chronic pain and mental health
chronic pain affects 1 in 5 people in Scotland and can impact their mental health and wellbeing
Pain is a normal part of life, whether it’s physical or emotional. But when pain doesn’t go away and lasts for months or even years, it’s known as chronic pain. Chronic pain is more than just an ongoing ache, it can affect your daily life, mental health and overall wellbeing.
This resource explores what chronic pain is and how it connects with mental health. You’ll also find practical tips for managing chronic pain, from lifestyle changes to professional support options.
What is pain?
Defining pain can be challenging as it is always a personal experience.
Pain is both a sensory and emotional experience, as many people report pain in the absence of tissue damage or any likely pathophysiological cause. People may also experience psychological pain. We can distinguish two (2) types of pain:
- Acute pain
- Chronic pain
Acute pain
It has a useful biological purpose. If we feel pain after an injury or surgery, it is our body’s normal reaction. As time goes, the pain improves and usually lasts less than three (3) months and resolves on its own.
Chronic pain
On the other hand, chronic pain is one that persists for longer than 3 to 6 months. It exceeds the normal healing time and does not have a clear biological purpose. It is much more strongly associated with psychological factors and also psychological comorbidities.
An example of chronic pain can include, taken from Oxford Children’s Rehabilitation Service:
Sarah fell over playing hockey and bruised her leg six months ago: the bruises have healed but it is still painful. She finds it difficult to walk and sometimes uses a wheelchair. She has seen many doctors, physiotherapists, had an X-ray, CAT scan and MRI. She has been told that although she has pain, there is ‘nothing wrong’ with her leg.
Chronic pain can show up in different ways, including:
- Complex regional pain: Severe, ongoing nerve pain, often after an injury.
- Widespread pain: Pain throughout the body, often linked to conditions like fibromyalgia.
- Abdominal pain: Ongoing pain in the stomach area, sometimes linked to digestion issues.
- Muscle and joint pain: Long-term pain in muscles, bones or joints.
- Chronic headaches: Frequent migraines or tension headaches.
How common is chronic pain in Scotland?
According to the Scottish Health Survey from 2022, chronic pain affects approximately 38% of adults in Scotland. It becomes increasingly common with age. Around 55% of people over 75 report experiencing chronic pain. However, it is still substantial among children and young people. 18% of people between the ages of 16 and 24 report chronic pain in Scotland.
“It ended up being a longer recovery progress. It put me backwards and now I experience more pain. There’s less movement in my wrist and I’m not as flexible with the skin all tight. It’s hard. I know it will take a bit of time. But horse riding, for me, is very beneficial because it gets me out of the house and keeps me moving.”
Lorna, who was referred to Change Mental Health’s Resilience service in Tayside, talks about her experience with pain and how it limited her horse riding and training.
Chronic pain strongly overlaps with mental health
Emotional toll of chronic pain
Living with ongoing pain doesn’t just affect your body. It can take a serious toll on your emotional wellbeing too. People with chronic pain often experience anxiety and fear, low mood, anger and feelings that life is confined.
Bidirectional relationship between chronic pain and mental health
Research shows that chronic pain and mental health problems can feed into each other in both directions. For example, people with depression or anxiety are more likely to develop chronic pain later in life or report physical pain symptoms. Those living with long-term pain are at higher risk of developing mental health difficulties. In fact, studies suggest that up to 60% of people with chronic pain also experience depression.
Suicidality in young people
For young people, the connection can be especially worrying. There is evidence of a two-way link between persistent pain and suicidal thoughts or behaviours, even when mental health diagnoses like depression are taken into account. This means that pain and suicidality can reinforce one another over time.
Limited life and work opportunities
According to the Scottish Health Survey from 2022, of those adults experiencing chronic pain, 40% reported that it limited their life/work a lot. Meaningful employment and engagement in leisure activities is key for good mental health.
Psychological pain
Psychological pain (also called emotional pain or mental pain) is the deep inner hurt people feel when they’re struggling emotionally. It can come from things like loss, trauma, hopelessness or feeling like a burden.
This type of pain is often linked to suicidal thoughts. Some theories of suicide suggest that when psychological pain feels unbearable and a person also feels hopeless or disconnected from others, the risk of suicidal thinking increases.
How can I support myself if I experience chronic pain?
- Gentle movement: Exercise can help, but what works best will depend on your body. This might be walking, stretching, dancing, swimming or yoga.
- Mindfulness and relaxation: These techniques can help you notice and respond differently to pain, thoughts and emotions.
- Talking therapy: A therapist can support you with the emotional impact of long-term pain.
- Sleep support: Pain can disrupt sleep, so finding ways to improve rest is key to managing symptoms.
- Stay connected: Support from friends, family or online groups can make a big difference.
- Medication: Medication may help, but it often works best alongside other strategies. Contact your GP if you need more advice.
support
Our National Advice and Support Service can help you and people you care for with mental health concerns and money worries.
We can link and signpost you to relevant local and national support, including our own Change Mental Health services, as well supporting with debt, grants and benefits.
The service is open Monday to Friday, 10am to 4pm (closed for lunch between 12.30pm to 1.30pm). Contact 0808 8010 515, email advice@changemh.org or fill in the form on the service webpage.
For full details about the service, visit the National Advice and Support Service webpage.
