How to Decrease Anxiety When You Have Chronic Pain
If you experience chronic pain, anxiety may be an all-too-familiar feeling. Some researchers believe that there’s a connection in the brain between the experience of pain and anxiety, and that each feeds the other.
“Anxiety serves a purpose—it’s a signal telling us that something's not right,” says Katie Willard Virant, a licensed clinical social worker and psychotherapist who treats people with chronic illness in St. Louis. “But when you have chronic pain, it can be like a fire alarm that's gone wonky, going off when it doesn't necessarily need to. There's a sense that every time we feel something, we want to pay attention to it.”
“It’s anxiety-inducing to always be in pain,” agrees Elana Miller, M.D., an integrative psychiatrist in Los Angeles. “There’s also the stress of uncertainty in not knowing when you wake up if it will be a good day or a bad day for your pain.”
Another theory behind the link between chronic pain and anxiety is that pain may decrease the production of dopamine, a brain chemical involved in feelings of pleasure, satisfaction, and motivation.
And although pain can make you anxious, anxiety also seems to influence the perception of pain. Some people with anxiety may have a lower pain tolerance, according to the Anxiety and Depression Association of America—putting pain and anxiety into a repetitive loop.
Fortunately, there are ways to manage anxiety while living with chronic pain. Try the following strategies to release anxious thoughts and feelings that may be tied to your pain.
Find a Doctor Who Takes Your Pain Seriously
It can increase anxiety to feel that your doctor is brushing off your complaints of pain, says Miller. It can happen to anyone, but Black people and women may be at particular risk of their pain being underrecognized and undertreated by their doctors, suggests recent research.
“If you feel like you’re not being heard and you're not getting the proper treatment, get a second opinion. Find another doctor who will listen to you,” Miller says. “Getting the physical symptoms addressed properly can remove a lot of the anxiety.”
Try Relaxation and Mindfulness Techniques
When you’re dealing with chronic pain, it can be difficult to stay in the moment without projecting what your pain means for the future, Miller says. “There's the daily experience of chronic pain, and then there are the stories we tell ourselves about that pain and what it means,” she explains.
Negative thoughts—such as “I'll never be able to do anything I love ever again” or “I’m going to feel this way forever”—can ramp up the anxiety. Instead, Miller says, practice noticing the pain without attaching any deeper meaning to it.
That may mean practicing mindfulness-based therapies. Mindfulness approaches such as deep breathing and meditation may have the ability to lower the perception of pain and increase feelings of well‑being in some people with chronic conditions, research suggests.
Virant also recommends trying medical hypnosis, which a 2022 study suggests may help in managing chronic pain.
“These therapies can help turn down that alarm system in your body,” she says.
Connect with a Therapist Who Understands Chronic Pain
“A therapist or psychiatrist who’s familiar with the connection between anxiety and chronic pain can help you navigate the complexities that come with that,” Miller says. “There is a huge connection between our nervous system in terms of pain and our mind and our experience of anxiety and depression, and they reinforce each other.”
Many medications that treat anxiety can also treat chronic pain, so it’s important to work with a prescriber such as a psychiatrist who can coordinate your medication to treat both conditions.
Take Care of Yourself
It sounds simple, but making sure you’re getting enough sleep and eating well can help in managing anxiety, Virant says. “Treat yourself as you would treat a beloved child,” she says.
This includes getting exercise, says Miller. Research suggests that even 10 minutes of aerobic exercise may help decrease anxiety, and this type of exercise may also help relieve pain. “Often people with chronic pain are afraid to be active, and they’re worried that it will worsen their pain,” she says. “But often that's not the case—just be aware of your body and its limitations.”
Start slowly and watch how you feel. Miller suggests going out in the sun and fresh air and taking a walk with a friend, which may make you feel better both for the exercise and for the quality time.
Taking care of yourself can also mean making sure you have a cozy and welcoming spot to relax when you need to rest at home because of the pain, Virant says.
“I always advise people to make their resting spot really comfortable—choose a very soft blanket, and maybe find a spot by a window where you can see outside, or have a vase of fresh flowers nearby. This will make you feel safe, and when you feel safe, you’re not as anxious,” she says.
The intersection between chronic pain and anxiety is real and challenging—and it’s worth finding strategies to help manage it. Work with your doctor to find what helps you, and take care to have some self-compassion along the way.
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