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Connecting the Dots Between Chronic Pain & Mental Illness

Published May 18, 2017    

“Chronic pain can act like water torture on your mental well-being. The more severe the pain, the more isolated and immobile you become. This isolation and inactivity can lead to all sorts of mental illnesses. It only makes sense that if you are unable to live your life due to [back] pain, depression will set in.”

Chinese water torture is a process in which water is slowly dripped onto a person's forehead repeatedly. This act allegedly can drive the restrained victim insane.

Drip. Drop. Drip. Drop. 

Does your chronic back pain feel like water torture? The more pain you may have, the greater the chance of that pain affecting all aspects of your life. From the physical symptoms, you feel that may cause isolation to your emotional wellbeing, chronic back pain can lead to various forms of mental illnesses, according to Vivi-Ann Fischer, D.C, chief clinical officer at Fulcrum Health, Inc., a Minnesota-based nonprofit.

She revealed, “Studies show that chronic physical pain can actually change your nervous system, programming you to be hypersensitive to pain even after you have physically healed.”

Fischer also explained that the inverse is also true, that mental illness can cause physical pain. Those with severe anxiety can develop headaches and muscle tightness and people with depression can develop back pain or even migraines — all directly linked depression.

Just because you didn't speak the facts out loud didn't erase their existence. Silence was just a quieter way to lie. — Jodi Picoult

Jodi Picoult is an American author who has sold over 40 million books throughout 35 countries worldwide.

Mental illness of any kind is like you're drowning, except you can see everyone around you breathing while you sink to the bottom.

Why do you think no one cares? Why do you feel like running away? It’s like you want to scream. Gasp for air, there’s nothing left. Sounds want to escape. Something exacerbates the movement from precipitating voice. The thoughts in your head could have sent you back to hell. You were in hell. Your life was hell — it doesn't have to be. But you remain quiet while your insides are screaming.

Maybe your silence is just another word for pain — and well your pain is exactly how it sounds.

When someone asks what's wrong, maybe you reply back saying, “I'm fine.”

In reality, you may be far from fine. Maybe you want to be more than fine, but don't understand why you aren't.

Mental illness has only recently drawn attention. In past years, it was often assumed that if a person was complaining of pain in a part of the body that looked to be healthy, they were either making it up or imagining it.

“We now know that this was a misjudgment on the part of medical providers,” The Cleveland Clinic reported. “In addition to such obvious factors as anxiety, stress, and depression, there are others that impact function. One is the person’s intellectual understanding of their health – the person who believes that activity endangers their spinal fusion may become an unnecessary invalid, while a more confident person with the same medical condition may be golfing.”

It makes sense someone who is confident enough to know (and really know) that strength doesn't come from what you can do —it comes from overcoming the things you once thought you couldn't do. It's falling down seven times and standing up on eight. It's understanding that your physical pain AND emotional pain is real. It's really just a big pill to swallow. 

And we may not all be there. Hey, some days we are definitely not there. But, that's okay. In order to get the confidence to know that your mental illness doesn't have to define you, we need to start at the beginning — accepting, training your brain, and taking action.

Throughout the majority of self-help programs, acceptance of well anything normally leads the charge. In addition, a variation of planning and taking action are necessary to help with what you are accepting.


Accepting is about letting go. You have to accept your reality and begin to seek out help. It isn't easy, but admitting you need help allows you to break the cycle of mental illness that you've been stuck in.

Accept that something is wrong in your life and that you no longer have control. You must admit complete defeat before building a new life. Embrace the truth and want to make an honest change. Understand that recovery can't be done alone, and acknowledge that you need help.

Sometimes, you just don't know the true weight of what you are carrying around until the day you feel its release. The next time you are thinking negative thoughts, try saying them out loud. You may be pleasantly surprised with how absurd they sound when you finally let it go.

Once you can admit what you are having trouble with, you can then start working to change your negative thoughts (we all have them), which leads us to another important aspect of recovery.

Train Your Brain

Catastrophic thinking can be defined as ruminating about irrational worst-case outcomes. Needless to say, it can increase anxiety and prevent you from taking action in a situation where an action is required. This can be especially true in a crisis situation or someone who lives with chronic back pain. Maybe you think because of your pain, you can't do anything and life is just hopeless. If you have these type of thoughts, speaking with a licensed therapist can help to train your brain from catastrophic thinking to rational thoughts. Yes, your pain may limit what you can do, but it doesn't have you stop you from living life. Repeat those words to yourself until you believe them.

You are in charge. The Cleveland Clinic reported, People who believe that their future depends on others – surgeons, spouses, Workers’ Compensation insurers, foremen, etc. – tend to be more depressed, more functionally impaired, and in worse pain than those who recognize that they are in charge of their own lives.”

