The 7 Most Common Emotions of Chronic Pain

I interviewed dozens of sufferers and experts for my new book to learn about the anger, guilt, grief, and other feelings that come with constant hurt

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I feel guilty every time it happens.

I’ll be in my La-Z-Boy listening to my wife tell me a story about how her cousin is trying to deal with her husband, who has a host of health problems. I’ll sit there trying to take in all the information, but my body is searing with head-to-toe hurt.

As my wife and caregiver continues to speak, I try to hide how I feel, but my face betrays me. I look grouchy, grumpy, and gruff.

“Are you mad at me?” she’ll ask, sensing that something is amiss and wrongly assuming that she did something to piss me off.

I am in searing pain as I sit there. As much as I try to focus, the discomfort distracts me from what’s going on around me. I just can’t concentrate.

As I wrestle with how to react to my wife, inside I am a mess of emotions. I’m worried about how long it will take the pain to pass, if it ever will. I am ashamed at seeming weak, too weak to “man up” and tough it out. I am guilty for making my wife feel bad, realizing she knows something is going on with me. I am angry and just want to scream. So, I just shut down.

I muster all the energy I can to answer her question. “No. You didn’t do anything wrong,” I tell her. “I hurt. I just need to sit quietly right now.”

As with many of the 62 million American adults with chronic pain, this kind of interaction embarrasses me. Because of the pain, we are not ourselves. Our negative emotions take over. We experience the maddening swirl of mind-body connections that make up our chronic pain.

This is a vicious feedback loop: Our pain affects our emotions and our emotions affect our pain.

For the last year, I’ve done extensive research into chronic pain, including interviewing dozens of sufferers and experts for my upcoming book Chronic Pain Chronicles: Insight and inspiration for sufferers, caregivers, and providers. Among the questions I ask:

What are the most common emotions chronic pain sufferers feel?

Though the answers could have been all over the place, there was remarkable consistency among sufferers and experts as to what feelings chronic pain causes.

Here are the seven most-common emotions of chronic pain (in alphabetical order), with perspective from people I’ve talked with.

Anger/rage/frustration

Anger and frustration are part and parcel of each other. Sufferers like me often feel trapped by our circumstances and this leads to feelings of rage.

“I become angry sometimes when I see others walking across the parking lot or in a store and not experiencing any pain or difficulty. I wonder why I can’t be like them,” observes Terry F., who lives in Knoxville, Tennessee (people who prefer not to use their last name are identified by first name and initial). “Why do I have to be impaired? I get angry when I am in pain and I become difficult to get along with. My husband frequently shows me compassion and I regret getting short with him.”

Sufferers often look for someone or something at fault, and sometimes that turns inward.

“Patients feel angry at someone who was to blame for their accident,” says Andrea Furlan, MD, author of 8 Steps to Conquer Chronic Pain, “or they blame the healthcare system for not helping them. They blame their family for not understanding them. They blame themselves for not having energy to do the exercises, lose weight, and take care of themselves.”

Women, in particular, often get mad because they are gaslit by doctors.

“In the days before I got diagnosed (it took me over 15 years to get a diagnosis and associated treatment), I felt a lot of anger toward the healthcare system as a whole,” recalls Brittany Ferri in Newark, New York. “Gynecologists and general providers dismissed me and told me that my symptoms were nothing out of the ordinary and something I’d just have to live with.”

Anxiety/fear/worry

“Fear is the main fuel of pain,” Furlan says. “The more fearful sufferers are, the worse the pain they feel. They fear their pain, moving (exercises), the chance medical doctors will stop prescribing their painkillers.”

Chronic pain is a beast. It’s wild and unpredictable, leaving sufferers in a constant state of alert, hypervigilance, and “dis-ease.” It causes a fear in the short-term (“Will my next step or standing up hurt like hell?”) and long-term (“Will I always feel like this?”).

“Patients fear that pain will get worse, or that their fears about the future will come true,” reports Kevin Huffman, DO (doctor of osteopathic medicine) and board-certified bariatric physician. “Patients can be fearful of losing their job, fearful of not being able to take care of themselves, fearful of not being able to take care of loved ones, or fearful of not being able to enjoy activities they love.”

Fear makes sufferers feel unsettled and even attacked.

“When your body is constantly in pain, the body itself can begin to feel like a source of danger,” says Justin Krull, registered physiotherapist and co-owner of Myofascial Canada in Mississauga, Ontario. “Life turns into something to be braced for or against, rather than enjoyed and lived. A lack of a sense of safety and connection with your essence (self, mind-body, intuition) is the single greatest determinant of lingering pain.”

