Summary: It is well known that people in pain have a poor mood and lose their temper more easily. Now a new study finds these changes come from physical changes in the brain. The main cause seems to be lower GABA levels in the medial prefrontal cortex (the front part of the brain that helps manage emotions). So chronic pain may cause emotional changes that last longer than the pain. That means doctors must also treat these emotional changes in people with chronic pain.
It is no secret that people in pain are often in a bad mood. They often wake up tense and anxious. They may snap at people. Most people think this is just an emotional reaction to pain. Pain does cause irritation and a short temper. But chronic pain causes bigger changes in the brain. If chronic pain is not treated well, it may change the brain for good. That raises the risk of emotional disorders.
So doctors need to check emotional health too. Pain scales alone are not enough. Often, these emotional changes help show how bad the pain really is. You may notice them yourself, or a caregiver may. And it is not just about how bad the pain is. It is also about changes in mental health.
For example, a person may not report severe pain. But they may still have frequent bad moods and other emotional problems. That is a sign the chronic pain is not well managed.
Why does chronic pain change your mood and emotions?
The new study found the brain basis for these mood changes in people with chronic pain. It found that chronic pain throws off the chemical balance in the brain. So people with chronic pain have a harder time controlling their emotions. Researchers say pain is not just an unpleasant feeling. It can cause major mood and emotional changes. It can even change what a person believes.
It is the first study of its kind to find that chronic pain can lower GABA levels in the medial prefrontal cortex. That means chronic pain causes serious damage in the brain. These changes may last longer than the pain. That is why treating chronic pain well matters so much. GABA is one of the brain’s most important calming (inhibitory) chemical messengers. When it runs low in certain brain areas, emotions change. For the study, Neuroscience Research Australia (NeuRA) scanned the brains of 48 people. Half had chronic pain. The other half were healthy adults.
Their findings were published in the European Journal of Pain. They found that people with chronic pain had significantly lower GABA levels than the healthy group. These results held up no matter what caused the chronic pain.
To control emotions, the brain needs a balance of calming and exciting chemicals. If GABA, a calming chemical, drops, you lose some control over mood and emotions. Low GABA means more than that. For example, different parts of the brain may have trouble talking to each other. But the most important and best-known effect of low GABA is stronger emotions.
This is not the first study to show that pain changes GABA levels in the brain. But earlier studies were in lab animals. This is the first study to confirm these changes in humans. Researchers say their findings show why mental health care matters for people with chronic pain. Doctors must treat mental health problems to help people with chronic pain.
The key point: chronic pain causes physical changes in the brain. The study also shows how brain pathways talk to each other. Once long-term pain has taken away happiness and drive, they are hard to bring back. There are many ways to treat chronic pain. But no medicine can reliably fix GABA levels in the brain. So doctors need other ways to help people with chronic pain recover emotionally.
Medical experts are now looking at other options, such as cannabis for managing chronic pain. Padda Institute of Pain Management in St. Louis has kept the trust of patients looking for chronic pain treatment. Interventional pain management methods give lasting relief and help patients get back to normal life.
Frequently asked questions
Can chronic pain cause irritability?
Yes. People with chronic pain often wake up tense and anxious and lose their temper more easily. A study from Neuroscience Research Australia, published in the European Journal of Pain, traced this to lower levels of GABA in the medial prefrontal cortex. GABA is a calming brain chemical. With less GABA, the brain has a harder time keeping emotions in check. So emotions run stronger.
What are the psychological effects of chronic pain?
Chronic pain brings bad moods, irritation, anxiety and a short temper. A long stretch of pain can take away happiness and drive, and they are hard to bring back. These are not just reactions to the pain. They come from chemical changes in the brain. When chronic pain is not managed well, those changes may become permanent. That raises the risk of emotional disorders.
Does chronic pain change the brain?
Yes. Researchers scanned the brains of 48 people. Half had chronic pain and half were healthy adults. The people with chronic pain had significantly lower GABA levels (more than chance would explain) in the medial prefrontal cortex, whatever caused their pain. Earlier studies had shown this only in lab animals. This was the first to confirm it in humans. And the changes may last longer than the pain.
Why does my pain doctor ask about my mood?
Pain scales alone miss part of the picture. Mood changes help show how bad the pain really is, whether you notice them or a caregiver does. A person may report only mild pain yet still have frequent bad moods and other emotional changes. That is a sign the chronic pain is not well managed. That is why treating chronic pain includes caring for emotional health.
Dr. Gurpreet Singh Padda, MD, MBA, MHP
