We’ve known for a while that chronic pain and anxiety have it in them to fuel each other. It’s not uncommon for people who experience chronic pain to also experience anxiety but up until recently, little was understood about the relationship.
Research published recently in the journal Biological Psychiatry has removed some of the mystery, offering new hope for the treatment of pain, as well as anxiety. The study found that a neurotransmitter in the body called … ready? … here we go … pituitary adenylate cyclase activating polypeptide (‘PACAP’) is released in response to stress and is also elevated in response to chronic pain. Neurotransmitters are chemicals in the brain that help send information between cells.
For neurotransmitters to do their job well, their levels have to be just right – not too high and not too low. When PACAP is elevated, we see symptoms of pain, anxiety or both. In previous research by members of the same research team, it was found that PACAP was elevated in women who had post-traumatic stress.
Here’s how it works. PACAP is found along one of the nervous system’s pathways to the brain. The pathway travels from the spinal cord to the amygdala, which is the seat of anxiety and emotions.
The researchers noticed that when there is chronic pain it’s not unusual to also see an increase in anxious behaviours – but – when the pathways for PACAP are blocked (effectively reducing the levels of PACAP), both anxious behaviour and pain are significantly decreased.
‘By targeting this [PACAP’s] regulator and pathway we have opportunities to block both chronic pain and anxiety disorders,’ – Victor May, Ph.D., senior author of study and professor neurological sciences at the University of Vermont.
The research team is now turning their attention to developing small molecule compounds that can reduce levels of PACAP.
‘This would be a completely different approach to using benzodiazepine and opiods – it’s another tool in the arsenal to battle chronic pain and stress-related behavioral disorders.’ – Victor May.
Whether chronic pain and anxiety occur together or separately, their intrusion into lives can be relentless. When they appear, they have a wide reach – for those who love someone who has to live with pain or anxiety, the struggle is also very real. Hopefully, this research brings us closer to finding an effective, safe way to manage pain and anxiety.
Caffeine is my disaster. One night I ended up in the ER from the anxiety. I had my triggers but the caffeine was the catalyst. But sometimes you’re in a position where an anxiety attack just has to be ridden. This last time ( I work overnight ) I had an attack ( post traumatic stress from current events? ) and had no choice but to ride it. I had the anxiety, the dizziness, the upset stomach, the whole nine. Luckily a friend was also working and we got to talking about other stuff, and had a few laughs. That made me feel remarkably better. Does laughing set off different chemicals in the body? It really tapered off after that. But the fibro took off. But HEY beats the anxiety. So is laughter the best medicine? All honesty here. I refuse medicating any of this short of Ibuprofen ( I prefer my liver and do not use acetaminophen ) for pain. I read about Cymbalta, oh the HORROR. Nope not gonna do it.
At the time of annexity I feel pain in my head . right behind the eyes. What can I do to get rid of it?
If you are sure that your pain is from anxiety, breathe strong deep breaths. I know it might sound simplistic, but let me explain. Anxiety is a physiological response. When your brain senses that there might be threat (this doesn’t mean there is danger – sometimes the brain hits the panic button unnecessarily), it surges the body with a number of different neurochemicals, including adrenaline and cortisol (the stress hormone). These neurochemicals are designed to make you faster, more alert and stronger so that you can deal with any potential threat. When there is no need to fight or no need to flee, there is nothing to burn up these neurochemicals so they build up. You will find a more detailed description of this here https://www.heysigmund.com/dealing-with-anxiety/. This is why anxiety comes with the physical symptoms.
Strong deep breathing activates something called the relaxation response. This is a physiological response that neutralises the fight or flight neurochemicals. When this happens, the physical symptoms will start to ease. The problem is that because the brain is so busy during an anxiety attack, it can be hard to remember to breathe strong deep breaths (in for 3, hold for 1, out for 3). To deal with this, practice strong deep breathing a couple of times a day. You only need to do a few breaths at a time. This will help the response to become more automatic so it will be easier to do when you need it.
Hey! Thanks for this. My gp wants me to attend pain clinics but they’re held 2 1/2 hours away and i don’t enjoy long distance travel. She doesn’t get that attending will cause anxiety which will increase the pain which increases the anxiety…
I hear the dilemma! Hope you are able to find a solution that works for you.
