Introduction
Chronic pain can affect your mental health and cause many emotional challenges. Your condition may feel overwhelming or distressing to manage at times. At Smile, we understand that in order to manage your physical and mental health as well as possible, sometimes you need some support. Although it can be tricky to navigate, with the right resources, it is possible to live well alongside your chronic pain diagnosis.
Aching, burning, stinging. All possible ways to describe the pain that you experience daily. Shooting pains, stiffness and throbbing. Versus Arthritis estimates that around 15.5 million people in England have a chronic pain condition and will have experienced many of these emotions and feelings. It is uncomfortable and makes you feel emotionally and physically drained. It feels unbearable, having to manage this constant discomfort. Very little seems to help in making the pain subside and the relentlessness interrupts your day to day life.
The most common chronic pain condition is severe back pain, with around 5.5 million people currently managing this. Other conditions like fibromyalgia, chronic migraines, arthritis and complex regional pain syndrome also cause severe difficulty for those affected. There are multiple conditions that fall under the category of chronic pain, and a large number of people will be impacted by at least one of these. As they are invisible conditions, it is not always taken as seriously as it should be.
It can be hard to manage any of these conditions on a daily basis but the intensity of the pain is especially hard to manage. It can be a challenge both physically and mentally. Although pain is something almost everyone will likely have experienced, chronic pain is much more severe and tricky to navigate. It is understandable why the physicality of the condition may result in emotional challenges.
Chronic pain and the effect on mental health
Having a condition like fibromyalgia or arthritis can be frustrating to manage because you are experiencing discomfort frequently. Pain is usually something that gets better, and so it is not uncommon that when it doesn’t, a mental health condition may develop. Anxiety and depression are the most common mental health conditions that could develop alongside a chronic pain diagnosis. Your condition is likely to impact on your day to day life, and adapting to life with chronic pain may feel difficult, or even impossible.
Smile therapist, Dr Sula Windgassen, talks within our app about understanding your pain. She says,“if we feel like there are many factors that inform whether we experience pain to a high degree for a long time that we can control, we might feel like the onus is massively on us and it's yet another thing that we have to get control of.” It is important to not put pressure on ourselves to control the factors that affect how we feel pain. If we do, it will likely cause further anxiety.
Although emotional changes may feel tricky to manage, there are lots of ways that you can improve your general wellbeing. They may also help with the emotional stress of your condition. Talking to others and surrounding yourself with a good support system is a great way to manage any unfamiliar, difficult emotions. Eating well, spending time doing the things you love and focussing on your breathing and practising mindfulness are also great techniques. Where possible, exercise and trying to get a good amount of sleep can be really beneficial too.
Misdiagnosis of chronic pain conditions
When you have a chronic pain condition you will probably experience a range of difficult emotions that can be hard to navigate. One of these may be the feeling of doubt. This is a common emotion, because at least 40% of those with a chronic pain condition have had their condition misdiagnosed. If this is to happen, it may cause you to doubt the severity of your condition, as it might have been invalidated by a medical professional. It may also make you feel anxious if this means that you are then unsure on the next steps to take that will allow you to be appropriately treated.
Being incorrectly diagnosed can be a traumatic experience. According to Sula Windgassen, “traumas can include things such as experiencing dismissal from others, including healthcare practitioners” and content within the Smile app explains how this can impact negatively on your mental health.
A condition such as fibromyalgia is commonly misdiagnosed because the combination of symptoms such as fatigue, pain, headaches and irritable bowel syndrome can also be linked to other conditions, such as sleep apnea and lupus. This means that lots of people are being told that they have a different condition, and not being treated for the condition they are actually managing. If this happens, your condition will not be getting any easier to manage.
A misdiagnosis can also be damaging to your physical health. If you have a chronic pain condition, you may need to rest in order to relieve the discomfort you are experiencing. However if you are misdiagnosed, you may decide to push through and continue doing tasks as usual, because you have not been told to do otherwise. This could then make your pain worse and affect your health.
How chronic pain can affect your daily life
Doing everyday tasks such as housework or shopping may be affected by chronic pain. If it causes you significant distress to move, you may be unable to carry out these tasks as you would have before a diagnosis.
Sometimes it can be good to try and move around, as not doing so may cause you to fall into a routine of limited movement and lead to a lack of mobility. If you do move around, tasks should not be too strenuous and should be carried out in moderation, so as not to cause further hurt.
You may find it overwhelming to try and find the right balance between adding movement into your routine and relaxing. It is also not uncommon to feel upset, as you may find it hard acknowledging that your life will be different to before a chronic pain diagnosis.
