Pain is not just a physical experience. It is also often a mental experience. How you perceive pain, the memories and emotions you attach to it, and when pain communication pathways chronically light up in the brain, contribute to making pain a mental experience. There are ways to address mental pain naturally.
Mental pain, also called psychological pain, psychic pain, psychological pain, emptiness, psychache, internal perturbation, and psychological quality of life may be characterized by[i]:
- Sense of loss or loss of self
- Perception of negative changes in self
- Intense feelings such as guilt, shame, loneliness, helplessness, inadequacy
- A discrepancy between perception of ideal and actual self
- Feelings of suffering
- Changes in self-image
- Association with mental disorders including anxiety, depression, eating disorders, as well as borderline personality disorder
- Association with physical pain
Mental pain can be measured with a 10-item questionnaire called the Mental Pain Questionnaire (MPQ) and has shown to be a reliable measure of mental pain.[ii] Addressing mental pain as a component of pain may be an important pathway to prevent and diminish the opioid epidemic.[iii]
What causes mental pain? Neuroinflammation or inflammation of the brain is a driving force for chronic pain and is also implicated in other neurological and psychiatric diseases such as Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, autism, major depression, and schizophrenia.[iv] This inflammation may be caused by exposure to toxins, infection, or injury and is mediated by the production of cytokines, chemokines, reactive oxygen species, and secondary messengers.
Mental pain may actually stem from a bad gut. The gut and brain are interconnected through the gut-brain axis. When symptoms of mental pain are present, a good first place to look is the gut. If gut symptoms such as heartburn, acid reflux, constipation, diarrhea, or stomach pains are also present, an evaluation for leaky gut, food sensitivities, toxins, or infection can help identify hidden causes of metabolic imbalances that can contribute to either physical or mental pain. When hidden causes such as hormone, immune, digestion, detoxification, energy production, and nervous system issues are present and overwhelm the body’s ability to achieve homeostasis (rebalance on its own), this is what Functional Diagnostic Nutrition Practitioners refer to as Metabolic Chaos®.
So, what approach should be made to address chronic pain, when mental pain is part of the equation? As a Functional Diagnostic Nutrition Practitioner, I would use client self-assessment profiles and functional lab testing to identify hidden causes of Metabolic Chaos. Lab test results are then, correlated with client symptoms. A personalized plan to address diet, rest, exercise, stress management, and supplementation can help to rebalance the body to reduce inflammation, improve gut-brain axis communication, reducing both physical and mental pain.
Diet is an important part of a plan for people with mental pain. The gut-brain axis supports more signals from the gut to the brain than the brain to the gut. Because of this, we know that the health of the microbes in our gut called the microbiome is critically important in this communication pathway. If the microbiome is unhealthy and the gut is leaky, correcting the diet and identifying food sensitivities, and rebalancing the gut microbiome is a critical aspect of healing.
Sleep quality is often an issue when people have chronic pain and can actually cause heightened sensitivity to pain.[v] Disrupted sleep can cause brain fog issues, inability to focus, fatigue, and contribute to a person’s ability to cope with physical pain, which leads to increased mental pain. So, addressing sleep quality is another part of the plan to reduce pain.
Exercise is also helpful to improve mood but can be challenging when a person is experiencing mental and physical pain. Developing a personalized exercise plan which considers the physical limitations, and the mental factors can help to reduce pain. This may require collaboration with other practitioners using modalities such as chiropractic or physical therapy.
Stress management is a huge component of a pain plan especially when mental pain is a component. Pain can be a significant cause as well as a result of stress. Promoting relaxation can help to lessen the fear of pain.[vi] Using mindfulness techniques such as breathing exercises, meditation, journaling, Emotional Freedom Technique (EFT) can be very helpful in reducing pain. Because of this, I offer stress management as part of my coaching program as well as a separate EFT program to help clients.
Natural supplementation as part of a healing protocol may help to address nutrient deficiencies, gut infections, or support digestion, detoxification, or hormonal balance. For mental pain, specifically, targeted supplementation with amino acids may help to alleviate anxiety, fear, worry, panic attacks, and feeling stressed or overwhelmed to rebalance neurotransmitters in the brain. They can also be helpful in addressing other problems that contribute to or exacerbate anxiety, such as sugar cravings and addictions. The amino acid mood questionnaire developed by Trudy Scott can help to identify what supplements may be helpful.[vii]
Mental pain can contribute to the cycle of trial and error in managing chronic pain. When chronic pain is present, the potential for mental pain should also be assessed. Pain can often be complex. While functional diagnostic nutrition practices are not a substitute for counseling or mental health services, addressing hidden stressors with diet, rest, exercise, stress management, and supplementation can help to reduce inflammation and pain. For more information, a free discovery call is available.
[ii] Svicher A, Romanazzo S, De Cesaris F, Benemei S, Geppetti P, Cosci F. Mental Pain Questionnaire: An item response theory analysis. J Affect Disord. 2019;249:226-233. doi:10.1016/j.jad.2019.02.030
[iii] Fava G, A, Tomba E, Brakemeier E, -L, Carrozzino D, Cosci F, Eöry A, Leonardi T, Schamong I, Guidi J: Mental Pain as a Transdiagnostic Patient-Reported Outcome Measure. Psychother Psychosom 2019;88:341-349. doi: 10.1159/000504024.
[iv] Ji RR, Xu ZZ, Gao YJ. Emerging targets in neuroinflammation-driven chronic pain. Nat Rev Drug Discov. 2014;13:533–548. [PMC free article] [PubMed] [Google Scholar]
[v] Pacheco, D. Pain and Sleep. The Sleep Foundation. 2020. https://www.sleepfoundation.org/physical-health/pain-and-sleep.
[vi] Scott, T. Anxiety Nutrition Solutions. 2017. Interview: Heal Your Pain Now + the fear-pain connection. https://www.everywomanover29.com/blog/heal-your-pain-now-fear-pain-connection/
[vii] Scott, T. Amino Acids Mood Questionnaire from The Antianxiety Food Solution, 2013. https://www.everywomanover29.com/blog/amino-acids-mood-questionnaire-from-the-antianxiety-food-solution/.