Chronic pain causes brain changes that increase depression and anxiety

People living with chronic pain have lower levels of a neurotransmitter crucial to regulating emotion and may experience higher levels of depression and anxiety as a result, a study has found.

According to the Australian Institute for Health and Wellbeing (AIHW), one in five Australians aged 45 and older live with a condition that causes persistent, ongoing pain.

The causes for chronic pain are varied, and include arthritis, serious back injuries, migraines, multiple sclerosis, cancer treatment, nerve damage, fibromyalgia and recovery from surgery. It can affect a person’s ability to work, exercise and socialise, and greatly lower their quality of life. Not surprisingly, those living with chronic pain are also more likely to develop symptoms of depression and anxiety.

A study, led by the University of New South Wales (UNSW) and neuroscience research group NeuRA, has found that chronic pain may actually cause a chemical imbalance in the brain that is responsible for the higher rates of mental illness.

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Neurotransmitters are a varied group of chemical messengers that transmit electrical signals between neurons and target cells. Some neurotransmitters amplify signals (called excitatory neurotransmitters), while others weaken them (inhibitive neurotransmitters).

It’s through these messengers that instructions are carried from your brain to all parts of your body.

One specific neurotransmitter, known as GABA, is the main inhibitory neurotransmitter in your central nervous system and is responsible for keeping your emotions (happy or sad) in check.

“Chronic pain is more than an awful sensation,” says the study’s senior author, Associate Professor Sylvia Gustin, a neuroscientist and psychologist at UNSW and NeuRA.

“It can affect our feelings, beliefs and the way we are,” she says.

“We have discovered, for the first time, that ongoing pain is associated with a decrease in GABA, an inhibitive neurotransmitter in the medial prefrontal cortex. In other words, there’s an actual pathological change going on.”

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The results showed that participants with chronic pain had significantly lower levels of GABA than the control group, a pattern that was consistent regardless of their type of chronic pain.

“A decrease in GABA means that the brain cells can no longer communicate to each other properly,” Assoc. Prof. Gustin says.

“When there’s a decrease in this neurotransmitter, our actions, emotions and thoughts get amplified.”

Although a link between chronic pain and decreased levels of GABA was previously found in animal studies, this is the first time it has been translated to human studies.

Assoc. Prof. Gustin says it’s still not clear exactly why chronic pain conditions, regardless of their origins, lead to such a dramatic loss of GABA.

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“We don’t know why it happens yet, but we are working on finding solutions on how to change it,” she says.

“It’s important to remember it’s not you – there’s actually something physically happening to your brain.”

Although there are extensive medication options to help treat chronic pain, there are currently no drugs that specifically target GABA levels in the brain. Traditional painkilling options usually target the nervous system as a whole, rather than specific parts of the brain, and can come with harsh side-effects.

Assoc. Prof. Gustin and her team have recently developed an online emotional recovery program, specifically targeted at people with chronic pain, as a non-pharmaceutical option for treating the neurotransmitter disruption.

“The online therapy program teaches people skills to help self-regulate their negative emotions,” says Assoc. Prof. Gustin, who welcomes people interested in learning more about the program to contact the team.

“The brain can’t dampen down these feelings on its own, but it is plastic – and we can learn to change it.”

To learn more about the online emotional recovery program, email Assoc. Prof. Gustin at [email protected]

Do you or a loved one suffer from chronic pain? Has it had an impact on your or their mental health? Let us know in the comments section below.

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Brad Lockyer
Brad Lockyer
Brad has deep knowledge of retirement income, including Age Pension and other government entitlements, as well as health, money and lifestyle issues facing older Australians. Keen interests in current affairs, politics, sport and entertainment. Digital media professional with more than 10 years experience in the industry.
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