Adds Rebelle Summers, a chronic pain sufferer, digital nomad, and writer: “There is always fear that the other shoe is going to drop, the fear that a day will come when there is nothing to be done but be in pain.”

Depression/despair/hopelessness

Chronic pain and depression are common companions. After trying all kinds of treatments that don’t bring much relief, sufferers can become despondent, leading to despair and hopelessness.

“Many of my clients seek therapy when they are at a very low point,” says Cynthia Shaw, PsyD, licensed clinical psychologist. “They may have struggled to connect with others, may have very few answers for their condition, may have to live with pain flares, and may struggle to keep up with the responsibilities of being a functioning adult. Accompanying this lowness is often a sense of hopelessness, not just about finding symptom relief, but more so about experiencing joy and meaningful relationships.”

There is also often a keen sense of loss.

“I felt intense, physical suffering and agony in my back and my neck. I also had all-over body pain from fibromyalgia,” Bryan, Texas, resident Stacey P. remembers. “The mental suffering I felt was depression and anxiety over my inability to live the life I had expected or planned.”

And, sadly, depression and despair can lead to thoughts of self-harm and suicide.

“I have suffered from depression for almost all my life,” pain sufferer Berenice Frazer-Gale of Ipswich, Suffolk, England tells me via email. “When I have a pain flare-up, I have suicidal thoughts. I wish the pain could end.”

[If you are in the US and feeling suicidal or thinking of self-harm, call or text the Suicide & Crisis Lifeline at 988. Counselors are available to talk to you 24 hours a day every day.]

Grief/regret

Grief is among the strongest emotions we chronic pain sufferers feel. We mourn our old lives and future ones that are never to come.

“I still grieve my former life,” explains Mark Harrington in Dallas. “Back home in Maine with my sister recently, we talked about the changes that life had brought my way, especially leaving my job in a school district. And suddenly it all overcame me and I began to cry. What I experienced was akin to the death of a loved one. I literally went from having a job I loved, a job that made each day fun, to unemployment. I now realize that just like losing a loved one, this grief will weaken over time. But it will never go away.”

“Grief has been my constant companion,” agrees remote worker Rebelle Summers, “I don’t mourn my old life, only for the one I would never get to live.”

It can be the everyday simple things that sufferers regret.

“I miss my old life when I’m working in my garden because I can no longer do the things I used to do and brought me joy,” says Terry F. in Tennessee. “I can no longer get on my knees and plant a row of bulbs or flowers because it is too painful. I so miss my old life.”

Some sufferers experience the classic Elisabeth Kübler-Ross stages of grief, but not in any particular order.

“While the stages of grief (denial, anger, bargaining, depression, and acceptance) are somewhat applicable, the emotional journey in chronic pain can be cyclical and iterative rather than linear,” explains Jason Polk, a counselor and the owner of Colorado Relationship Recovery in Denver.

Some people feel grief is good.

“I have gone through a state of mourning about the ‘old me,’ but I have let that go,” says Roz Potenza, who lives in Tampa Bay, Florida. “I have come to accept where I am at this point in my life. I think we might need to go through a grief period. It’s healthy to acknowledge that you aren’t the same person you were.”

Guilt/shame

Guilt is a heavy burden for pain sufferers. We feel shame at being disabled and for the toll that pain takes on our families.

“I do have guilt, for what I have cost my wife,” Jim Ferrone in Flemington, New Jersey, says in an email questionnaire. “Her life would have been much different if I hadn’t had a stroke. I logically know that there is nothing I could have done to prevent it, but I still feel guilty.”

“Sometimes I feel guilty for being a burden,” adds Texan Mark Harrington. “Everybody says to me ‘You’re not a burden’ but when people help you so much, it’s hard not to feel a little guilt. And then I always wonder could I have done something that would have prevented this. I know that’s insane thinking. But I’m human. And maybe I’m insane. LOL.”

Feeling too much guilt can sour relationships with family members, friends, and others.

“Addressing this guilt that people with chronic pain often feel regarding the perceived burden they place on their loved ones is crucial because it can significantly impact their relationships and overall mental health,” advises Joni Ogle, a licensed clinical social worker (LCSW) and a certified sex addiction therapist (CSAT).

“Constant pain is exhausting,” says Berenice Frazer-Gale in the United Kingdom. “I struggle to sleep. I get headaches and I have had to change my plans to fit in with my pain levels. Every day my pain is different. I want to be a calm, level-headed wife, mother, and friend, but pain makes me cranky. I feel guilty a lot for not doing things with my children or family and friends.”

Guilt comes from different places, including the idea that we shouldn’t feel that way.