This info sounds promising. As a chronic pain patient, I’m not seeking drugs but I am seeking pain relief. If the answer was simply to stand on my head 5 minutes a day, I would do it (well, maybe not ‘simply’)! My question though is this. What about patients, like myself, that have been taking opiates for 25 years and benzodiazaines for 10 years? I have already been through hell coming off opiates due to DEA & CDC pressure. I’ve heard the coming off the benzos is even more difficult. I just hope there is some built in help for us to make these switches.
Coming of benzos is difficult, but with the right support it can definitely be done. It’s really important that it’s done closely with the a doctor. It sounds as though you’ve already done some tough stuff – you have what it takes to do this. I wish you all the best.
Lori,
I have also been on Benzos for over 30 years, mainly Valium nd Xanax.
I was withdrawn under medical supervision, in hospital and no side affects -over a period of 2 months gradual withdrawal.
I was put on Clonazapan late last year and my new psychiatrist is trying to wean me off that also, but because of sleep issues and and the positive results of combining it with melotonin, he is keeping me on it, until the Pain clinic does their procedures on my back and I see the sleep specialist.
If successful he will gradually withdraw me and HOPE for the best.
I have had no negative side-effects due to gradual withdrawal, Trust your doctor and good luck.
Thanks so much Robert. It makes so much sense why you would feel as though you are on a knife edge when you’re in pain from your autoimmune arthritis. I hope research like this is able to move towards finding ways to bring relief for you.
I suffer from autoimmune arthritis. When I flare and the pain level is high, it often feels like being on an emotional knife edge.
Thank you for a great article. Sharing.
I think like a lot of therapists I’ve felt the connection existed for a long but to have tangible clinical evidence is fantastic. As stated the link is self fuelling, chronic pain begets anxiety, enduring anxiety begets chronic pain.
I hear you Ang! There’s a lot we know intuitively, or through personal experience but it’s always great to have the evidence, and to know that science is working on moving things forward.
Any suggestions for what sufferers can do in the meantime?
Currently trying CBT, but it’s been a long gruelling road of severe anxiety and chronic pain.
Thanks
Leanne there are a lot of articles on this link about ways to manage anxiety https://www.heysigmund.com/category/being-human/anxiety/. Hope there is something here that is helpful for you.
Once again some brilliant info. Where do you get your research from -used to be able to when I worked for The Black Dog,
This info is great, just wish my doctor here at the Home would read it.
Suffering from severe back pain -new procedures being done shortly and unable to have any more ops, plus complex PTSD, boy did I identify.
Thank you so much for your dedication and help-it should be bottled
Thanks Jasmin! Sometimes new research can take a little while to filter through. The good doctors will be onto it though. The references for the research are hyperlinked in the article – just click on the words in dark blue print and that will take you there.
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karenyoung_heysigmund
I love being a parent. I love it with every part of my being and more than I ever thought I could love anything. Honestly though, nothing has brought out my insecurities or vulnerabilities as much. This is so normal. Confusing, and normal.
However many children we have, and whatever age they are, each child and each new stage will bring something new for us to learn. It will always be this way.
Our children will each do life differently, and along the way we will need to adapt and bend ourselves around their path to light their way as best we can. But we won’t do this perfectly, because we can’t always know what mountains they’ll need to climb, or what dragons they’ll need to slay. We won’t always know what they’ll need, and we won’t always be able to give it. We don’t need to. But we’ll want to. Sometimes we’ll ache because of this and we’ll blame ourselves for not being ‘enough’. Sometimes we won’t. This is the vulnerability that comes with parenting.
We love them so much, and that never changes, but the way we feel about parenting might change a thousand times before breakfast. Parenting is tough. It’s worth every second - every second - but it’s tough.
Great parents can feel everything, and sometimes it can turn from moment to moment - loving, furious, resentful, compassionate, gentle, tough, joyful, selfish, confused and wise - all of it. Great parents can feel all of it.
Because parenting is pure joy, but not always. We are strong, nurturing, selfless, loving, but not always. Parents aren’t perfect. Love isn’t perfect. And it was meant to be. We’re raising humans - real ones, with feelings, who don’t need to be perfect, and wont need others to be perfect. Humans who can be kind to others, and to themselves first. But they will learn this from us.
