Is there a difference between physical and emotional pain?

I consider myself lucky that I’ve never been a victim of mental abuse.  Neither have I been a victim of domestic violence or rape.  But I have intimate and long-term knowledge of constant, physical pain and what that does to the brain.

I’ve also been lucky that I haven’t suffered from major depression, constant anxiety, or PTSD. Yet there are plenty of pain patients who suffer from these mental illnesses, whether it’s from chronic pain itself, or a history that might include some form of abuse.

But just because I’ve been lucky in these respects, that doesn’t mean I don’t fear that the pain will eventually drive me insane.  What will my brain do to keep me sane?  In the future, could I suffer from a disassociative disorder, or even schizophrenia?

Many doctors (and all insurance companies) don’t seem to grasp the fact that the brain treats emotional and physical pain in the same way.  It doesn’t matter to the brain if the pain is physical or mental, the human response is the same.  The medical industry thinks there’s a difference, claiming mental pain is subjective, while physical pain is objective.  But that’s only because they’ve found ways to measure physical pain, while measuring mental pain is in its infancy. And really, measuring physical pain is also in its infancy, as measurements like the 1 to 10 pain level test clearly illustrate.

I don’t believe that I suffer from more pain than someone who suffers from mental illnesses like drug addiction or depression.  Just like my pain can cause suicidal thoughts, so too can these mental illnesses.  While the drug war rages on, we may not discover if the treatments are the same for both physical and mental pain, but there’s enough of an overlap to believe that they can.

In fact, the medical industry’s lack of understanding of chronic pain is partially responsible for the increased rates of drug abuse and addiction.  Sure, it’s easy to prescribe pain medications to treat physical pain — after all, there’s “proof” that the pain exists.  But alone, these treatments don’t address the mental weight of dealing with constant, debilitating pain.  The same could be said for an illness like depression — just treating the depression doesn’t make up for not treating the physical pain that usually accompanies it.

The brain can’t tell the difference between mental and physical pain, so using treatments that dismiss one or the other will only be partially successful.

This study was not done in order to promote acetaminophen and other analgesics as psychoactive drugs. Rather, the idea was to emphasize that over the course of evolution, our bodies decided to take the economy route and use a single neural system to detect and feel pain, regardless of whether it is emotional or physical. While it may be a good idea to take a pain reliever in the acute phase of feeling physical and emotional pain, no one is proposing this a long-term cure for dealing with hurt feelings and grief.

Pain, of course, is always both a physical and an emotional experience. If I stub my toe, in addition to the physical pain, I am likely to be also angry or disappointed with myself or with someone else who is convenient to blame (Why did you leave that box in the hallway where I couldn’t see it until I hurt myself? Now look what you’ve done!!)…

20 thoughts on “Is there a difference between physical and emotional pain?

  1. I feel physical pain is also subjective. Some have higher pain thresholds and all the 1-10 test does is tell them how you feel as compared to YOUR worst pain. My 10 might be different than yours. It is all subjective in my opinion.

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  2. I agree with you J. There’s an emphasis on separating physical from mental pain. The very first outpatient program for mental illness I attended was an introduction to depression. It was facilitated by a nurse. She expressed how annoyed she was with the medical industry’s stubborn segregation.

    She brought up the point that many people don’t even know they’re clinically depressed until they experience physical pain and see their doctor only to find out that all the tests are “normal” and then they begin to open up about how they are. Depression causes physical pain.

    With bipolar disorder my brain takes my body for a ride…whether it’s adrenaline rush, go go go, or totally exhausted and lethargic and all I want to do is sleep.

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  3. i do not at all believe or indeed experience mental pain and physical pain in the same way. there is absolutely no way i could possibly confuse mania (yes, this is a mental ‘pain’) with a broken foot. there is no way i could ever confuse the mental pain of suicidal depression with the excruciating physical pain of 2 discs in my back being compressed and herniated to the point i cannot use my leg. i have a choice, i can keep my mental illnesses managed, and have stable moods and live independently or i can have a healthy body. the catch is if my mind is kept ‘healthy’, and i am sane and want to live, then my kidneys will die soon. but if i treat my body, then my brain goes crazy and i cant help but swing from mania with psychotic features right down to suicidal depression. so to me, mental pain and physical pain are not in any way alike, especially in the experience of them. and for me, living with physical pain or early death is better if it means i can have my mind and moods managed and love and live life fully. what is the point of a sick brain and mental pain that devastates your ability to function at all, just to have a body live a very long time?

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    • You might not experience mental and physical pain in the same way, but your brain does. However, our brains are susceptible to perception, which changes the way everybody experiences pain. The point I was trying to make is that no one’s physical pain is stronger or more debilitating than someone else’s mental pain. They’re not equal, but many pain patients believe that physical pain deserves to be treated, while mental pain does not.

