by Douglas L. Anderson, PsyD

Do you experience pain that is chronic in nature?  If you do, you are far from alone.  Estimates suggest that about 50 million U.S. adults are experiencing chronic pain.

Broadly speaking, there are two kinds of chronic pain - chronic pain and high-impact chronic pain.  The difference relates to severity of impact.  People with chronic pain are able to maintain normal life activities despite their pain.  People with high-impact chronic pain experience limitations in major life domains, including work, social, recreational, and self-care activities.

I doubt anyone with chronic pain or high-impact chronic pain will find this next statement surprising.  Depression and anxiety commonly co-occur with unrelenting pain.  For example, about 50% of people diagnosed with fibromyalgia also experience depression at a clinical level in any 12 month period.  If you have arthritis, migraine headaches, or pelvic pain the prevalence of depression in any 12 month period is about 20%.

The numbers are even higher when it comes to anxiety disorders.  More than 50% of people with chronic pain due to temporomandibular joint disorder, fibromyalgia, and chronic abdominal pain also experience an anxiety disorder.  If your pain is due to migraine headaches, pelvic pain, or arthritis the prevalence of anxiety is around 35% to 40%.

Chronic pain (defined as pain that lasts more than three months) and depression and anxiety co-occur and contribute to each other.  That is, just as pain can exacerbate our emotional struggle with anxiety and depression, so anxiety and depression can exacerbate our level of pain.

Many people have taken or are taking opiates as a way to deal with chronic pain.  Opiates work well when it comes to reducing pain, but they come with plenty of downsides - various side effects and concerns about addiction.  The medical community is therefore very slow to prescribe these medications due to their many dangers, and that has led to a search for non-pharmacological ways to deal with chronic pain.

Psychotherapy has often been a last ditch effort to deal with chronic pain, but the medical community and the psychotherapy community are working together more these days, and psychotherapy is increasingly seen as something we need to incorporate much earlier in the treatment of chronic pain.

We know that negative emotion and thought about pain can increase the pain signals in the brain, leading to the experience of greater pain.  If we are able to help someone manage their emotions and thoughts more effectively we can reduce the experience and impact of chronic pain.

Pain is a normal part of life in many ways, but chronic pain and high-impact chronic pain can make living a normal life very difficult.  The mix of medical and psychological treatment occurring together holds out hope that chronic pain can be better managed, commonly reduced, and sometimes removed altogether.

If you are one of the 50 million American adults living with chronic pain or high-impact chronic pain, I suspect you are already making use of medical interventions.  I encourage you to consider making use of psychological help as well.  

We have competent and caring therapists in all four of our locations - River Counseling Services in Platte, Sioux Falls Psychological Services, and Stronghold Counseling Services in Sioux Falls and in Yankton - who will meet you where you are, offering hope. That is our mission. You may schedule an appointment at the Platte office at 605-337-3444 or meet with one of our Sioux Falls or Yankton based therapists from your computer, smartphone, or in person at any of our clinics. To schedule an appointment, please call 605-334-2696.