294: Emotional Confidence Through Chronic Pain
If you deal with chronic pain you know that managing emotions often feels emotionally draining. There is a lot of science-based evidence on the emotion-pain connection – which is what I will be sharing about today. You are not alone in the emotions you experience with chronic pain and I am walking this journey right alongside you.

WHAT YOU’LL LEARN:
- [03:39] Four Scientific Reasons Why Chronic Pain Can Feel So Emotionally Debilitating
- [14:19] Suffering is Not Something We Can Avoid – But We Can Reframe It
- [19:21] How Can We Use ADD to Walk Through Chronic Pain?
- [30:12] A Real-Life Example of How I Used ADD as Emotional Support While Dealing With a Frozen Shoulder
- [32:10] Want Support Managing Emotions Around Chronic Pain? Join Us In The Emotional Confidence Club!
[03:39] Four Scientific Reasons Why Chronic Pain Can Feel So Emotionally Debilitating
When it comes to emotions around chronic pain or other illnesses, some very specific brain-based things are happening that can contribute to these up-and-down or challenging emotions.
First, our brain's pain and emotional processing systems overlap. A really interesting study was done in 2019 at a university in Korea. They published this study on chronic pain and how it affects the brain. In that study, it says “Chronic pain and depression share similar changes in neuroplasticity and involve overlapping neurobiological mechanisms. Monoamine neurotransmitters such as serotonin, dopamine, and norepinephrine, are decreased in both chronic pain and depression patients. Additionally, brain regions involved in brain pathways such as the prefrontal cortex, hippocampus, and amygdala are similar to those involved in mood disorders.”
Let’s break this down. So in the first sentence, they say that the structure of how the brain is put together regarding physical pain and our emotions is shared between those two. It is understandable that if there is an issue with one, then it is going to trigger or overlap with the other. They also talk about these neurotransmitters (serotonin, dopamine, and norepinephrine), that are decreased in both chronic pain and depression patients. These neurotransmitters tend to elevate our mood and bring calm and are typically lower when we are going through depression. And then it talks about how brain regions involved in pain pathways are similar to those involved in mood disorders. This reinstates that the pain pathways that we use in our brains to experience physical pain are also the ones that help us in processing mood disorders.
-The prefrontal cortex is part of our brain that focuses on logic processing
-The hippocampus is often related to memory and emotion
-The amygdala is where many of the “fight or flight” neurological reactions happen in the brain
Each one of those areas is activated during times of feeling pain and the process of emotions. The bottom line is that when we are in physical pain, emotional pain is also being triggered.
Secondly, like it just stated here, many patients with chronic pain also have mood disorders such as depression and anxiety. There were some statistics I saw that suggest roughly 35% to 45% of people who have chronic pain also experience depression.
There was another really interesting study in 2024 where they surveyed 32,000 people across the US, and they found that a total of 23.9% of adults with chronic pain experienced persistent anxiety and depression, compared with only 4.9% of people without chronic pain.
Consider that: According to this study, almost five times the number of people who had chronic pain also had persistent anxiety and depression.
Another statistic found that a total of 55.6% of people with chronic anxiety and depression reported having chronic pain versus only 17.1% of people without these mental health conditions. This further demonstrates the link between depression, anxiety and other mood disorders with chronic pain.
So chronic pain can affect our moods, but our moods can also raise our chances of living with chronic pain – it goes both ways. I want to share these things to not depress us or make us more upset – I am sharing this so you understand there is a link between the two and that it is normal you are feeling this way.
I hope that if you are struggling with chronic pain, it helps you to understand that this is how your brain is put together.
Also, when we are struggling with chronic pain, our emotional resources are more quickly depleted. If you have ever dealt with chronic pain you know that it takes a certain amount of energy to just function and appear normal. We are consistently emotionally on edge because our energy is directed towards healing and coping with pain. So there is a balance that is always off. Our body is devoting a lot of resources to the pain we are experiencing and it takes a lot of perseverance and endurance. This is not to justify the sinful actions that we take with our emotions, but to help us understand why our emotional resources are more quickly depleted during these times of chronic pain, why it makes sense, and how it can be that we might be quicker to anger or quicker to frustration or to overwhelm.
