I have chronic pain and I feel emotionally exhausted...

If you’ve ever experienced a throbbing headache or an intense toothache, then you probably have an idea of how invasive and incapacitating physical pain can be. And if the pain persists long enough to be a chronic condition, it can have an impact on the person’s physical, emotional and mental health.

What is chronic pain?

Chronic pain is defined as pain that persists for longer than three months. 

All pain has an adaptive value and can act as a protective factor by alerting us to when something in our body isn’t working as it should be. It becomes an issue when the levels of pain are higher than an individual can handle. Pain can certainly impact one’s mental health, and add to the person’s stress.

When a pain becomes chronic and consistent, it can impact the quality of the person’s life, and determine (to a certain extent) how they live their life. With increasing work being done on the mind-body connection, it’s becoming clearer that no pain is independently physical or emotional. While the impact on physical health may seem obvious, there are several other aspects that are related, and not always easily visible.

Emotionally, pain can also lead to uncertainty, apprehension and emotional turmoil, and also impact a person’s sense of self. It can reduce a person’s productivity, with direct (or indirect) financial repercussions. If the pain is severe, then even getting through the day can become a struggle. Emotional fatigue is common among sufferers of chronic pain.

High levels of pain can stress the body’s physical and emotional systems. We’re all able to manage pain up to a certain level, but when the pain crosses that threshold, the body’s cortisol levels go up and this impacts our cognitive faculties too. A person in intense pain may not be able to concentrate; may feel low or anxious, and their judgement can be affected too.

Physical pain and emotional pain

Sometimes, physical pain can also lead to emotional pain - and unlike physical pain, emotional pain can be hard to recognize and quantify. Emotional pain can begin as feelings of apprehension or worry about one’s condition, and become more intense. This emotional pain can make the experience of chronic pain much harder to cope with, to the extent that the physical pain worsens. This is why no pain can be said to be either independently physical or emotional; and why management of chronic pain can be more effective when mental health is taken into consideration.

People with chronic pain are said to be at three times the risk of developing a mental illness - most commonly anxiety or depression. While chronic pain can lead to mental health issues, it’s also true that the stress caused by the emotional state of feeling low can worsen a person’s experience of chronic pain.

Self-care for chronic pain:

1. Be sure to invest your energy in self-care. This can help both your physical and your emotional wellbeing. Establishing an eating routine and eating healthy; exercising as much as your condition allows you to and realigning your sleep patterns to ensure you’re getting a good night’s quality sleep, can help. 

2. If you’re in constant pain, physiotherapy can help.

3. Seek emotional support from friends and family–or a therapist if required–to come to terms with your altered circumstances and physical capacity.

4. Stress can make pain worse. So identify what situations cause you stress and try to stay away from them. If these are situations that you cannot avoid, you can learn ways to cope with them so your stress levels are in control.

5. Regulate your eating patterns and ensure that you eat a balanced, nutritious meal.

6. Practice sleep hygiene so you can sleep well whenever possible. This could include leaving your gadgets out of the bedroom, and creating your own unwinding ritual so you can sleep well.

7. Reach out to your support systems when you need to, for emotional or practical support.

This piece has been written with inputs from Hiba Siddiqui, Counseling Psychologist and Psycho-oncologist; Dr Shantala Hegde, Assistant Professor (Neuropsychology), NIMHANS; Dr Anand Jayaraman, Consultant Psychiatrist and Pain Management, JISAR, Bangalore.