Physical pain takes a toll on our mental wellbeing, whether or not we acknowledge or admit it. It's far beyond just being physically exhausted or having a “bad day”. Chronic physical pain changes our brain and the way we think and act, even after the pain lessens.


It's amazing how pain can affect our mental health and how it can cause us to think and feel negatively about our lives and ourselves.


Here are 10 ways on how being in long-term physical pain can impact our mental health:


  1. Makes you feel lonely and depressed


Persistent pain reduces social involvement and increases the risk of depression. These changes can be explained by the psychological mechanisms that mediate the relationship between pain and depression, such as cognitive bias and disuse behaviour. In turn, reduction in social involvement and onset of depression have implications for physical health.


Depression may be explained by activation of schemas that result in attributions of negative outcomes to stable and global causes. Pain may activate such schemas. Other psychological processes associated with pain, such as focusing on pain-related information, may also result in pessimistic attributions about the future.


Pain may also result in an increase in depressive symptoms due to reduction in physical activity (disuse behaviour). Decreased activity is commonly observed in patients with chronic pain. Disuse behaviour is associated with negative moods and reduced self-efficacy, which are also symptoms of depression.


  1. Makes you feel insecure


It's not just in your head.


If you've ever been in long-term, physical pain and found yourself feeling more insecure than usual, it's not just in your head.


A new study published in the Journal of Personality and Social Psychology found that when people experience chronic physical pain, it also alters their personality — specifically making them feel less confident and more insecure.


“There is an old saying: ‘Pain is what the patient says it is,'” Dr. Gary Kaplan, founder of the Kaplan Center for Integrative Medicine and author of Total Recovery: Solving the Mystery of Chronic Pain and Depression, said in an email to The Huffington Post. “The subjective experience of pain can be shaped by many different factors.”


While this study didn't look at the cause of chronic pain, Kaplan said he believes it may come down to how people experience emotions.


“Our emotions are stored in our musculature,” he said. “This is why we get ‘butterflies' when we are nervous, or have a ‘knot' in our stomach when we are angry.”


In other words, people who experience depression tend to tense their muscles as a response to their feelings — which can lead to chronic back pain, muscle tension and headaches.


  1. Makes you feel invisible


The key is that when there's pain, the brain tends to focus on the pain – and that means less attention for everything else. “Pain is such a big deal for the brain; it takes up so much space in our awareness,” says Ajay Wasan, MD, co-director of the Center for Pain Relief at University of Pittsburgh Medical Center (UPMC).


That includes less attention for yourself – your appearance, your personality, how you interact with others. You become invisible.


“Someone who has chronic pain often feels like they're not themselves anymore,” says Dr. Wasan. “It can make you feel like you don't count.”


  1. Makes you feel like a burden to others


Many patients with chronic pain feel like a burden to others. They worry about being a nuisance.


This can be an especially difficult struggle for those living with chronic pain because these feelings of guilt and shame may be unwarranted and unhelpful.


When you're in constant pain, it's hard to do much at all, let alone participate in all the activities you used to enjoy before your condition. It's easy to feel guilty when other people are doing these things and you are not.


It doesn't help that some people may not understand what it's like to live with a chronic health condition or that they seem to expect you to carry on as usual while you're in pain.


It can make you feel like a burden when you have to ask others for help. You might need help with your daily routine, such as getting dressed or washing up, or getting around if you have mobility issues due to chronic pain. But it is important to remember that friends and family usually want to help, even if they don't always know how best to do so.


  1. Makes you feel worthless, useless and hopeless


Your sense of self-worth is intrinsically linked to your physical being. If you are injured, you will not be able to do the things you want to do and that can make you feel worthless.


The mind is a powerful thing, and how it works is still largely a mystery. But we do know that the brain is the most complex information processing device known to man, containing billions of neurons or nerve cells. These cells use electricity to communicate with each other, which allows us to think, remember, move and feel.


Pain occurs when our nervous system sends signals to our brains – sending messages through nerves in the spinal cord and brain stem – that something harmful has happened or is about to happen. Normally, pain signals switch off once the danger has passed and the body has healed itself. But for people living with chronic pain, this does not happen and they can experience pain for months or even years at a time


The psychological effects of chronic pain can be very difficult for sufferers, leading to anxiety and depression which will only heighten the sensations of pain felt by the body.