Lastly, when we are struggling with chronic pain or illness, we often come face to face with spiritual questions that we may have been running from. We might be asking “Why me God? Why would you allow this to happen in my life? Where are you? Why won’t you heal me?” Chronic pain can be a trigger for a spiritual crisis and open up a lot of questions we may have. I know many of us want to know why things happen and I can also think of several people in my life whom I think “Why can’t God just heal them?” The emotional side of chronic pain is something we all deal with.
I am sharing these so that if you struggle with chronic pain and you feel like your emotions are out of control, I want you to know that these factors are playing a role. This helps us to understand the full picture and the obstacles that are thrown against us.
[14:19] Suffering is Not Something We Can Avoid – But We Can Reframe It
It is important that we understand these biological, physiological, and psychological factors to help us acknowledge what is happening. We do not have to just “think happy thoughts” but I also want to remind you that we get to decide how we are going to approach what we are walking through.
Yes, there’s a proven link between chronic pain and emotion-related disorders like anxiety and depression. But never forget that we have a mind–and the Holy Spirit!–to choose how to address these things in a Christ-honoring way. The mind of Christ helps us understand things beyond this world. We have the Trinity to help us through this and we are not alone, even if we feel like we are.
I want to acknowledge, admit, and proclaim over you today that if you have Jesus, you are not alone in this journey. This aspect of managing emotions through chronic pain might be the thing that allows you to delve deeper into what it means to know God.
We live in a culture where suffering is continually trying to be avoided but this is part of the human condition. In books like First Peter, you will see that suffering is part of being a Christian. Suffering is not something that we can avoid and we do know that even our Lord told us we could expect suffering – but this suffering will not last forever. God has experienced it and has overcome it.
Instead of getting lost in questions like “Why can’t you heal me?” we need to ask, “What is the gift through this suffering?” For me, my chronic pain has forced me to slow down a lot. It has forced me to be obedient to God, be still, say no, and not overbook my schedule. I think a lot of this has shown me a need to trust the Lord more.
[19:21] How Can We Use ADD to Walk Through Chronic Pain?
So how can we use ADD when it comes to chronic pain? I wanted to walk you through this so you can use it in your own life. The first step in ADD is “acknowledge” and in this step, we want to help ourselves recognize why it is plausible that we are feeling this way. So how can we recognize that link between physical pain and emotional pain and why does it make sense we might be more on edge? We need to acknowledge this as real. This does not give a license for sin, but it simply allows our hearts to be seen in pain. It allows us to tap into God’s compassion. This is important as we move through chronic pain or a diagnosis that may never go away.
Many in my family struggle with chronic illnesses. Someone I love deeply has type one diabetes, requiring constant insulin and monitoring, a lifelong burden he carries. He has moved past anger, but the weight of it remains. When people ask how he is doing, there is often nothing new to say, it is the same struggle. But that does not make it any less hard.
A close friend battling cancer has faced years of chemotherapy. While I cannot fully grasp her pain, I understand the feeling of “here we are again.” The struggle is ongoing, and the pain is just as real each day. We need to remember that God hears us. It is okay to feel weary, to cry out in frustration or exhaustion. Whether the burden feels unbearable or manageable, God is always there – steady through every stage.
One of my favorite verses on this topic is Psalm 56:8 which says, “You keep track of all of my sorrows. You've collected all of my tears in your bottle. You have recorded each one in your book.”
Some of us are afraid of acknowledging because we are afraid we are going to get stuck in a pity party but I want you to know that this is only one step and the rest of the emotional management process helps counteract this.
The second step is discern and the purpose of this is to help us identify what is true and what is not true. In this situation, we can identify what patterns of emotions are there that we could have allowed to turn into lies in our heart, or that could be these soundtracks that are being built in our brain that are harmful. This is where we are coming to God and asking Him what we need to see as the truth. This is especially crucial in long-term suffering, like chronic pain, where the struggle remains constant. If we are not careful, lies can creep in, leading us to doubt our faith, lose hope, or feel disheartened. We need to be honest about these feelings and ask God for clarity and guidance to navigate them.
Psalm 139 is a great verse about discernment. Verses 23 & 24 say, “Search me, O God, and know my heart, test me and know my anxious thoughts, point out anything in me that offends you, and lead me along the path of everlasting life. So show me, Lord, those things I know that you know me, show me those things that are not lining up with your truth. I've allowed emotions to be here that maybe are dissuading me away from the truth that you want me to believe about myself, about the situation, about this illness. Show that to me God, and show me how to act differently.”
