Whether a veteran has been wounded in combat, has experienced a non-battle injury or is currently working through a recovery, chronic physical pain has the potential to play a significant role in his or her rehabilitation and reintegration process. Managing the psychological and emotional effects of chronic pain can be just as challenging as the pain itself. This article will give you a better understanding of how chronic pain and psychological health are inter-related and provide you with four tips to help you successfully manage chronic pain and improve your psychological well-being.
What is Chronic Pain and How Does it Relate to Psychological Health?
For pain to be considered “chronic,” it usually must be experienced in one or more areas of the body for a period lasting between three to six months – although it can last longer, sometimes years. Chronic pain can be caused by normal wear and tear on the body, physical injury, accidents or chronic medical illness. In some cases, it can even be experienced without any known cause.1,2
Although chronic pain may be thought of as solely a physical problem, it can have effects on psychological health as well. Research shows that depression can be a common side effect of chronic pain due to its persistence. Chronic pain can also stem from a traumatic event, such as a dangerous experience in combat, a physical assault, a motor vehicle accident or some type of disaster.2 Under these circumstances, the person may experience chronic pain and posttraumatic stress disorder (PTSD) concurrently.2 Approximately 15 percent to 35 percent of patients with chronic pain also have PTSD.2 Research also shows that survivors of physical and psychological abuse can be more at risk for developing certain types of chronic pain later in life.2
How to Successfully Manage Chronic Pain
If you are currently coping with chronic pain, familiarize yourself with how it can affect your psychological health and follow the four tips below to manage your pain and improve your well-being:
#1 - Develop a Comprehensive Treatment Plan with Your Physician
Creating a comprehensive pain management plan with your primary care physician and patient care advocate may not eliminate your pain, but it has the potential to change your attitude, emotional state and outlook on life. When you work to address both the physical and psychological symptoms, you can put yourself in the best position to cope with chronic pain. The Mayo Clinic recommends the following basic guidelines for creating a comprehensive pain management plan with your physician:3
- Get a comprehensive medical evaluation. Ask your primary care physician to review your physical condition, psychological responses and the current status of your medications. Be prepared to discuss how your pain is affecting your job and life at home.
- Manage your medications. Medications prescribed and monitored by your physician can be useful tools in addressing severe pain, however it may be helpful to reduce reliance on – and even eliminate – some medications as treatment progresses. This is especially true for opioid medications (e.g., morphine) which can act as depressants.
- Enroll in physical therapy. Weight gain, loss of strength, reduced stamina and limited activity can commonly occur with chronic pain. Physical therapy can be a great solution to these challenges.
- Use stress management techniques. Psychological health care, group therapy, lifestyle management, family counseling and biofeedback – a method of monitoring changes in your body using medical equipment – are all good stress management techniques. Talk with your doctor to find out which one works for you and incorporate it into your pain management plan.
- The same area of the brain is affected by both pain and depression.
- The brain uses the same chemical messengers to regulate both pain and depression.
- Chronic pain may cause issues that can naturally lead to depression, such as stress, trouble sleeping and anxiety.
#2 - Take Steps to Help You Cope and Build Resilience
Psychological and emotional well-being are just as important as receiving medical treatments to help alleviate chronic pain.6 The American Psychological Association offers the following tips to help you cope with the effects of chronic pain as well as help you build resilience  and learn the necessary skills to manage chronic pain:6
- Manage your stress by learning healthy ways to deal with stress, such as getting enough sleep, eating healthy and exercising.
- Think positively by focusing on the improvements that you’re making in managing your pain. For example, if you’re feeling better today than you did last week, take note of the healthy steps you took towards the achievement.
- Become active and engaged by participating in a hobby that you enjoy or spending time with friends and family, which will help take your mind off of the pain.
- Find support by joining a support group and sharing your experience with others who are also coping with chronic pain.
Read the Real Warriors Campaign article, “Psychological Fitness – Keeping Your Mind Fit ,” for tips and tools to help you cope with the psychological health concerns often experienced with chronic pain.
#3 - Report All the Effects of Chronic Pain to Your Doctor
Even though you may be experiencing chronic pain, you can be on your way to feeling better about yourself, sleeping better and having better interactions with your family members, friends and coworkers. In order to stay on the right track, record all the effects chronic pain is having on your life and report them to your doctor. This will keep your doctor up-to-date with your symptoms, so he or she can develop an ideal treatment plan.
Begin this process by taking a self-assessment of your current situation. Consider inviting someone close to you to join in this process and think about the following questions:
- Have concerns arisen at work since you started dealing with chronic pain?
- Have you been experiencing stressful family interactions?
- Are you having financial or legal trouble?
After taking this initial assessment, look at the list below of signs and symptoms associated with depression, as reported by chronic pain patients.7 If you can identify with any of these signs of depression, reach out for support and report them to your doctor.
- Ongoing sadness or anxiety
- Feeling hopeless or empty
- Feeling irritable or restless
- Difficulty concentrating or remembering details
- Trouble sleeping
- Overeating or loss of appetite
- Reduced sexual activities
- Thoughts of hurting yourself
#4 Reach Out for Support
Reaching out is a sign of strength. If you notice your pain is having a negative effect on the way you relate to others – including family members, children, your spouse or friends – your experiences at work or your outlook on life, reach out to one of the following resources:
- Log on to Real Warriors Live Chat  where you can speak with a trained health resource consultant who is ready to talk, listen and provide the guidance and resources you’re looking for. Call 866-966-1020 or log on 24/7.
- Read the VA’s “Chronic Pain and PTSD: A Guide for Patients ” for valuable information about chronic pain and psychological health issues.
- Visit a Vet Center , a community-based center operated by the Department of Veterans Affairs (VA), that offers counseling and outreach services. Find a Vet Center in your region  or call 800-905-4675 (EST) or 866-496-8838 (PST) during normal business hours.
- Speak to a patient advocate who can help coordinate your care and make the treatment process easier for you. To speak with a patient advocate, contact your regional VA facility .
Taking steps to proactively manage both the psychological and physical effects of chronic pain will initiate a process of healing and ultimately help you better cope with the effects of chronic pain. If you think chronic pain is affecting you psychologically, talk to your doctor so you can begin treating all of the symptoms and chart a course toward recovery.
1 “NINDS Chronic Pain Information Page ,” National Institute of Neurological Disorders and Stroke, National Institutes of Health. Last accessed Nov. 17, 2014.
2 “Chronic Pain & PTSD: A Guide for Patients ,” National Center for PTSD, Department of Veterans Affairs. Published May 11, 2010.
3 Plumbo, Ginger. “Comprehensive Approach Can Break the Chronic Pain Cycle ,” Newsroom - Health Information, Mayo Clinic. Published May 11, 2010.
4 Hall-Flavin, Daniel K. “Pain and Depression: Is there a link ?” Depression (Major Depression), Mayo Clinic. Last accessed Nov. 17, 2014.
5 Bair, MJ, RL Robinson, W Katon, and K Kroenke. “Depression and Pain Comorbidity: A Literature Review ,” Department of Medicine, Indiana University School of Medicine. Published Nov. 10, 2003.
6 “Coping with Chronic Pain ,” American Psychological Association. Last accessed Nov.17, 2014.
7 “Depression and Chronic Pain ,” National Institute of Mental Health, National Institutes of Health. Last accessed Nov. 17, 2014.