Parenting is the role which needs us to be our most human, beautifully imperfect, flawed, vulnerable selves. Let’s not judge ourselves for our shortcomings and the imperfections, and the necessary human-ness of us.❤️
Sep 2
karenyoung_heysigmund
Sep 2
karenyoung_heysigmund
The Raised Good Online Summit is a brilliant ✨FREE✨ event that brings together those of us in the parenting space from such diverse backgrounds as psychology, anthropology, evolutionary science, natural health, childhood education, and neuroscience.
I don’t know that there are many things that draw as much information as parenting. This is a great thing - we’re learning, opening, growing as parents. And so much information can also be so overwhelming! Especially when it comes with too many ‘shoulds’ or ‘shouldn’ts’ that steer us too far away from our parenting hearts.
We’re here for you, so you can be there for them. Everything you need to be the parent you want to be is already in you. It always has been. The key is hushing the noise that says otherwise, and owning our power to love and lead them through everything that comes with a full, wondrous, messy, growthful childhood.
At the end of the 5-day summit, you’ll gain:
- greater confidence as a parent;
- the awareness to be lead by your parenting heart and the confidence to practice this intuition daily;
- research backed information to support you to be the parent nature intended;
- factual insight to support you to navigate challenging parts of parenting.
The summit is FREE and will be taking place from September 12-16.
We’d love you to join us!
Clink on the link in the bio to register.♥️
Sep 2
karenyoung_heysigmund
Brains and bodies crave balance.
When our bodies are too hot, too cold, fighting an infection, we’ll will shiver or fever or sweat in an attempt to regulate.
These aren’t deliberate or deficient, but part of the magnificent pool of resources our bodies turn to to stay strong for us.
Our nervous systems have the same intense and unavoidable need for balance.
When the brain FEELS unsafe (doesn’t mean it is unsafe) it will attempt to recruit support. How? Through feelings. When we’re in big feels, someone is going to notice. Our boundaries are clear. Were seen, heard, noticed. Maybe not the way we want to be, but when the brain is in ‘distress’ mode, it only cares about the next 15 seconds. This is why we all say or do things we wouldn’t normally do when we’re feeling big sad, angry, anxious, jealous, lonely, frustrated, unseen, unheard, unvalidated.
In that moment, our job isn’t to stop their big feelings. We can’t. In that moment they don’t have the resources or the skills to regulate so they need our help.
When they’re in an emotional storm, our job is to be the anchor - calm, attached, grounded.
Breathe and be with. Hold the boundaries you need to hold to keep everyone (including them) relationally and physically safe, and add warmth. This might sound like nothing at all - just a calm, steady, loving presence, or it might sound like:
‘I know this feels big. I’m here. I want to hear you. (Relationship)
AND
No I won’t hear you while you’re yelling. (Boundary) Get it out of you though. Take your time. I’m right here. (Relationship. The message is, bring your storm to me. I can look after you.)
OR
No I won’t let you hurt my body / sibling’s body. (Boundary. Step away or move sibling out of the way.) I’m right here. You’re not in trouble. I’m right here. (Relationship)
OR if they’re asking for space:
Ok I can see you need space. It’s a good idea that you take the time you need. I’m right here and I’ll check on you in a few minutes. Take your time. There’s no hurry. (Relationship - I can look after you and give you what you need, even when it’s space from me.)’♥️
Aug 26
karenyoung_heysigmund
I think this is one of the hardest things as parents - deciding when to protect them and when to move forward. The line isn’t always clear, but it’s an important one.
Whenever our kiddos feels the distress of big anxiety, we will be driven to protect them from that distress. It’s what makes us loving, amazing, attentive parents. It’s how we keep them safe.
The key is knowing when that anxiety is because of true danger, and when it’s because they are about to do something growthful, important, or brave.
We of course want to hold them back from danger, but not from the things that will grow them.
So when their distress is triggering ours, as it is meant to, and we’re driven to support their avoidance, ask,
‘Do they feel like this because they’re jn danger or because they’re about to do something brave, important, growthful.’
‘Is this a time for me to hold them back (from danger), or is it a time for me to support them forward (towards something important/ brave/ growthful)?’
And remember, the move towards brave can be a teeny shuffle - one tiny brave step at a time. It doesn’t have to be a leap.❤️
Aug 16
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