The psychological aspects of pain include the emotional and social factors that contribute to the perception of pain. They can also involve the emotional impact experienced by people who live with chronic pain, such as arthritis, fibromyalgia, lupus or chronic fatigue syndrome.

In recent years, the medical community has recognized that pain is not simply a physical response to an unpleasant external stimulus (noxious stimulus). Rather, there are a number of biological, psychological and social factors that interact in complex ways to influence the experience and perception of pain. Although this is an area that is recognized by the medical community, it is not fully understood and is still being investigated.

Factors that can influence a patient’s experience with pain include:

• Past experiences with pain
• Genetic factors
• Depression and other mood disorders
• Pain coping methods
• Beliefs or fears surrounding the pain

Understanding the psychological aspects of pain may be particularly important among people who experience chronic (long-term) pain. Some patients with chronic pain do not respond to traditional analgesics and may be treated with other drugs, such as antidepressants. Lithium, a treatment for bipolar disorder, is sometimes prescribed as a headache medication to prevent cluster headaches.

Chronic pain patients may experience several physiological and psychological consequences as a result of the pain. They include:

• Insomnia or other sleep disturbances
• Anxiety and depression
• Loss of enjoyment of life
• Inability to maintain close relationships
• Feelings of hopelessness and helplessness
• Suicidal thoughts

Chronic pain patients are also at a higher risk of developing mood disorders, such as depression, and attempting suicide.

Scientists have identified several factors that are associated with patients who have difficulty recovering from injury and are at a greater risk of developing chronic pain and disability as a result. They include:

• History of major psychopathology. Patients with a mood, anxiety, thought or personality disorder have a greater chance of developing chronic pain due to poor coping mechanisms.
  
  
• History of substance abuse or dependence. Patients with past substance abuse problems are more apt to experience chronic pain. Patients can also develop substance abuse problems through the use of medications to treat pain, such as opioids.
  
  
• Job dissatisfaction. People who are unhappy with their jobs are more likely to have chronic pain.
  
  
• History of psychological abuse. This may result in a higher risk for chronic pain.
  
  
• Negative or anxiety-producing beliefs about pain. People with little confidence in their ability to overcome pain are at a greater risk for developing chronic pain.
  
  
• Overall attitude towards pain. Patients with optimistic attitudes about their abilities to recover from pain are better able to avoid chronic pain than patients with negative attitudes.