Pain has a psychological component. This is not to say that pain is in your head. Instead, your mood can act as a volume control for pain – turning it up and down.

Serotonin is a chemical in our brain that is linked to both mood and pain perception. The lower your mood, the more pain you feel.

Anxiety Increases Pain

  • Anxiety increases muscle tension which results in greater pain
  • Anxiety also increases alertness to physical changes in the body
  • Anxiety results in more worried and catastrophic thoughts, which may prevent you from doing things despite your pain

Depression Increases Pain

  • Pain magnifies low mood
  • Feeling depressed makes it difficult to change habits
  • Depression results in feelings of isolation and loss of self confidence
  • Depressed people can feel out of control and have many negative thoughts, possibly preventing you from doing things despite the pain
  • Feeling depressed results in avoidance of social activities and events, this all leads to a vicious circle of isolation and low mood.


Our thoughts affect how we feel. When we feel low in mood, we tend to have a lot of negative thoughts. If we can identify that we are having these thoughts, we can challenge them and hopefully replace them with more realistic/balanced thoughts. Ask yourself these questions:

  • What is the evidence for this thought?
  • Are there any alternative ways of thinking about this?
  • What would I say to a friend who is in the same situation?
  • What would my friend say to me?


By challenging negative thoughts, and replacing them with more realistic or positive ones, we can:

  • Feel more in control
  • Raise our mood
  • Help ourselves relax
  • Increase our motivation
  • Increase energy and activity
  • Decrease pain
  • Manage life better