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Insights from Personal and Professional Frontlines

Living with chronic pain is a physically exhausting experience that extends far beyond physical discomfort. I know this both from my own lived experience with peripheral neuropathy and major nerve damage and as the CEO of People USA, a peer-led non-profit that serves individuals with behavioral health challenges, many of whom struggle with chronic pain as well. It is an unrelenting companion that often brings along adverse mental health and cognitive impacts. The physical pain and subsequent mental health struggles can completely reshape an individual’s life. Understanding these complexities is crucial for effective coping strategies and improved quality of life. Chronic pain has a profound impact on overall quality of life, including mental wellbeing. According to a survey conducted by the American Pain Society, over 50% of individuals living with chronic pain report experiencing moderate to severe disruptions in their daily activities, social relationships, and emotional wellbeing.

Steve Miccio

Steve Miccio, CEO, People USA

I was 17 when I began to feel pain in my feet and legs. I ignored the pain and continued being youthful and playing sports, mountain climbing, working and even skydiving regularly. When I reached my twenties, the pain grew to a level where I could barely walk, and finally had to use a wheelchair by the time I hit 30.

Research suggests that chronic pain can lead to structural and functional changes in the brain. Areas associated with processing pain, such as the prefrontal cortex and limbic system, may undergo alterations, affecting cognitive processes. Additionally, the constant barrage of pain signals can overload the brain’s capacity, disrupting its ability to focus and concentrate. That is what happened to me. I can personally relate to individuals we serve at People USA who often report difficulties with memory, attention, and decision-making. This cognitive fog, commonly referred to as “pain brain,” can be debilitating, impacting everyday tasks and overall productivity.

Beyond cognitive challenges, chronic pain takes a toll on mental wellbeing. It is common for individuals to experience depression, anxiety, and mood disturbances as they navigate the complexities of their condition. The relentless nature of pain can wear down resilience, leading to feelings of hopelessness and despair. In fact, studies have shown that individuals with chronic pain are at a significantly higher risk of experiencing depression. I was severely depressed in my 30’s even though I was on medication that allowed me to walk. However, the pain never went completely away. According to research published in JAMA Psychiatry, 30-50% of individuals with chronic pain also meet the criteria for clinical depression.

Moreover, chronic pain often disrupts sleep patterns, exacerbating psychological distress. Sleep disturbances not only contribute to mood disorders but also further exacerbate cognitive difficulties, creating a vicious cycle of pain, sleeplessness, and mental challenges. It was in my 30’s that I was hospitalized in a psychiatric hospital. I was in severe distress.

Furthermore, the emotional impact of chronic pain extends beyond the individual suffering. Family members and caregivers often experience heightened stress and emotional strain as they witness their loved one’s struggle with pain. This dynamic can strain relationships as it did for me and create additional challenges in coping with chronic pain. Many of the individuals we serve at People USA become isolated from their loved ones, which causes an added layer of loneliness and despair. The link between chronic pain and suicidal ideation is significant. A study published in the Journal of Pain Research found that individuals with chronic pain are three times more likely to report suicidal ideation compared to those without chronic pain. The study underscores the urgent need for mental health support for chronic pain patients.

Individuals grappling with chronic pain encounter numerous hurdles, yet there are avenues they can explore to bolster resilience and enhance their overall wellbeing. I found as I was trying to recover both emotionally and physically, some of these suggestions helped me:

  • Education and Self-awareness stand as pivotal starting points. Many in this population lack the language to articulate their mental and cognitive struggles, despite understanding their physical condition. Recognizing the interconnection between these facets can empower individuals to better navigate their condition.
  • Physical Activity and Exercise, though daunting, hold promise. Engaging in gentle activities like walking, swimming, or yoga can assuage symptoms and uplift mood. Gradual escalation, overseen by healthcare experts, promises enduring advantages.
  • Social Support emerges as a lifeline. Maintaining ties with friends, family, and support circles proves vital in pain management. Emotional reinforcement, practical aid, and a sense of belonging mitigate the psychological toll. Isolation, common due to physical limitations, is curtailed by nurturing relationships.
  • Peer interactions offer invaluable solace and understanding, especially for mental health challenges linked to chronic pain. When I discovered peer support, it was my new hope for recovery and drove me to become the executive director of People USA. The following highlights how peer support has served me and how we use them at People USA to serve individuals on this arduous journey:
  • Mutual Understanding and Validation: Shared experiences foster validation, assuaging feelings of isolation. Support groups provide a non-judgmental space where individuals can express emotions freely, finding solace in mutual empathy.
  • Emotional Support: Peers extend empathy and encouragement, alleviating the burden of solitary struggles. Knowing they are not alone fortifying individuals, instilling hope and resilience.
  • Practical Coping Strategies: Support groups exchange coping mechanisms, offering tools for managing pain and mental health. Shared insights empower individuals to navigate their path toward healing.
  • Mentorship and Community: Seasoned members inspire newcomers, highlighting recovery’s feasibility. Participation engenders a sense of belonging, combating the isolation endemic to chronic pain.

Peers and support groups offer a lifeline to individuals grappling with mental health issues due to chronic pain. Through shared understanding, emotional support, practical coping strategies, and a sense of belonging, these networks play a vital role in fostering resilience, empowerment, and healing. By connecting with peers who understand their journey, individuals can find the strength and support needed to navigate the challenges of chronic pain with courage and perseverance.

Chronic pain presents complex challenges that extend beyond physical discomfort. Cognitive fog, mood disturbances, and disrupted sleep patterns compound the struggle. Moreover, chronic pain exacts a toll on loved ones, magnifying emotional strain.

I still live with chronic pain; however, I have been able to improve my quality of life by using many coping strategies, including constant medical monitoring and educating my loved ones. Having support is so important and we at People USA want people to know that we are here to support them. We will continue to offer coping mechanisms: education, exercise, social support, peer support, practical tools, validation, and empowerment. By embracing these resources, individuals find a sense of belonging that help minimize negative symptoms and fosters hope and perseverance in the face of chronic pain’s unyielding assault on wellbeing.

Steve Miccio is CEO of People USA.

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