showed that the “feeling of pain makes an individual less inclined to behave according to social norms that regulate most social and economic interactions.” This study also illustrated that receiving pain signals constantly can result in mental rewiring that negatively affects the brain in regions associated with attention and mood.
People with chronic pain tend to focus on that pain, eventually allowing it to overtake their lives. Common stressors that they were once able to deal with become overwhelming and too much to handle, causing chronic pain patients to avoid societal and job responsibilities, and even physical activities that they once enjoyed. This leads to chronic pain patients often taking on the “sick-role.”
Treatments for Chronic Pain
People suffering from chronic pain can undergo treatment not only for their pain, but also for their depression and other psychological comorbidities that might result from the chronic pain itself. Here are a few:
- Pharmacologic therapies, such as antidepressants like amitriptyline, help treat both the physical pain and the depression.
- Physical therapy that focuses on core and strength training can help chronic pain patients continue physical activities that they enjoy.
- Relaxation techniques and behavioral therapy can help patients deal with the emotional stressors brought on by their chronic pain.
All of these therapies not only treat the physical pain but aim to treat the emotional and mental pain to maintain the patient’s original personality before the chronic pain overtook the individual’s life.
Community Discussion – Share your thoughts here!
What types of non-narcotic therapy have you or your loved used to treat chronic pain? What has worked well for you, what would you recommend to others?
About the Author:
Rachael Mattice is the Content Manager for Sovereign Health Group, an addiction, mental health and dual diagnosis treatment provider. Rachael is a creative and versatile journalist and digital marketing specialist with an extensive writing and editing background.
Her portfolio includes numerous quality articles on various topics published in print and digital formats at award-winning publications and websites. To learn more about Sovereign Health Group’s mental health treatment programs and read patient reviews, visit http://www.sovhealth.com/. Follow Sovereign Health Group on Twitter, Facebook, Google+ and LinkedIn.
The opinions and views of our guest contributors are shared to provide a broad perspective of addiction. These are not necessarily the views of Addiction Hope, but an effort to offer discussion of various issues by different concerned individuals.
Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on May 6th, 2015
Published on AddictionHope.com, Drug & Alcohol Abuse Treatment
- he American Academy Of Pain Medicine. (n.d.). Retrieved April 27, 2015, from http://www.painmed.org/patientcenter/facts_on_pain.aspx
- Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research. (n.d.). Retrieved April 27, 2015, from http://www.nap.edu/catalog/13172/relieving-pain-in-america-a-blueprint-for-transforming-prevention-care
- Chronic Pain and Depression. (n.d.). Retrieved April 27, 2015, from https://www.acatoday.org/content_css.cfm?CID=2187
- Resources. (n.d.). Retrieved April 27, 2015, from http://www.biausa.org/brain-injury-community.htm
- Gustin, S., McKay, J., Petersen, E., Peck, C., Murray, G., & Henderson, L. (n.d.). Subtle Alterations in Brain Anatomy May Change an Individual’s Personality in Chronic Pain. Retrieved April 27, 2015, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4188621/