Over 40 million people in the U.S, approximately 18% of the population, suffer from anxiety. While anxiety is often a debilitating disease, when combined with the chronic pain suffered by nearly one in four in the U.S., the results can be devastating for the patient, their family, and their friends. Chronic pain and anxiety feed off each other, with one condition intensifying the other. People with anxiety are more likely to suffer from chronic pain, and those with chronic pain commonly suffer from some degree of anxiety.
How are chronic pain and anxiety related? The research
One of the ways in which anxiety and chronic pain are related is believed to be through a complex series of connections in the brain.
Dr. Min Zhuo and his team at the University of Toronto have found not only a series of links between chronic pain and anxiety in the anterior cingulate cortex, the region of the brain that plays a part of emotion formation, processing, and learning, but they have also found a molecule with the potential to reduce anxiety that stems from chronic pain.
The first discovery relates to Long Term Potentiation (LTP), which is simply the brain’s ability to become more efficient at processing things that repeatedly occur, such as pain and anxiety. LTP seems to occur in the anterior cingulate cortex for both pain and anxiety. Most commonly, the number of receptors increases in this area, which may explain why the perception of anxiety and pain intensifies the longer they exist.
Before Long Term Potentiation occurs, this can be blocked with the newly-discovered molecule NB001, which makes this efficient neurological processing less likely to occur. Essentially, the molecule blocks the brain’s ability to wear a direct path to pain and anxiety. This molecule also helps reduce pain in animal study subjects.
Research on treating chronic pain and anxiety
The brain is a powerful player in the relation between chronic pain and anxiety, not just in the way that neurons interact and change the physical structure but also in the way chronic nerve pain causes brain inflammation. New research out of the University of California – Irvine (UCI) and the University of California –Los Angeles (UCLA) has linked inflammation in the brain caused by chronic nerve pain to a number of different mood disorders including anxiety, depression, and even substance abuse.
Inflammation in the brain restricts the release of dopamine, our brain’s system of pleasure and reward that can be released as an analgesic to help relieve chronic pain. It instead activates immune cells called microglia that inhibit the release of dopamine. This might also explain why opioids are generally ineffective against long-term chronic pain. In studies completed on laboratory mice, opioids failed to stimulate the release of dopamine in the brain, specifically in the presence of inflammation. Mice treated with a drug that blocked the activation of microglia quickly felt relief.
Catherine Cahill, associate professor of anesthesiology and perioperative care at UCI, believes that this discovery can help connect pain, brain inflammation, and mood disorders like anxiety. She noted that although the research is new, the next goal is to apply this mood-regulation to humans, saying:
“We have a drug compound that has the potential to normalize reward-like behavior, and subsequent clinical research could then employ imaging studies to identify how the same disruption in reward circuitry found in rodents occurs in chronic pain patients.”
Anxiety does not have to be a part of chronic pain. There are steps you can take to identify and work through anxiety symptoms.
Talk to your doctor about chronic pain and anxiety
If you are feeling increasing symptoms of anxiety, talk to your doctor. The perception of pain can be intensified by anxiety and other mood disorders, but if your doctor isn’t aware it is difficult to address those symptoms. Anxi