The final step is decide, and it has two parts. First, we ask: What is the next step God wants me to take? Now that we’ve identified the emotion and the truth, what action is He calling us to? For long-term struggles like chronic illness, this process may need to be repeated often, each time with a slightly different outcome. The decide step focuses on what specific action we are called to take right now in managing both the situation and the emotions surrounding it. Frustration, though uncomfortable, can actually be useful here. It can push us toward action, like reaching out to a doctor about a new treatment or exploring a therapy we have delayed. For example, this week, my physical therapist recommended something new to help in my recovery, and I’ve been putting off making the call to that doctor. But then I asked myself “How much longer am I going to sit in this frustration before I take the step?” That’s part of my decide moment this week.
The decide step may involve actions related to the illness itself, but it can also extend to our relationships. We need to reflect on how our emotional responses to chronic pain or long-term struggles have impacted others:
- Have we allowed frustration or stress to affect our interactions?
- Have we hurt others through words, attitudes, or actions stemming from our pain?
For instance, when I was first experiencing frozen shoulder, before I even had an official diagnosis, the pain was constant and intense. I would have episodes of pain that felt like a level 12 on the scale, worse than anything I had experienced, even natural childbirth. During that time, I know I had moments where my attitude was not right. I snapped at my family, said things I shouldn’t have, or used a sharp tone. And later, I had to own up to it and say, “I’m sorry.” Sometimes, the decide step means taking responsibility and apologizing for moments when our pain caused us to respond poorly. It is about humility and making things right while continuing to manage the ongoing challenges with grace.
And then that second step of this whole process of deciding is figuring out “where are we going to emotionally dwell?” It is about shifting our mindset and asking: Will I stay stuck in frustration, repeating the same discouraging thoughts or will I choose a perspective of hope and expectancy?
Yes, the struggle is real. The pain, the exercises, and the limitations are still there. But we get to decide how we view it. Will we see it through the lens of despair or through the lens of God’s refining work in our lives? Even if the situation doesn’t change, how is He shaping us through it? This decision requires intentionality. Without it, we can easily slip back into anxiousness, overwhelm, or exhaustion. So, this step is also a prayer: Lord, this is where I want to be. Help me get there. Show me the steps I need to take to remain in a place of hope and expectancy, trusting You through it all.
[30:12] A Real-Life Example of How I Used ADD as Emotional Support While Dealing With a Frozen Shoulder
So let’s walk through what this could look like in a real situation. For me, again I have to acknowledge that it makes sense that I am feeling like this because I have been working through this frozen shoulder for almost six months. It is causing constant pain, I am not sleeping, I have to go to physical therapy several times a week, and it is taking time away from my life. It is frustrating that it feels like the movement is so slow. But it is not true that nothing is working and it is also not true that I will not get through this. I sometimes have to face these lies. It is true that God is using this for a purpose that He loves me and that this season is thankfully going to end and I am grateful for the progress I have seen.
Then the last D (which is “decide”) I am saying to myself that I need to stop fighting God and slow down. I am going to cooperate with God and on the days where I feel a little short and it results in a bad attitude, I am going to apologize to people. I am also living with hopeful expectation that the Lord is using this to continue to refine me. Through this, I am grateful I have an opportunity to connect with God in a very real way every single day, all day long.
[32:10] Want Support Managing Emotions Around Chronic Pain? Join Us In The Emotional Confidence Club!
If you are resonating with this, I would recommend two different things:
1. Get the book Emotional Confidence: Three Simple Steps to Manage Emotions with Science and Scripture. It will outline the ADD process and discuss managing emotions using science and scripture.
2. If you also want help implementing what you have learned with other Christian women, join the Emotional Confidence Club. This is a great place to be if you want to use these tools in your everyday life.
If you are experiencing chronic pain, I want you to know that I am right there with you and that, more importantly, the Lord is there with you. These strategies can be very helpful for reframing some of your emotional experiences. If I can be a resource in these ways, either through the book or the club, I would love to partner with you!
RESOURCES:
Tired of up-and-down feelings stealing your peace, sabotaging your relationships, and filling your mind with self-defeating thoughts? If so, make sure to get my new book, “Emotional Confidence: 3 Simple Steps to Manage Emotions with Science and Scripture”.
Want to see what Emotional Confidence is about? Download the first chapter for FREE!
Ready to know how to manage emotions for more calm, stronger relationships, and a closer walk with God? Want to implement the concepts discussed in my book “Emotional Confidence”? Then join the Emotional Confidence Club!
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