Millions Battling Chronic Pain And Concurrent Mental Health Condition

October 5, 2023 / Thomas Cohn, MD

New research from the University of Arizona Health Sciences and published in the journal PAIN found that nearly five million Americans experienced the co-occurrence of chronic pain and a mental health condition like anxiety or depression, leading to functional limitations in their daily life.

As we’ve mentioned on the blog in the past, it’s not uncommon for chronic pain and a mental health condition to develop alongside one another because chronic pain can have a significant effect on your physical, mental and emotional health. If you are forced to miss social events, your career aspirations are limited or you simply find it hard to pull yourself out of bed in the morning because of physical pain, your mental health will also take a hit. For some, that manifests in the form of anxiety or depression.

In a review of data from 31,997 people who participated in the National Health Interview Survey, researchers found that that roughly 38.1 million Americans are dealing with a chronic pain condition, 9.6 million are dealing with a diagnosed mental health condition, and 4.9 million are dealing with co-occurring chronic pain and a mental health condition. Additionally, adults with chronic pain were roughly five times more likely to report anxiety or depression compared to adults without chronic pain.

“The study’s findings highlight an underappreciated population and health care need – the interdependency between mental health and chronic pain,” said the paper’s lead author Jennifer S. De La Rosa, PhD, director of strategy for the University of Arizona Health Sciences Comprehensive Pain and Addiction Center, which funded the study. ”This work is so exciting because it offers the opportunity to use team-based interdisciplinary approaches to medicine, leveraging what is known across disciplines to meet the needs of these individuals.”

Chronic Pain And Mental Health Conditions

Other important findings from the study include:

Nearly 70 percent of people with co-occurring symptoms reported limitations at work.
More than 55 percent of people with co-occurring symptoms reported difficulty taking part in social events
Nearly 44 percent of people with co-occurring symptoms said they had difficulty running errands alone
Among all U.S. adults living with unremitted anxiety or depression, the majority (55.6%) are people who also have chronic pain.

This study only further emphasizes the idea that you can’t simply focus on treating the physical aspects of a chronic pain condition. Pain weighs heavy on your mind, and if you’re only focused on the physical pain, you may find that your mental health is suffering.

Even if you don’t believe your mental health has been affected by a chronic pain, you need to be aware that you’re at a higher risk of certain mental health disorders. You need to trust your care to a provider who will give you the comprehensive care you need to tackle all aspects of your chronic pain condition. Dr. Cohn and his team have done that for years for other patients, and we’d be more than happy to put our experience to work for you. For more information, or for help with a different chronic issue, reach out to Dr. Cohn and his team today at (952) 738-4580.

The Link Between Anxiety and Chronic Pain

September 2, 2016 / Thomas Cohn, MD

Researchers say the expression of a single peptide has been linked to both anxiety disorders and chronic pain, suggesting that we may be on the verge of a breakthrough for treating patients with both conditions.

Currently far too many patients are being prescribed a combination of drugs to treat both their anxiety and chronic pain condition, which researchers say can be dangerous. Instead, researchers say the discovery of the expression of pituitary adenylate cyclase activating polypeptide, or PACAP for short, could change the way we simultaneously treat the two conditions.

“Chronic pain and anxiety-related disorders frequently go hand-in-hand,” said Dr. Victor May, a professor of neurological sciences at the University of Vermont and study author.

Chronic Pain and Anxiety Disorders

For the study, researchers used mice to determine where the pathways for stress and pain intercept. By applying what the team called a “PACAP receptor antagonist,” researchers were able to successfully reduce both stress and pain in the rodents.

“By targeting this regulator and pathway, we have opportunities to block both chronic pain and anxiety disorders,” said May, who plans to next develop small molecule compounds that can antagonize PACAP actions. “This would be a completely different approach to using benzodiazepine and opioids — it’s another tool in the arsenal to battle chronic pain and stress-related behavioral disorders.”

The findings are intriguing because the US Food and Drug Administration recently issued a strong warning against mixing opioid painkillers and benzodiazepines, which is a current standard treatment for patients with chronic pain and anxiety. You can read more about the study here.

The Link Between Anxiety, Depression, and Pain

December 31, 2013May 24, 2017 / Thomas Cohn, MD

According the International Association for the Study of Pain, pain is defined as:

“an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.”

This is one of the best descriptions of what pain is and is used worldwide to explain the experience of pain.

Pain and Emotion

Pain is an emotional experience. Emotions such as happiness, sadness, and anxiety are generated in the brain. Thus, pain and anxiety are intimately linked in the brain in terms of the locations that generate these perceptions. As noted in the definition, pain has unpleasant emotional components, which most people perceive as anxiety.

The link between pain and anxiety is, in reality, more than just theoretical. Sensation that is interpreted as pain is processed in several areas of the brain. Some of the main regions of pain sensation are in very close proximity to the regions that process emotions of anxiety and depression. When there is prolonged activity in the areas that process pain sensation, the areas nearby that process depression can be activated. The areas then can spontaneously interact, pain sensations can be interpreted as anxious emotions, and anxiety can be misinterpreted as pain.

Anxiety and Chronic Pain

Those who have chronic pain often become depressed and anxious. The two sensations become intermingled, and often the pain is greatly amplified by the depression. Treating the emotional consequences of pain is often as important as treating the physical causes of pain. If the depression and anxiety are not controlled, the pain is not controlled. Once the depression and anxiety are controlled, insight into pain can occur and pain often becomes manageable. There may be a physical cause to the pain, but if the emotional components are not controlled, then the pain is not controlled.

Comprehensive Treatment

Since pain, anxiety, and depression are intimately linked in the brain, comprehensive pain care involves treatment that is aimed at all aspects. A comprehensive pain program looks at both physical control of pain and emotional control of the consequences of pain. These programs link psychological approaches to pain, with physical methods. A pain psychologist is often involved in patient treatment. Medications for chronic pain that affect both physical signals of pain and emotional components then become understandable in their effectiveness.

Pain is a complex medical issue. It has both physical and emotional components. The physical side is the tissue damage and perception of signals. The emotional side is the anxiety and depression that is linked to the chronic pain signals. Treating chronic pain, due to its emotional components has long involved a multidisciplinary approach that includes psychological management.