There is a strong link between chronic pain and depression – chronic pain can be both emotional and physical and it’s sometimes difficult to determine which came first, the pain or the depression. We explore the link and give useful advice to help when living with chronic pain.
What is chronic pain?
Chronic pain is usually defined as persistent pain that lasts over three months despite medication or treatment.
Chronic pain can be the result of an injury or specific problem, where the pain lasts much longer than would be expected for recovery, or often the case, where there is no obvious injury and the pain just creeps into your daily life.
When pain becomes chronic, you may experience:
• High levels of stress
• Low energy
• Mood fluctuations
• Muscular aches and pains
• Lower mental and physical performance than previously
It can disrupt usual sleep patterns and cause you to wake at night. This can make you tired and less productive during the day. You might also lack the desire or energy to exercise, choose unhealthy foods, and struggle with controlling your weight.
As changes in your body make you more sensitive to pain, chronic pain gets worse and you may begin to get pain in areas of the body that used to feel fine.
The ongoing pain can lead to being easily annoyed and make it difficult for you to deal with other people – if you care for children, work full-time or run a business this may make your life seem too challenging. These feelings can fuel irritability, low mood and negative thoughts.
Chronic pain and depression
The impact of chronic pain on your daily life directly contributes to depression.
Researchers once thought the relationship between pain, anxiety, and depression were due to psychological reasons rather than biological factors. Chronic pain is depressing, and likewise major depression may feel physically painful.
But as researchers have learned more about how the brain works, and how the nervous system interacts with other parts of the body, they have discovered that pain shares some biological mechanisms with both anxiety and depression.
Depression and chronic pain share some of the same neurotransmitters – brain chemicals that act as messengers travelling between nerves, as well as some of the same nerve pathways in the brain and spinal cord.
If you suffer with depression, you’re more likely to choose unhealthy coping strategies for living with chronic pain and may not practice good self-care.
People with chronic pain are 3 times more likely to be depressed, and people with depression are 3 times as likely to develop chronic pain.
Can swearing help with pain?
In her book Swearing Is Good for You, scientist, journalist, and public speaker Dr Emma Byrne writes about an experimental study examining the effects of swearing on pain tolerance carried out by behavioural psychologist Richard Stephens from the School of Psychology at Keele University in Staffordshire.
We often react by swearing if we stub a toe on some furniture or accidentally touch a hot pan, and Stephens felt there had to be an underlying reason why we do this.
In the 2009 study, Stephens and colleagues asked 67 students to list five words that they’d likely use if they hit their thumb with a hammer, with the first word listed being their swear word for the experiment. A control group were then asked to list five normal words to describe a wooden table.
The participants were instructed to immerse their hand in a bucket of ice water and keep it there for as long as they could to test pain tolerance.
Participants were told to repeatedly say their chosen word/swear word until they could no longer take the pain of the freezing water and then remove their hand from the bucket. Their heart rates were measured before and after the task, along with their perception of pain, and amount of time spent submerging their hand in the ice water.
On average, participants experienced increased heart rate and decreased ‘perceived’ pain when swearing compared to when not swearing, particularly among female participants.
The group using their swear word were better able to tolerate the pain and kept their hands in the bucket of ice water for about 40 seconds longer than those using their word to describe the table. And results of this study have been replicated numerous times, including by Dr Byrne herself.
Although interestingly, the more frequently participants swore in their daily lives, the less effective swearing was at reducing their pain and the shorter their staying power in the ice water test.
In the context of pain, swearing appears to serve as a simple form of emotional self-management.
How can counselling help with chronic pain?
Swearing aside, living with chronic or long-term pain is tough. When you have both chronic pain and depression, it’s even tougher.
Chronic pain and depression can affect your whole life. Therefore, treatment approaches should help addresses all the areas of your life that are affected.
Depression magnifies pain. It makes everyday living more difficult. So, it’s important to know that psychotherapy can help relieve the depression and make chronic pain more tolerable.
Psychotherapeutic Counselling is different from traditional counselling as it concentrates on the client as a whole person (mind, body and soul). By talking, weekly, we can explore, together, areas where life seems out of control and work towards bringing peace to the situation.
My name is Liz and I’m a qualified psychotherapeutic counsellor accredited and registered with the UK Council for Psychotherapy and a registered member of the British Association for Counselling and Psychotherapy.
I aim to create an environment where you feel comfortable, safe and relaxed, giving you the opportunity to explore the difficulties you have, reflect on the past, and find ways of coping better.
Book a free initial consultation with Liz today.