  1. Have suicidal thoughts


Suicide is a major public health concern. According to the Centers for Disease Control and Prevention, it's the 10th leading cause of death in the United States. While suicide occurs across all age groups, the highest rates are among middle-aged adults.


Suicide risk increases when people are experiencing psychological pain, such as depression or anxiety. But researchers have found that people with chronic physical pain are more likely to consider suicide, even when they aren't depressed. In fact, one study found that chronic pain is associated with suicidal thoughts and behavior independent of depression.


Physical pain can lead to changes in our brains that may contribute to feelings of hopelessness, which is a major risk factor for suicide. When we're in pain, certain areas of our brain — particularly those involved in emotional regulation — become less active while others become overactive. And when these regions fail to communicate with each other effectively, we may lose our ability to tolerate distress and suffer from anxiety and depression. These changes in brain activity can lead us to perceive the future more negatively, which is why we tend to think “I'll never feel better” when we're struggling with chronic pain.


  1. Feelings of anger, sadness, resentment and bitterness towards yourself or others


If you’re in long-term physical pain and are struggling to cope, it can cause you to feel angry, sad, resentful and bitter towards yourself or those around you. Anger can be directed at both your condition and how it makes you feel. It is a natural human reaction to the emotional pain caused by an injury or illness.


A common symptom of depression is feeling sad most of the day for two weeks or more without any relief. Depression can often be a result of living with chronic pain and being unable to do the things that used to make you happy.


Resentment can come from feeling ignored by others because they don’t understand what it’s like to live with constant pain. Bitterness occurs when you have a ‘why me?’ attitude towards your condition, as if you think you deserve better.


  1. Feelings of guilt for not being able to do the things other healthy people take for granted (ie: do chores around the house, read a book without falling asleep every 5 minutes from exhaustion or just going out with friends)


When you live with chronic pain, you feel guilty.


You feel guilty because you can't work as much as you used to, or perhaps not at all.


You feel guilty because you don't have the energy to socialize or be a good partner.


You feel guilty because your family and friends have to shoulder more of the responsibilities of daily life.


Most of all, though, you feel guilty because you're just so darned sick of feeling lousy all the time. You want your old life back, but until that happens, you want at least some reprieve from persistent pain and fatigue. You want a day when your knees don't hurt and your shoulders don't ache and your head doesn't throb and burn. And when that day comes — if it ever does — you'll take it and not look back for a second.


  1. A sense of loss of control over your life


Research has shown that people with chronic illnesses or physical pain are more likely to worry and experience stress than others. This may be because they feel out of control, or because they're afraid of not being able to do the things they love.


Some people with long-term physical pain also struggle with anxiety disorders and depression. Many have trouble sleeping, which can lead to more anxiety and depression. If you've been in physical pain for a long time, it's important to talk to your doctor about these issues.


  1. You lose interest in doing activities that once brought you joy or happiness


The physical pain that we feel as a result of an injury or illness can have consequences that extend beyond the physical.


This is especially true for those who suffer from chronic pain, which is any pain that lasts for a year or longer.


In addition to the physical toll that chronic pain takes on us, it can also cause us to lose interest in many of the enjoyable activities in our lives.


While you might experience this decrease in motivation as depression, it's actually what psychologists call “anhedonia.”


Anhedonia is the inability to experience pleasure from activities that previously brought you joy; it's often associated with depression because people who are depressed tend to be less motivated to do things they enjoy. But unlike depression, the lack of pleasure experienced with anhedonia isn't accompanied by feelings of sadness or hopelessness.


Anhedonia can be both a symptom and a cause of depression — one study found that about 50% of people with major depressive disorder also had anhedonia. The fact that both can occur together isn't surprising: if you're experiencing symptoms of depression such as low mood and sleep troubles, you're less likely to have the energy or motivation to engage in activities that once made you happy. 


The physical and mental symptoms of chronic pain can be prevented from overlapping by being aware that they are distinct from one another, and recognizing the warning signs. At the end of the day, no matter how bad your condition may be, a positive mindset will always help you cope better.


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