Summary: It is well known that people in pain have a poor mood and more easily lose their temper. However, a new study now finds that these changes result from physical changes in the brain. It mainly seems to occur due to reduced GABA levels in the medial prefrontal cortex. It means that chronic pain may cause emotional changes that may outlast the pain. Hence, doctors must also focus on managing these emotional changes in those living with chronic pain.
It is no secret that people in pain are frequently not in a good mood. Such people often wake up agitated and anxious and may readily lose their temper. However, people think it is just an emotional reaction to the pain. Though pain indeed causes specific emotional reactions like higher irritation and a bad temper. However, chronic pain causes bigger changes in the brain. Thus, if chronic pain is not managed adequately, it may lead to permanent brain changes, increasing the risk of emotional disorders.
Therefore, doctors need to evaluate emotional health, too, and paying attention merely to pain scales is not sufficient. Quite often, these emotional changes, whether self-reported or reported by caretakers, may help better understand the pain severity. Moreover, it is not just about pain severity but also about mental health changes.
For example, a person may not report severe pain. However, they may still have emotional changes, frequent bad moods, and other emotional issues. This indicates that chronic pain is not well managed in an individual.
The new study could identify the neurological basis of these changes in mood and emotion in those living with chronic pain. It found that chronic pain affects mental health by causing chemical imbalances in the brain; thus, people living with chronic pain find it harder to control their emotions. Researchers say it is vital to understand that pain is not just an unpleasant sensation. Instead, it can cause significant mood and emotional changes and even changes in the belief system.
It is the first study of its kind that found that chronic pain could reduce GABA levels in the medial prefrontal cortex. It means that chronic pain is causing severe pathological changes in the brain, and these changes may outlast the pain, hence the importance of chronic pain management and treatment effectively. GABA is among the most important inhibitory neurotransmitters in the brain. Therefore, its low level in certain brain parts causes emotional changes. For the study, Neuroscience Research Australia (NeuRA) conducted brain scans of 48 people. Half of them were living with chronic pain, and the other half were healthy adults.
Their findings were published in the European Journal of Pain. They found that those living with chronic pain had significantly lower GAGA levels than control groups. These findings were consistent and did not depend on the cause of chronic pain.
For humans to control emotions, a balance of inhibitory and excitatory neurochemicals is a must. However, if GABA, an inhibitory neurotransmitter, is reduced, it results in a reduced ability to control mood and emotions. Of course, reduced GABA levels mean much more. For example, it means that different brain centers may have trouble communicating with each other. However, the most important and known impact of low GABA levels in the brain is an amplification of emotions.
This is not the first study to show that pain alters GABA levels in the brain. However, earlier studies were in lab animals, and this is the first study to confirm these changes in humans. Researchers say that their findings highlight the importance of taking care of the mental health of those living with chronic pain. It also shows that doctors must manage mental health issues to help those with chronic pain.
It is vital to understand that physical changes in response to chronic pain are happening in the brain. It also shows how various neural pathways communicate with each other. Once the prolonged pain experience has taken away happiness and motivation, they are pretty tricky to restore. Although there are many ways of treating chronic pain, there are no medications that can reliably correct GABA levels in the brain. Hence, doctors need to find other ways of emotional recovery in chronic pain patients.
Medical experts are now looking for alternatives such as cannabis for managing chronic pain. Padda Institute of Pain Management in St Louis has kept the trust of patients who are looking for chronic pain treatments. Interventional pain management methods are known to provide lasting relief and regaining a regular lifestyle.
By Gurpreet Singh Padda, MD, MBA