Another way that your condition can affect your daily life is that it may significantly disturb your sleep, as between 50 and 80% of those with chronic pain have sleeping difficulties. Conditions like chronic migraines can sometimes cause fatigue, which means that although you are feeling exhausted and like you need to sleep, you can’t because of the pain you are experiencing. This will cause further feelings of fatigue and you may not have much energy. A lack of sleep and a disrupted sleep pattern will affect your mood significantly, and you may feel irritable or depressed.
Judgement from others
Chronic pain is invisible and you may therefore feel like others will judge you or tell you that it is ‘in your head’ or ‘not as bad as you are making out’. Chronic pain is incredibly misunderstood and people often feel that there is not enough information around for others to understand the impact.
Those with complex regional pain syndrome feel that this is especially true. If you are managing CRPS, you may find that your symptoms have been dismissed and that it is not treated as a ‘proper’ condition. This can make you feel like your condition has been invalidated and as though you are misunderstood.
You may worry that unless you make your discomfort evident constantly, others will assume that your pain can’t actually be that bad. Of course, this is not true, and often you are trying to live your life as you usually would. However, it may concern you that others will make assumptions about your health, and you may want to try and hide any feelings from them so as to avoid judgement. This can cause emotional distress, but can also make your condition worse.
Other concerns you may have when managing chronic pain
Having a chronic pain condition can sometimes mean that you are unable to participate in certain activities. It may be upsetting if you feel that you are restricted by your condition, and this may then have an impact on your mental health. This may be more likely if your condition causes you to miss out on social occasions, as it may mean that you find yourself feeling isolated from others.
You may feel like you are letting people in your life down if you are not able to support them as much as before a diagnosis. Dr Francesca Sawer, one of our Smile therapists says that “guilt is a feeling that we have done something wrong or if we have not done enough”. Often the reason for this guilt is “ we feel worthy or somehow deserving of punishment”. It is important that you try and let go of these feelings, because your condition is not your fault and there is nothing you can do to prevent it. You should stop blaming yourself for factors out of your control.
Another worry you may have when you are managing a chronic pain condition is how you will be able to financially support your family. In some circumstances, your condition may mean that you are unable to work and this will mean that your finances may suffer. This can make you feel anxious about how you will be able to support your loved ones.
Often there is no cure for chronic pain, and your mental health may be affected knowing this. It can be tricky to accept that you have a lifelong condition. You may be concerned about your loved ones having to witness you in a significant amount of pain for the rest of your life, as this is likely to upset them as well. It may make coming to terms with your diagnosis quite hard. For advice on how to accept a diagnosis, have a look at the Smile app to see content from Tamara Hubbard, which may help you manage any difficult feelings that could occur when getting a diagnosis.
How a chronic pain diagnosis can impact your loved ones
If you have a loved one who is managing chronic pain, it is likely that the condition may affect aspects of your life as well. For example, being in pain may stop someone from doing the things they would usually do before a diagnosis. This can include simple things that they do around the house, like cleaning and tidying. If they are finding it harder to carry out daily tasks, you may find, as their loved one, that you have more responsibilities in your day to day life. You may be doing more to support you and your family than you might have done before a loved one’s diagnosis.
Your relationship with that person might change too, as if they are unable to do social activities that they did before a diagnosis, you may feel isolated and disconnected from them. As chronic pain is not widely spoken about and the emotional impacts are not highlighted, you might find it hard to empathise and understand the level of discomfort your loved one is going through. This may lead to a strain in your relationship with that person because it might frustrate your loved one if they feel like you are not doing enough to understand and support them. Though you will be trying to support them, it may upset you that you are unable to help or fix things for them.
How to get mental health support when managing chronic pain
Those who are experiencing a chronic pain condition are four times more likely to have depression or anxiety than those who don’t have a chronic pain condition. This is because chronic pain can make you feel a range of difficult emotions like helplessness, overwhelm and upset. It is very possible that you may develop a mental health condition alongside your chronic pain condition because of the challenges that may arise.
If you are finding it difficult to manage your mental health as well as chronic pain, there is lots of support available and you can equip yourself with the tools to live well. At Smile we have many resources that may help including videos on understanding pain, managing guilt, understanding trauma and accepting a diagnosis. Our content and expert led workshops are there to support your mental health when you have a chronic physical health condition.
Chronic pain can be uncomfortable to manage daily and it is completely understandable if you are finding it difficult to manage the emotional repercussions of your condition. There are lots of resources and tools that make it possible to manage both your physical and your mental health well, whether that be surrounding yourself with a good support system or accessing therapy. It is possible to live well alongside a chronic health diagnosis.
Smile is a mental health app for people managing chronic physical health conditions. To access the resources mentioned above, download the app now from Google Play or Apple App store.