Infano brings to you 10 Days Of Mental Health in collaboration with The Logical Indian in lieu of World Mental Health Day on October 10. Sonam Manoj, a Pain Psychologist tells us how chronic pain and mental health illnesses are interlinked and methods to treat them.
Chronic pain could be heart-wrenching and so is depression, anxiety, and other mental health challenges. Research shows that pain shares a biological similarity with depression and anxiety. The same play of neural pathway is observed in chronic pain as it is observed in depression, anxiety, and grief.
When a person undergoes pain for a long period of time, it is observed that the brain can fuse the experience of these two occurrences, often making it difficult to distinguish between the two.
Chronic pain and mental health
Patients suffering from depression, anxiety, PTSD often complain about physical pain. Similarly, when one is undergoing a phase of chronic pain, the immobility one experiences and the inability to function normally, right from doing their daily tasks to being unable to take part in their preferred hobbies can affect one’s self-regard and esteem.
This loss of involvement in the usual pleasure-giving activities often leads to distress and the first thing that changes are, undoubtedly, the behavior of the person. These behavioral changes slowly start to affect the relationships of the patient, both personal and professional, further leading to hampering some close-to-heart inner circle and social networks, thereby leading to damage in the mental and emotional state of wellbeing. One leads to the other and there is no end.
My experience as a Pain Therapist
As a psychologist and a pain therapist, I have very closely observed that patients suffering from depression or stress disorders exhibit more severe pain than other people. It becomes harder to work on these patients than people who come in with regular pain conditions.
Some of the most common mental health issues that we find in chronic pain patients are insomnia, depression, stress disorder, and anxiety. It is also observed that these conditions can further hamper the chronic pain condition that already exists. It is like a vicious cycle, one leading to the other in a loop.
The other dimension to the pain-related mental health issues also is long assistance and dependence on strong pain killers. This dependence on the high potent medication especially opioids starts to hinder the normal cognitive processes or thinking of a person. Again, one would observe a chain reaction of unending distress and uncomfortable experiences in this case. To treat a case like this becomes very challenging for a therapist.
Focus on pain can camouflage the presence of mental health disorder
Psychogenic pain
Sometimes these pain flare-ups can also pass off as Psychogenic pain, a short-term or a long-term pain condition that is associated with a psychological or emotional condition and not a physiological one. You must have heard of patients complaining about neck and shoulder pain or lower back pain, heading for clinical screening and coming back with no specific physiological diagnosis. This is what we call psychogenic pain.
Tension Myositis Syndrome
A very common syndrome that we come across in patients with psychogenic pain is the TMS, Tension Myositis Syndrome, which is a psychological condition causing physiological symptoms like chronic back pain, gastrointestinal problems, and fibromyalgia. In some cases, one would also observe the presence of chronic headaches and sleep disturbances.
The symptoms have no explainable cause and pass off like that from a psychogenic origin. The patients whom I have come across with this syndrome have usually had a history of trauma of some sort, loss of a loved one at an early age, abuse – physical and sexual, accident with no physical injury, etc.
Pain Management
Now, the good news is that it is possible to cope with this pain by implementing a holistic approach to the treatment. There is a slow yet promising rise in pain clinics in the country that deals with the multidisciplinary and wholesome approach to pain management, which involves equal interventions from pain specialists or orthopedics, pain psychologists, physiotherapists, and nutritionists.
Also, many of these treatments can be practiced independently after initial guidance from the health care professional or the pain specialist.
Psychotherapies for pain management
In patients with mental health conditions, there are various established psychotherapies that can be used for pain management which can be combined with medication.
Cognitive Behavioural Therapy is one of the oldest and most established non-pharmacological treatments for pain management. It helps one with adding resources into their wellbeing bag, that would help them cope with the pain rather than victimize themselves. This can be combined with relaxation training, talk therapies, counselling sessions, and movement therapy.
Co-occurrence of pain and mental health conditions is very common and is best worked on with a tailor-made multi-disciplinary approach.
If you are suffering from pain or depression, go seek a pain therapist or a pain medicine specialist before it worsens. Living a quality-filled and pain-free life is your right!
This article has been authored by Sonam Manoj, Consultant Psychologist & Pain therapist at Cloudnine Hospitals & Alleviate Pain Clinic.
Sonam holds her Masters in Clinical Psychology She is a Ph.D. research scholar, rigorously researching in the field of Pain Medicine and Neuropsychology. She has also earned a Post Graduate Diploma in E-Pain Management from NHS, United Kingdom. She holds a Diploma in Counselling and a Postgraduate Diploma in Life Skills, Reproductive Health and Personal Safety from Christ University, Bangalore.
Sonam Manoj is an active member of the International Association of Pain Research, USA.
She is known for tailoring therapies for patients suffering from stress-related pain, fibromyalgia, pain challenges in children with needs, sportspersons, and also works on ‘Geriatric pain management programs.
You can reach her at sonamjagasia1@gmail.com