“Because I don’t physically look disabled, I sometimes tend to gaslight myself so that maybe it’s not as bad as I’m making it out. My guilt is especially prominent when I prioritize rest. That there are so many other things I ‘should’ be doing even though I know I will trigger a flare or burnout if I entertain those internal demanding voices,” pain sufferer Summers tells me.

Loneliness/isolation

Pain is extremely lonely because we each have an individual, unique experience of it. You cannot feel my pain and I cannot feel yours.

“It can be lonely having loved ones who can’t possibly know what this is like,” observes sufferer Jacob Kendall of Fairhope, Alabama.

“When my pain is high, I often isolate until I feel better,” says Stacey P. in Texas. “That’s not always a great idea. My doctor has told me that no matter what, I must keep moving even if it hurts. Isolation is depression’s cousin, and I will not let either one overcome me.”

Many times, pain brings an intense sense of “otherness” (being apart from or unlike other people).

“It’s common for chronic pain to lead to feelings of sadness and isolation,” reports Taher Saifullah, MD, founder of Spine & Pain Institute Los Angeles. “Many patients withdraw from activities and social events because they fear making their pain worse or feeling misunderstood.”

It hurts when we have to leave behind our work, social connections, family functions, hobbies, travel, and more.

“No one can take loneliness away; it’s invisible and not well managed,” says Susan Hoffman, from Frisco, Texas. “Yes, I think I feel stigmatized because of how unabated and insidious it is. If I had cancer, as ironic as that is, I’d be more accepted.”

Digital nomad Summers remembers that she felt lonely living in pain throughout her entire childhood and early adulthood: “I felt broken, but I couldn’t let anyone in to see my brokenness for fear that people would leave if I did. And that fear was confirmed when I did start being honest with people, not because I actually was the burden that I was made to feel I was, but because the version of me that I had to mask ended up attracting many of the wrong people.”

Isolation is a struggle for sufferers of all ages, but particularly the young.

“This is true especially for those who experience ailments at a younger age and who struggle to keep up when it comes to physical activities,” observes Shaw, the psychologist. “Dating or making friends are challenging enough tasks for anyone; they can be even more challenging for those with chronic conditions. There may be anxieties about not being accepted or needing to go through the whole rigamarole of sharing intimate pieces of their lives and enduring possible consequences and unknown reactions. It can become exhausting and lonesome.”

“People have said to me that I’m too young to have chronic pain,” adds Katie Schweiger of Minneapolis, who was 24 when I interviewed her. “They compare what they have been through to what I’ve experienced and then they don’t let me talk. I know that I am young, and it doesn’t seem that I should be in pain, but I know people who are younger than me who have chronic pain. I try to stay calm but, in my head, I am so mad.”

Resilience/grit/optimism

The emotions associated with chronic pain aren’t all bleak. Many of us discover strength we never knew we had. We develop the courage to face up to our conditions and the hope to keep moving forward. Most of all we are resilient and we have grit, the ability to push through problems and remain optimistic.

“Those most successful in managing chronic pain tend to exhibit resilience, an openness to various treatments, and a proactive attitude toward managing their condition,” explains licensed clinical social worker Joni Ogle.

Resilience can provide the will to push forward.

“Every so often I’ve been told I’m brave, whether it was moving to New York City at age 19 or writing vulnerably about an experience,” says Summers. “But I see those sparks of courage in me not necessarily about wanting to be brave, but about wanting to be more actively engaged with my life rather than being a passive passenger. I want to know how to make my life more enjoyable and feel worthwhile regardless of what my pain threshold of the day is.”

Coping with pain requires plenty of patience. It takes persistence to keep seeking answers despite the challenges chronic pain brings.

“I believe resilience and adaptability are two important traits shared by those who manage chronic pain the best,” reports Ryan Peterson, MD, of the NuView Treatment Center in Los Angeles. “In addition to using meditation or calming methods and being open to experimenting with various pain management treatments, those in pain typically possess a robust support system. A major contributing factor to their toughness emotionally is their capacity to maintain flexible minds and concentrate on what they can control rather than what they cannot.”

Sufferers who are resilient express pride in not letting pain win.

“I have demonstrated extreme resilience through these 15 years of disability,” says Stacey P. “I have been a beacon for my friends who are also going through tough times. I believe my disability has made me stronger and wiser. I handle the unexpected with much more grace now than I ever did.”

“When my husband talks about my pain, he says I am ‘the strongest person he knows,’” adds UK resident Frazer-Gale. “But I am trying only to get through the day. It feels nice to hear those kinds of phrases. It encourages me to carry on and be strong.”

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Retired journalist Randall H. Duckett is writing a book on living with chronic pain. He invites sufferers to tell their stories. Contact him through randallhduckett.com.