When pain goes from acute pain, which happens for a specific reason such as a toothache, to chronic, constant pain lasting months from causes such as nerve damage or cancer, it becomes a chronic part of life. Treatment for chronic pain still leaves much to be desired as it’s now become clearer that pain medication is not safe for the indefinite management of long-term pain. As pain is often connected and communicated via the central nervous system, the question remains, how is all this pain affecting our brains?
Feelings as Facts
During normal brain function when one area of the brain speaks up the others quiet down, which is how the brain maintains balance. However, a recent study found this to be different in the brains of people that suffer from chronic pain. This study, conducted by Northwest University’s Feinberg School of Medicine, found that in cases of those with chronic pain, a part of the frontal cortex, a part of the brain mostly associated with emotions, is constantly active, regardless of what other parts of the brain are. When a certain part of the brain is always lit up, this constant activity can alter the connections that neutrons have to each other and this can have lasting negative effects as neurons pass information back and forth via this connection. This is also detrimental for them as they become worn out from being overloaded. According to the research, it is the first time that a brain disturbance is seen in chronic pain patients and is not directly related to the sensation of pain.
What does this all mean? Simply stated the research indicates that chronic pain isn’t simply a sensory issue. Some of the issue centers in the part of our brains that manage emotions. Emotions, such as depression and anxiety, can make life even more unbearable for the person living with constant pain. Furthermore, some emotional issues actually manifest physical symptoms, the excess of emotional activity in the brain can perpetuate the issue of chronic pain.
Currently in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) several different issues, such as pain syndrome, have been condensed into one diagnosis, somatic symptom disorder. According to Dr. Leslie J. Crofford, “This diagnosis is characterized by ‘distressing somatic symptoms plus abnormal thoughts, feelings, and behaviors in response to these symptoms.’ Importantly, the previous requirement that symptoms had to be medically unexplained is removed and psychological symptoms surrounding the somatic symptoms have been added. These include excessive thoughts, feelings, or behaviors related to somatic symptoms or associated health concerns as manifested by rumination and/or high level of anxiety about health or symptoms and/or excessive time and energy devoted to symptoms or health concerns.” What are somatic symptoms? Somatic simply means “relating to the body”. While somatic implies that these issues are strictly in the physical body, it has been recognized that it’s a mental health issue to manage extreme or intrusive pain. There is a connection between the body and the mind, and in moving forward to find more effective treatments, researchers and doctors are working to heal through that link.
Treating the Body, Preserving the Mind
The constant disruption to the balance and equilibrium in the brain can have negative, long-lasting effects, as over time the brain can become permanently rewired this way. When looking forward and avoiding the use of opiate pain medications, treating the mind becomes a reasonable first line of defense. In the treatment of somatic stress disorder, a number of different remedies are used to calm the overactive frontal cortex and potentially treat chronic pain disorders. The common treatments include:
cognitive behavioral therapy (CBT) – a form of psychotherapy, CBT is a short term, goal-oriented approach to changing thoughts and behaviors by changing attitudes. This is accomplished by examining one’s thoughts, feelings, beliefs, and works on the way a person behaves in order to deal with the emotional result of these.
Serotonin reuptake inhibitors (SRIs) – SRIs are used to help the body more effectively distribute serotonin, a chemical the brain produces that increases a sense of well-being. They are often used to treat anxiety and depression.
No matter what kind of physical or psychological symptom someone is diagnosed with, it’s important to be well informed in order to be a proactive part of care. The more that you understand what is happening inside your body the better equipped you will be to advocate for the right kinds of treatment. There is almost never a one size fits all type of treatment for a diagnosis, so be sure to utilize the accessibility of information to help find the right one for you.
Ashley Addiction Treatment is an innovative treatment program located on Maryland’s Chesapeake Bay. Ashley provides support for professionals seeking help with addiction. We are able to help people with co-occurring disorders and offer confidential treatment programs to meet your needs. Please reach out to us today at 800-799-4673.