Chronic Pain: How It Affects the Mind

Chronic pain is no joke. I’ve had to deal with it off-and-on since my early twenties due to plantar fasciitis. Recently it has hit me hard with the start of new work that keeps me on my feet. The pain is visceral and, at its worst, can leave my feet swollen and disfigured.

Soon I began to notice that the unrelieved pain altered my attitude, negatively so, which disturbed me. I’m a laidback person and I like positivity within and without. But the debilitating foot pain kept me irritable and short-tempered at just about anything: the ringing phone, the faucet water being too hot, my own ineptitude.

The pain essentially "decommissions” me. Anything that is not an emergency is put on hold. Often I will strand myself on the couch until bedtime; and when the pain is unbearable, I simply wave the white flag and crawl in bed early, relinquishing any remaining portion of the evening.

I started thinking, Why does this happen?

Young people would be quick to deem older people crabby or irksome. And what caretaker hasn’t discovered some elderly or ill and feeble one to be irritable? More importantly, however, is there a reason why these people get this way…why my own 30-something self would kick the wall for anger if it didn’t mean walking on knobs for days thereafter?

This has allowed me to reconsider my mother who once dealt with chronic hip pain. I recall how my siblings and I thought her to be reclusive by choosing to stay home or not participate when the family wanted to be active. But now I know better.

I understand that pain has its way of changing our minds. My pain has made me empathic to people who suffer with chronic pain more regularly and intensely than I do. I have experienced how pain really can be the excuse for mood swings and many other abnormal behaviors.

It all has to do with the “wiring” in the brain. When my feet are afflicting me signals travel from the injured area into the brain via two paths. One is a normal route that results in the pain being understood as a physical sensation. The other path, however, is through two areas of the brain that control emotional learning and pain registry: the amygdala and anterior cingulate cortex.

The significance is that I am not merely feeling foot pain, especially chronic pain, but I am also experiencing a negative emotional reaction to it.

The brain of a normal, uninjured person exists in a state of equilibrium. There are many areas of the brain that manage certain functions of the body and psyche; none are used at all times but only when needed for a task. A brain characterized by equilibrium is one in which there are generally about the same number of active regions as there are inactive regions.

But when a person is in chronic pain the region of the brain associated with mood and attention is always active. The constant activity rearranges nerve connections and leaves the sufferer at higher risk for mental problems. This person’s brain now reorganizes mental resources to cope with daily duties.

People in pain may have problems doing simple math to recalling information. But this is a small issue to the problems chronic pain sufferers often face.

Loss of sleep, irritability, and depression are common among chronic pain sufferers. Even worse are sexual dysfunction, a waning self-worth, and suicide. Substance abuse and addiction characterize about one-quarter of chronic pain sufferers.

These are indeed “negative emotional reactions.” But there is a double whammy to this.

Chronic pain also has known physiological effects on the body, including hypertension, gastrointestinal impairment, and depressed immune system; the potential for heart attack, bowel obstruction, pneumonia, and sepsis also exists.

So persons dealing with severe pain have more trouble because of failing health—and the added emotional burden it now heaps on their already hurting bodies and minds.

I used to hate school growing up and sometimes had strange fantasies of doing harm to myself, like breaking a limb, just to stay home. It is funnier now because I meet other people who had the same masochistic tendency.

What needs to be seriously addressed relating to youth though is the avoidance of premature pain and early onset health issues at stake in their choices today.

Many youth are very active in school and extracurricular youth league sports. Trends show, however, that injury, overexertion, and simple overdoing it have led to an epidemic of youth joint, bone, and tissue problems, issues that are commonly seen in people in their fifties and older.

The word of caution to youth (and their parents) is to make wise decisions about not just their activities but their bodies and future health. Pain must be avoided at all costs.

I am satisfied to know why my mood alters as it does, and I can be a better emotional assistant to those needing relief. Still, knowing is half the battle: I must free myself of pain as much as possible. This is everyone’s goal because we’re all susceptible to injury, something that hampers quality of life. Moreover, chronic pain brings unwelcome guests and avoiding it is everything we can do to enjoy life.