chronic pain affects mental health

The relationship between chronic pain and mental health:

According to the American Psychiatric Association (2020), chronic pain and mental health disorders co-occur; meaning, one has the potential to exacerbate the other. Many people with chronic pain have a high chance of having a mental health disorder such as anxiety, depression, PTSD, and bipolar disorder. For instance, about 35-45% of people with chronic pain experience depression. Physical or somatic pain can also be a symptom of people with mental health disorders like anxiety. In a study that screened over 160,000 people, 47% of participants who endorsed having chronic pain met criteria for severe depression. In contrast, 36% denied chronic pain and did not meet criteria for severe depression. According to researchers (Vadivelu et al., 2017), severe depression symptoms can predict development of chronic pain over time; chronic pain increases risk of depression symptoms. Indeed, Serotonin and Norepinephrine are associated with pain signaling in the nervous system and are implicated in both anxiety and depression symptomatology (Harvard Health Publishing, 2021). About 65% of adults in medical settings receiving treatment for depression report at least one physical pain symptom (Harvard Health Publishing, 2021).

How can chronic pain cause mental health issues?

Arthritis is inflammation of joints and can be painful. The physical limitations and impairments caused by arthritis can hinder one from engaging in necessary daily activities and preferred social activities. This in turn yields negative mood, anxiety, frustration, isolation, and depression symptoms. Similarly, fibromyalgia is a disease associated with bodily pain and is linked to elevated anxiety disorder symptoms. Fibromyalgia disproportionately affects women. In fact, women with fibromyalgia are five times more likely to develop anxiety disorders than women without fibromyalgia. Within one year, the chance of an adult with multiple sclerosis to develop major depression is two-fold compared to adults without multiple sclerosis. They also have an elevated chance of developing anxiety, panic, and mood disorders. Adults with backaches and headaches/migraines have an increased chance of developing major depression and anxiety. The sensation of pain is a feature believed to prolong depressive symptoms. Unfortunately about 29% of adults taking pain medications (e.g. opioids) will end up misusing them and developing an addiction disorder (Tebra Inc, n.d.), (Mental Health America (n.d.).

treating chronic illness and mental illness

How can you treat mental health symptoms linked to chronic pain?

  • Pharmacological interventions as recommended by psychiatry and PCP can help by reducing inflammation and other physical symptoms while simultaneously addressing the emotional and psychological pain.
  • Psychotherapy can be an effective place to process thoughts and feelings, and learning coping skills to manage any complex situations that might be influencing pain
  • Stress worsens mental and physical health. Stress reduction techniques such as physical exercise, meditation, healthy diet, adequate sleep, journaling, self-soothing, and pleasurable activities (e.g. music, movies) can be useful in managing stress and learning to deal with issues in healthy ways to mitigate the effect on mental and physical health.
  • consider enrolling in pain rehabilitation programs for structured and interdisciplinary pain management approaches that may utilize services of psychiatrists, nutritionists, and generalists
  • Take a moment to notice positives and any progress (i.e. “I feel pain but the pain has subsided this week compared to last week”). Rather than absolutely giving up to the pain, you may shift your mood by acknowledging that you’re uncomfortable and actively working toward uncovering a healthier way to live. In other words, focus on the small steps and process instead of the idealized destination (American Psychological Association, 2011).

(Mental Health America (n.d.))


1. American Psychiatric Association . (2020, November 13). Chronic pain and mental health often interconnected. American Psychiatric Association .

2. American Psychological Association . (2011). Coping with chronic pain. American Psychological Association .

3. Harvard Health Publishing. (2021, September 16). Pain, anxiety, and depression. Harvard Medical School.

4. Mental Health America. (n.d.). Chronic pain and mental health. Mental Health America.

5. Tebra Inc. (n.d.). The mental toll that comes with chronic pain. West Texas Pain Institute.

6. Vadivelu N, Kai AM, Kodumudi G, Babayan K, Fontes M, Burg MM. (Summer 2017) Pain and Psychology-A Reciprocal Relationship. Ochsner J., 17(2):173-180. PMID: 28638291; PMCID: PMC5472077.