Coping with the emotional impact of chronic pain

Pain does not just affect the body. It also affects how people feel emotionally. People can experience many losses because of pain, for example jobs, finances, and home life, which sometimes leads to loss of confidence and low self-esteem.

Thought patterns can become negative, low and full of frustration. Pain can take over, disrupting sleep, making tempers short and memory and concentration poor. Such feelings can also affect peoples’ ability to cope with pain and even the levels of pain experienced (see also ‘Sleep, stress and environmental factors‘).

Nearly all the people that we talked to said that pain affected them emotionally. The worst time for many people was going through the frustrating and often unsuccessful process of searching for a diagnosis and treatment for their pain. In the early stages people were anxious about the cause of pain and frightened at the prospect of worsening pain, particularly when they experienced a flare-up. (See also ‘Coping with flare-up‘).

Often people felt disbelieved by the medical profession and even doubted themselves. One woman described how she stopped taking her medication to see if it was all in her head.

Started wondering whether she was imagining the pain so stopped talking her medication and found…

Age at interview 32

Gender Female

Age at diagnosis 26

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Many people experienced feelings of ‘Why me?’ ‘What have I done to deserve this?’ although some offset this by saying that it could happen to anyone and there were people worse off than them. However, these feelings could resurface when people were having a particularly bad time. A man who sometimes felt this way tried to avoid a downward spiral by thinking positively.

Says you have to challenge the “why me” thoughts with “I can cope” and “it will feel better in…

Age at interview 48

Gender Male

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Those who had been injured were often angry with the person or organisation responsible. A man who felt angry towards his employers was helped by a psychologist to come to terms with his accident and move on with his life. A woman came to accept that her injury was an accident that could have happened to anyone.

Was bitter with his employers but the psychologist helped him realise that he needed to accept…

Age at interview 57

Gender Male

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Chronic pain often stopped people doing things that they used to do, which could make them feel frustrated. Bound up with this was a sense of guilt and anxiety because they could no longer work or care for the family. Many peoples’ lives had changed completely and some even said that they hated what they had become, although others emphasised that you could live a fulfilling life despite pain (see also ‘Coming to terms with pain’).

Chronic pain can lead to isolation and loneliness, partly because it’s difficult to get out but also because people withdraw into themselves. A man said he felt vulnerable when he was out and about. Another described an experience that others had, of getting a painful muscle spasm in public and being taken for a drunk.

Had several spasms of pain in public and was embarrassed because people thought he was drunk….

Age at interview 48

Gender Male

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Isolation also came from a feeling that others, even friends and family, could not understand the pain. On the other hand people sometimes felt like they had pushed friends and family away because pain made them self-centred and they were often angry and aggressive towards others (see also ‘Impact on the family’, ‘Relationships and sex life‘ and ‘Impact on friends and reaction of others‘).

Explains that you can feel lonely even when your family are around because pain is very…

Age at interview 49

Gender Female

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A man told us that he had turned to alcohol in the belief that it might help his pain, but realised it made him abusive and was not going solve his problems. Healthier ways of coping included exercise, meditation, and yoga, or just breathing deeply.

Used to drink alcohol in the hope it would help his pain but realised it just made him abusive.

Age at interview 41

Gender Male

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Feelings of anxiety, frustration, anger, low self-esteem, isolation, guilt etc. all contributed to low mood or feeling down. Many said they often felt tearful, although for some having a good cry could be therapeutic.

When she has a flare up she tries stretching and taking a bath but says that sometimes a good cry…

Age at interview 59

Gender Female

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Feelings could spiral out of control. One woman described a vicious cycle of increased pain and feeling down. She and others realised the importance of breaking this cycle. People had different ways of doing this, including spending time with friends and family, praying, talking to a professional or people from a support group, meditating, finding a distraction, challenging negative thoughts, and thinking positively.

Explains that pain and how you feel are a vicious cycle and you need to find ways of breaking it.

Age at interview 25

Gender Female

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Feeling down could lead to depression, although people were keen to point out how different ‘real’ depression is from simply feeling low. Some found it difficult to admit they were depressed and were angry when their doctor suggested they see a psychologist or psychiatrist or take antidepressants because it felt like their pain was being labelled a psychological problem.

Found it hard to admit that she was depressed and was annoyed that her GP suggested…

Age at interview 42

Gender Female

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Despite this, many went on to find counselling helpful, especially if the counsellor understood chronic pain. Some found antidepressants helped to get them through a particularly bad time, sometimes in combination with counselling. A few people told us that they had depression before the pain and said that either one could make the other worse.

For some, reaching a low point prompted them to seek help. A few people told us that they had thought about whether life was worth living and had contemplated suicide. They strongly advised people in that situation to contact a support group or the Samaritans.

Became completely reclusive and lay in a darkened room but then started to think about who he…

Age at interview 54

Gender Male

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Has felt suicidal in the past and recommends picking up the phone and talking to a support group…

Age at interview 57

Gender Male

Age at diagnosis 50

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People told us about things that keep them going. Families and friends were many people’s motivation in life. Others found pets gave them purpose and were a great comfort and company particularly if they were alone a lot. One woman said that her dog’s joy was ‘infectious’. Another said that, when she had felt like ending it all, her dog had kept her going.

Explains that her dog comforts her, gets her out of the house and helped her to dismiss suicidal…

Age at interview 52

Gender Female

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Faith and support from other members of their religious community were important to some people. Some tried not to let the pain stop them from having good times like a night out or a special outing.

Accepts that sometimes hell have pain for a few days after doing something he really wants to…

Age at interview 54

Gender Male

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Nevertheless, even appreciating simple things in life could lift people’s mood, as could laughter, which was thought to help release pain-relieving and mood-enhancing chemicals.