Pain And The Brain (more coming soon)

Psychology and Pain

Chronic pain can be best understood from a Psychological perspective which views pain as a complex, multifaceted experience emerging from the dynamic interplay of a patient’s physiological state, thoughts, emotions, behaviors, and sociocultural influences. A psychological perspective focuses on viewing chronic pain as an illness rather than disease, thus recognizing that it is a subjective experience and that treatment approaches are aimed at the management, rather than the cure, of chronic pain.

Current psychological approaches to the management of chronic pain include interventions that aim to achieve increased self-management, behavioral change, and cognitive change rather than directly eliminate the locus of pain. Benefits of including psychological treatments in multidisciplinary approaches to the management of chronic pain include, but are not limited to, increased self-management of pain, improved pain-coping resources, reduced pain-related disability, and reduced emotional distress – improvements that are effected via a variety of effective self-regulatory, behavioral, and cognitive techniques. Through implementation of these changes, psychologists can effectively help patients feel more in command of their pain control and enable them to live as normal a life as possible despite pain. Moreover, the skills learned through psychological interventions empower and enable patients to become active participants in the management of their illness and instill valuable skills that patients can employ throughout their lives.

Physiological/Biological Factors

  • Location of injury.
  • Intensity of stimulation and amount of tissue damage
  • Type and density of receptors present
  • Biologically-based differences in pain threshold and sensitivity
  • Amount of competing sensory (large fiber) activity

Psychological Factors

  • Emotional status of the individual. Negative emotions usually increase pain and positive emotions reduce it.
  • Concentration effects.
  • Individual beliefs and expectations regarding the experience of pain.
  • The individual's belief over the how much control they have over their pain.
  • The individual's experiences with pain
  • Culturally related beliefs about pain influences
  • General physical health of the person with pain.


How are depression and chronic pain linked?

Scientists don’t fully understand know how depression and chronic pain are linked, but the illnesses often occur together. Chronic pain worsens depression symptoms and is a risk factor for suicide in people who are depressed.

Bodily aches and pains are a common symptom of depression. Studies show that people with more severe depression feel more intense pain. According to recent research, people with depression have higher than normal levels of proteins called cytokines. Cytokines send messages to cells that affect how the immune system responds to infection and disease, including the strength and length of the response. In this way, cytokines can trigger pain by promoting inflammation, which is the body’s response to infection or injury. Inflammation helps protect the body by destroying, removing, or isolating the infected or injured area. In addition to pain, signs of inflammation include swelling, redness, heat, and sometimes loss of function.

Many studies are finding that inflammation may be a link between depression and illnesses that often occur with depression. Further research may help doctors and scientists better understand this connection and find better ways to diagnose and treat depression and other illnesses.
One disorder that has been shown to occur with depression is fibromyalgia. Fibromyalgia causes chronic, widespread muscle pain, tiredness, and multiple tender points—places on the body that hurt in response to light pressure. People with fibromyalgia are more likely to have depression and other mental illnesses than the general population. Studies have shown that depression and fibromyalgia share risk factors and treatments.

Chronic Pain Depression Treatments

Depression is diagnosed and treated by a health care provider. Treating depression can help you manage your chronic pain and improve your overall health. Recovery from depression takes time but treatments are effective.

The most common treatments for depression include: Cognitive behavioral therapy (CBT), a type of psychotherapy, or talk therapy, that helps people change negative thinking styles and behaviors that may contribute to their depression, SSRI, a type of antidepressant medication that includes citalopram (Celexa), sertraline (Zoloft), and fluoxetine (prozac) serotonin, and SNRI, a type of antidepressant medication similar to SSRI that includes venlafaxine (effexor) and duloxetine (Cymbalta).

Most depression treatments are well tolerated and safe, talk with your health care provider about side effects, possible drug interactions, and other treatment options. For the latest information on medications, . Not everyone responds to treatment the same way. Medications can take several weeks to work, may need to be combined with ongoing talk therapy, or may need to be changed or adjusted to minimize side effects and achieve the best results. people living with chronic pain may be able to manage their symptoms through lifestyle changes. For example, regular aerobic exercise may help reduce some symptoms of chronic pain. exercise may also boost your mood and help treat your depression. Talk therapy may also be helpful in treating your chronic pain. Having more control over chronic pain decreases depression.

Signs and Symptoms of Depression

  • Ongoing sad, anxious, or empty feelings
  • Feeling hopeless
  • Feeling guilty, worthless, or helpless
  • Feeling irritable or restless
  • Loss of interest in activities or hobbies once enjoyable,
  • including sex
  • Feeling tired all the time
  • Difficulty concentrating, remembering details, or making
  • decisions
  • Difficulty falling asleep or staying asleep, a condition
  • called insomnia, or sleeping all the time
  • Overeating or loss of appetite
  • Thoughts of death and suicide or suicide attempts
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