The Relationship between Chronic Pain and OCD

Chronic pain and OCD are two disorders that are incredibly challenging to live with and to overcome. In this article, we’re going to breakdown what exactly chronic pain is, what OCD is, how these two relate to one another, and what to do if you’re experiencing both.

What is Chronic Pain?

Pain that lasts longer than 3 to 6 months is considered chronic pain. The International Classification of Diseases by The World Health Organization defines ‘chronic pain’ as “pain that persists past normal healing time and hence lacks the acute warning function of physiological nociception.’ ‘Nociception’ refers to how our bodies detect pain and send pain messages.

Symptoms of Chronic Pain

Chronic pain can be experienced as joint pain, muscle aches, reduced mobility, stiffness, lack of flexibility, social withdrawal, fatigue, insomnia, mental illness, skin rashes and irritations, cognitive problems and more. 

What Causes Chronic Pain?

Chronic pain can be caused by a variety of things. 

If we get injured, chronic pain is when we experience pain well past the usual recovery time. This can happen due to numerous reasons – the most common being central sensitization, or when there’s nerve damage from our injury.

Having an illness can weaken the body and the immune system, making it more susceptible to chronic pain. 

Chemical imbalances can also be a cause of chronic pain. Our brain must be balanced in order for our bodies and minds to function properly. When chemicals in the brain are imbalanced, it can lead to symptoms of chronic pain.

How to Treat Chronic Pain

Treatment for chronic pain heavily depends on the type of chronic pain experienced and on the individual. 

There are psychological therapy treatments, meaning talking based therapies. Many of these methods of treatment have been scientifically proven to help patients overcome chronic pain. 

These therapy treatments include things like Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT), Graded Exposure Therapy, Graded Motor Imagery (GMI), Biofeedback, Mindfulness and Creative Therapies like art or music therapy.

What is OCD?

Obsessive-Compulsive Disorder (OCD) is a mental disorder that causes obsessions that lead to anxiety. Individuals experiencing obsessions might compulsively act on a behaviour or ritual designed to ease the anxiety, called compulsions. This cycle frequently repeats itself on a daily basis.

There are many different types of OCD. The type of OCD one might have can be determined by looking at the types of obsessions the sufferer experiences. 

When someone with OCD exclusively experiences obsessions around bodily functions, this could be diagnosed at Sensorimotor OCD. A sufferer who experiences obsessions around harming themselves or others might be diagnosed with Harm OCD. Knowing the type of OCD the individual is experiencing helps to avoid triggers and figure out a course of action for treatment.

Symptoms of OCD

There are three main elements to OCD symptoms. 

Obsessions are intrusive thoughts, images or urges which feel as if they are experienced out of the individuals control. Intrusive thoughts are experienced by around 80% of people without OCD, however, we can link intrusive thoughts to OCD when the individual attaches great significance to these thoughts and finds them highly distressing.

As obsessions make the sufferer feel uncomfortable and distressed, they cause high levels of anxiety which leads to an emotional response. The individual may feel like they need to do something to reduce the experienced anxiety. 

Compulsions are the actions that the sufferer takes to manage their anxiety and calm down. While compulsions may work to reduce anxiety in the moment, it isn’t long before another obsession comes into the mind and causes more severe anxiety, causing this cycle of obsession, emotional response, and compulsion to repeat.

What Causes OCD?

OCD has no single cause. A variety of psychosociological and biological factors have been linked to OCD. 

Chemical imbalances in the brain can be a cause of OCD, as well as genetics. Studies have shown that we are  45%-65% more likely to develop OCD if a relative has OCD. These numbers increase if it’s a close relative.

Personality type has also been linked to OCD. People with OCD typically possess personality traits such as perfectionism, indecisiveness and/or impulsiveness. 

Stress and personal experience are also linked to OCD.

How to Treat OCD

We can recover from OCD through a course of therapy treatment. The most popular therapy treatment for OCD worldwide is a mixture of Cognitive Behavioural Therapy (CBT) and Exposure Response Prevention (ERP). 

Sometimes, medication may be necessary as an accompaniment, which must be discussed and agreed upon under the care of a healthcare professional. Medication alone should not be used to treat OCD, as studies have shown a 90% relapse rate in patients who only use medication for treatment without therapy alongside.

How do Chronic Pain and OCD relate to one another?

Chronic pain and OCD may live together simultaneously, however, they aren’t necessarily related to one another. Experiencing them both at the same time adds an extra layer of complication to OCD recovery, as the way the person experiences obsessions and compulsions may be influenced by the chronic pain.

People with OCD may rely on physical pain to encourage avoidance behaviours. For example, a person with contamination OCD who also experiences chronic lower back pain (unrelated to OCD) may have difficulty placing dishes in the dishwasher or washing dishes by hand. This could result in the individual avoiding making dishes dirty in the first place. Untreated, the combination of this type of chronic pain and OCD can lead to nutrient deprivation and dehydration as the individual avoids eating or drinking to avoid compulsively washing and cleaning.

Likewise, someone with OCD may experience compulsions that cause chronic pain, repeatedly loading the dishwasher despite the experience of pain.

Another example of this might be someone who suffers from Sensorimotor OCD, where obsessions revolve around bodily functions. People with sensorimotor OCD already experience high levels of anxiety when they start to notice things like their heartbeat or number of breaths per minute. The anxiety typically latches onto the idea that the individual is not safe. 

Experiencing chronic pain with sensorimotor OCD may make recovery more challenging, as a part of their obsessions come from a physical source. Usually, with OCD, sufferers are aware that their obsessions are irrational, however, with sensorimotor OCD and chronic pain, realising that our obsessions are irrational can be more challenging, as the intrusive thought of ‘am I safe’ physically feels like the answer is ‘no’.

Physical Symptoms of OCD: Chronic pain

OCD predominantly has mental symptoms, however, it also has physical symptoms. Physical symptoms can appear throughout recovery, as we’re putting the body and mind into new situations which are challenging and cause the individual stress, which can manifest into physical symptoms like headaches, nausea, bowel movement issues, skin problems and more.

OCD recovery takes time, and physical symptoms can be felt for a while before our body starts to get used to this new way of thinking. For this reason, recovery can lead to chronic pain, however, working closely with healthcare professionals who are aware of physical symptoms will ensure that the pain is managed and dealt with.

Treatment is worth it!

In both instances of chronic pain and OCD, treatment is worth it. Chronic pain is difficult to live with, it can affect our lives to the point of not being able to truly live them anymore. There are many treatment options for chronic pain, so be sure to speak with a healthcare professional to figure out what the best course of action is for treatment. 

OCD treatment is very individual. There are different types of therapy treatment that work well for different people. OCD recovery requires patience and a lot of hard work, but it is more than possible. 

Treatment and recovery ensure you’re able to get your life back. Always be open with your doctors about how the treatment is going, and remember that you are never alone in your struggles.

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