Remember that you are in control of your life and your thoughts whether you believe it or not. Consider adding positive affirmations to your morning routine. Positive affirmations can be used to reprogram your thought patterns and change the way you think and feel about things. They are short positive statements that can help you focus on goals, get rid of negative, self-defeating beliefs and program your subconscious mind.

We all know you look in the mirror at least once before you leave the house. Instead of just checking to make sure your hair isn't a mess, take a few minutes, stare at your reflection and speak these words:

  • I believe in, trust and have confidence in myself.
  • I know I can accomplish anything I set my mind to.
  • I forgive myself for not being perfect because I know I'm human.
  • I never give up.
  • I accept what I cannot change.
  • I strive to be open-minded.
  • I have control over my thoughts, feelings, and choices.
  • I look for humor and fun in as many situations as possible.
  • I make the best of every situation.
  • I practice patience, understanding, and compassion with others as well as myself.

Take Action

Exercise. Maybe reading the word exercise scares you a bit. Maybe your first thought was, “There's no way I can run laps around the track or lift weights at the gym.” If you did, don't even fret. We have you covered. Exercise includes a countless list including any form of activity. Simple stretching, yoga, light walking, or even mediation can turn your frown completely upside down.

Steady exercise helps ease your symptoms in three ways:

  1. Releases feel-good brain chemicals that may ease depression (neurotransmitters, endorphins, and endocannabinoids)
  2. Reduces immune system chemicals that can worsen depression
  3. Increases body temperature, which may have calming effects

Regular exercise has many psychological and emotional benefits, too, which include:

  • Increased confidence. Meeting exercise goals or challenges, even small ones, can boost your self-confidence. Getting in shape can also make you feel better about your appearance.
  • Lest you forget. Exercise is a distraction that can get you away from the cycle of negative thoughts that feed anxiety and depression.
  • More social interaction. Exercise and physical activity may give you the chance to meet or socialize with others. Just exchanging a friendly smile or greeting as you walk around your neighborhood can help your mood.
  • Cope in a healthy way. Doing something positive to manage anxiety or depression is a healthy coping strategy. Trying to feel better by drinking alcohol, dwelling on how badly you feel, or hoping anxiety or depression will go away on its own can lead to worsening symptoms.

Staying active. The Mayo Clinic agrees that staying active will help you overcome depression, “Certainly running, lifting weights, playing basketball and other fitness activities that get your heart pumping can help. But so can physical activity such as gardening, washing your car, walking around the block or engaging in other less intense activities. Any physical activity that gets you off the couch and moving can help improve your mood.” Well said Mayo Clinic — well said. 

To continue, they added, “You don't have to do all your exercise or other physical activity at once. Broaden how you think of exercise and find ways to add small amounts of physical activity throughout your day. For example, take the stairs instead of the elevator. Park a little farther away from work to fit in a short walk. Or, if you live close to your job, consider biking to work.”

Talk therapy. Any form of talk therapy does not make you weak — in fact, it means you are that much stronger because you are doing something to help yourself. Anyone who says otherwise is the weak one.

The Depression and Bipolar Support Alliance explained, “Talk therapy is not just 'talking about your problems;' it is also working toward solutions.”

The alliance said that some therapy may involve homework, such as tracking your moods, writing about your thoughts, or participating in social activities that have caused anxiety in the past, which might encourage you to look at things in a different way or learn new ways to react to events or people.

Psychotherapy benefits include:

  • Understanding your illness
  • Defining and reaching wellness goals
  • Overcoming fears or insecurities
  • Cope with stress
  • Make sense of past traumatic experiences
  • Separate your true personality from the mood swings caused by your illness
  • Identify triggers that may worsen your symptoms
  • Improve relationships with family and friends
  • Establish a stable, dependable routine
  • Develop a plan for coping with crises
  • Understand why things bother you and what you can do about them
  • End destructive habits such as drinking, using drugs, or overspending

Healing is possible. Regardless of the treatment option you choose, just know that your decision to get help already puts you ahead. You can't win if you don't play, just as you can't get better if you don't do something about it.

“The victim inside us all ceases when we stand up in opposition of that which oppresses or intimidates us. Something powerfully intrinsic happens when the courage to no longer be silent awakens within us and we are compelled to confront our problems rather than cower to them. The things that torment us thrive on our hushed fears and insecurities and they are made powerless by a resilient voice; an inner voice that says...'No More!'” ~ Jason Versey

“In your first few sessions, you will probably do most of the talking. You should tell the therapist why you are there and what you would like to get from therapy. Make a list of short- and long-term goals with your therapist at the beginning of treatment,” concluded the Mayo Clinic.

“After a few sessions, your therapist may be able to give you an idea of how long therapy will take and when you can expect to see changes in your moods.”

Last change: January 29, 2019