MHM Magazine

Issue 6 | 2021 | MENTALHEALTHMATTERS | 27 MHM complications of chronic pain. The risk for suicide is significantly reduced if patients with chronic pain attend proper pain clinics with a multi-disciplinary approach. Large epidemiological studies amongst patients who suffer from chronic pain disorders showed, that a higher suicide risk is not associated with patients who are treated with painkillers and benzodiazepines, but is increased in those who are dependent or addicted to these treatments. This probably points to people who self-medicate. Almost every patient who suffers with ongoing chronic pain should be referred to a multi- disciplinary team, which will usually include a psychiatrist, psychologist, pain specialist, physio therapist and an occupational therapist, to cover all areas of life affected by chronic pain. Psychiatrists know that almost every person who suffers from chronic pain also suffers from a mental health disorder, most commonly depression and anxiety. Many people, and sadly, some healthcare providers, misdiagnose or fail to identify the mental health issues of patients with chronic pain. If these mental illnesses are not treated adequately, the risk for suicide increases. We know that both chronic pain and major depression are conditions which are influenced by a chronic inflammatory state. We also know that psychotherapy and controlled exercise, as well as a healthy, balanced lifestyle, is imperative in proper management of both conditions. In ancient times people thought that physical and emotional pain were interlinked, now we have scientific proof of that link: it’s the inflammatory response, which perpetuates the pain, but also causes an auto-immune response in the brain, leading to an imbalance in monoamine neurotransmitters, causing depression. Scientists refers to it as “the brain on fire” and this dual disorder should be treated with both antidepressant and anti- inflammatory medications. Helplessness, hopelessness and pain catastrophising are associated with suicidal thoughts amongst patients with chronic pain disorders. This highlights the importance of psychotherapy (specifically CBT based therapies) in the treatment of chronic pain. Insomnia is also associated with a higher suicide risk. Every patient suffering from chronic pain should understand the importance of good sleep hygiene, and every effort should be made to ensure a good night’s rest. Alcohol and substance abuse could lead to worsening of psychiatric symptoms and insomnia, and should be avoided at all cost. Many self-medicating addicts thinks they can’t survive without these substances, but once they’re properly detoxed their quality of life improves dramatically! Mental and physical pain flies together like birds of a feather … and should always be managed simultaneously. References available upon request