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      • sorry no. my brain interprets the two as completely distinct and separate feelings. and in the face of both, the mental is worse bc the physical is not all encompassing, it has borders, edges, i can isolate it, compartmentalize it. it does not use up all available brain function. the mental pain does. my mind can think of nothing else, focus on nothing, can’t process or understand anything else going on in the world, in my life. and both kinds of pain should be treated differently. vicodin does not work on psychic pain. pot only dulls it a bit, but it comes back. the only thing that stops mental pain is lack of consciousness. they just are not at all alike. and they each require different methods/treatments.

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        • Then I guess you and I are exact opposites. I can push mental pain to the side, but my physical pain appears to be the same as your mental pain. Of course, since I’ve never experienced that level of mental pain, I’m only guessing. Figuring out how the brain works is not an exact science, and everybody’s brain is different and unique.

          Perhaps I have more experience in the realm of addiction. And maybe my comparison is more for that kind of mental illness. After all, the mental illnesses I talk about in this post are depression, anxiety, and PTSD, not bipolar.


        • well, bipolar is not the only struggle i have. i have spent years being so deeply depressed i gave up hope of ever coming out of that place. bipolar also has its depressions, which can also be psychotic, and i have ptsd and i have a separate diagnosis of anxiety as well. so i think my response covers the main mental health issues you discuss.

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        • I can only go by my own experience of spending a week in a mental hospital with a woman who suffered from Major Depressive Disorder. And I can tell you that she never experienced mania, which is a hallmark of bipolar. I can also say that she was in as much pain as I was, and that part of that pain was physical. I wouldn’t put anxiety, depression, and PTSD in the same class as bipolar, even though depression is a part of bipolar and these conditions can overlap. I don’t think anxiety, depression, and PTSD include the psychotic part.

          I wasn’t trying to suggest that bipolar be treated with pain medications, nor should other illnesses that include psychosis. But many people who suffer from psychosis also suffer from medical conditions that include pain, so not treating their pain seems rather cruel to me. However, each patient should choose for themselves.


  4. Emotional pain scars you for sometime, especially if you let it. I’ve been in physical and mentally/emotionally abusive relationships before. My son’s father would cheat on me, tell me I was this or that. The day before I left, he hit me and threw me down on the floor. That was when I had enough and took off with my son who was 2 at the time. It’s pretty bad when your own ‘family’ does it to you too. But you know what? I choose not to be a victim anymore but a survivor. I was angry for many years and thought it was all my fault but it wasn’t. I was just a kid when some of it happened. I’m not going to lie, I’ve had nightmares or bad days thinking about it but not as often as before. I think most physical pain is what you want to believe in your mind. If you keep telling yourself I’m sick or I’m in pain then you will be. I’ve told myself I’m not sick, I feel good and I begin to.

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    • If you have something like the flu or pneumonia, you can tell yourself you’re not sick, but that won’t change the fact that you are. If you have a broken bone, you can tell yourself it doesn’t hurt, but that won’t repair the bone.

      With constant, chronic pain, you can try to distract yourself from the pain, but it never goes away, no matter how strong your willpower is. You can learn how to manage the pain and deal with it better, but you can’t make it disappear. When pain becomes chronic and intractable, the pain lives in your nervous system, cemented both by memory and by the physical condition that can’t be cured.

      I’m glad you were strong enough to turn your back on being a victim, and time does attempt to heal all wounds. But you’ll never be able to get rid of the scars. Even though scars are a type of healing, they are also a reminder of the violence and abuse. In other words, your brain never forgets.

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      • True. You forgive but you don’t forget. Like I said I was angry for years but not anymore. It was only hurting me. My family even wondered why I was so upset all the time. I would just tell them I hated my job or because I didn’t have money. I never told them what happened, especially stuff when I was a kid. The person who abused me when I was a kid is dead. I forgave him for my sake.

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        • Forgiveness is a way of moving forward, which is always a good thing. Do we need to forgive to move forward? I guess that depends on the crime. For instance, forgiveness is not possible for the babysitter who murdered my niece.

          And if I had been abused by, say, one of my parents, I don’t think I’d be able to forgive. Maybe I could come to an understanding about why it happened, and if asked for forgiveness, maybe I could put it behind me. But I’ll let people’s gods give them forgiveness.

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    • I can describe being able to escape abuse as lucky, but that’s really not the case, is it? Then my luck would’ve depended on the humanity of everyone I’ve ever been in contact with.

      What is luck, but being in the right place at the right time? Really, not much to it. Now, if I was really born under a lucky star, I would have won the lottery. 🙂 But since I don’t really believe in luck, I’ve never bought a lottery ticket. 😀

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  5. Kat, I think J means that the EFFECT of pain on the central nervous system is the same, whether the pain has a physical cause or an emotional one. 🙂 We feel them differently, just as we feel all the many different sorts of physical pain differently, too, but the stress on our nervous systems is the same. Ergo, pain from a non-physical cause deserves treatment as much as pain from any physical cause does.

    L. X

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