Your stomach feels like it’s in severe pain. You get a headache, and it feels debilitating. You feel a sharp pain in your leg, but despite no clear cut, the pain is extreme and unmanageable. Others may even comment that it seems like you have low pain tolerance, and you worry that you’re missing something more severe.
What if it’s your mental health?
When you’re dealing with anxiety, depression, trauma, or other mental health challenges, pain genuinely hurts more. This isn’t about being weak or dramatic. It’s about how your brain processes pain signals when you’re under psychological distress.
The connection between mental health and physical pain is real, measurable, and backed by neuroscience. Let’s talk about why this happens and what it means for anyone who’s ever felt like their pain response doesn’t match what seems reasonable.
How Your Brain Processes Pain
Pain isn’t just about physical damage. Your brain doesn’t have a simple “pain detector” that objectively measures harm and reports back. Instead, pain is your brain’s interpretation of signals from your body, filtered through emotional state, past experiences, stress levels, and mental health.
When you’re physically hurt, nerve endings send signals to your spinal cord and up to your brain. Your brain then decides how much that should hurt based on context. This is why the same injury can feel different depending on circumstances – a paper cut during a stressful day feels worse than the same cut when you’re relaxed.
Your brain’s pain processing centers overlap heavily with areas that regulate emotion, stress, and mood. The anterior cingulate cortex and the insula — key regions for pain perception — are also involved in processing emotional distress. When these areas are already overactivated by anxiety, depression, or trauma, they amplify pain signals.
This means that when you’re struggling mentally, your pain threshold drops. Your nervous system becomes more sensitive. The volume gets turned up on everything.
Depression and Pain Amplification
Depression doesn’t just affect your mood. It fundamentally changes how your nervous system functions. People with depression have altered pain processing at a neurological level.
Research shows that people with depression have increased activity in brain regions associated with pain and decreased activity in areas that regulate and dampen pain signals. Essentially, the brain’s natural pain control system stops working as effectively.
This can look like:
- Chronic Unexplained Pain — You have back pain, headaches, or body aches that don’t have a clear physical cause. Doctors run tests that come back normal. The pain is real, but it’s being generated or amplified by the depressed nervous system.
- Lower Pain Threshold — Minor injuries hurt more than they should. A slight bump feels like a major collision. You’re not exaggerating. Your brain is genuinely perceiving more intense pain from the same stimulus.
- Prolonged Pain Recovery — When you do get hurt, the pain lasts longer. What should be a few days of soreness turns into weeks. Your nervous system can’t downregulate the pain response effectively.
- Increased Sensitivity to Temperature — Cold feels colder, heat feels hotter. You’re more uncomfortable in situations that wouldn’t bother someone without depression.
Depression also causes inflammation throughout the body. Inflammatory markers increase, which sensitizes nerve endings and makes everything hurt more. Chronic pain and depression create a feedback loop — pain worsens depression, depression amplifies pain.
Anxiety Makes Your Body Hypervigilant
Anxiety puts your nervous system on high alert. Your body is constantly scanning for threats, and that includes potential sources of pain or discomfort. When you’re anxious, your pain sensitivity increases because your nervous system interprets pain as a potential danger signal that needs immediate attention.
This is what anxiety-related pain sensitivity looks like:
- Muscle Tension Creates Real Pain — Anxiety causes chronic muscle tension. Your shoulders, neck, jaw, and back are constantly tight. This tension creates genuine pain — headaches, back pain, jaw pain from clenching. The pain isn’t “just anxiety.” It’s real physical pain caused by the sustained muscle contraction that anxiety produces.
- Hyperawareness of Body Sensations — This is a big one. With anxiety, especially panic attacks, you notice every twinge, every ache, every uncomfortable sensation. Your nervous system is hyper-focused on potential threats, and physical discomfort registers as a threat. When you have panic disorder or health anxiety, your brain not only interprets everything it feels as a threat – it also amplifies it, and then your brain is convinced something terrible is happening because, subjectively, you are experiencing something terrible happening.
- Pain Catastrophizing — When you feel pain, your anxious brain immediately jumps to worst-case scenarios. This catastrophizing actually intensifies the pain experience. Your brain interprets the pain as more dangerous, which increases the pain signal.
- Heightened Startle Response — When you’re anxious and something causes sudden pain or discomfort, your reaction is more intense. You jump more, tense more, feel more distressed. You physically react faster and more strongly to stimuli.
People with panic disorder often experience chest pain, stomach pain, and other physical symptoms that feel identical to serious medical conditions. The pain is real. It’s caused by the intense physiological response of panic — muscle tension, hyperventilation, increased heart rate. Your body is genuinely in distress, creating genuine pain.
Trauma Changes Your Nervous System
Trauma fundamentally alters how your nervous system responds to the world. When you’ve experienced trauma, your body becomes hypersensitive to potential threats, and that includes pain.
People with PTSD have a sensitized nervous system. The autonomic nervous system — which controls automatic functions like heart rate, breathing, and pain response — gets stuck in a state of hyperarousal. This means:
- Your pain threshold drops significantly. Stimuli that wouldn’t hurt someone without trauma genuinely hurt you more.
- Your body holds trauma in physical tension. Muscles remain chronically tight in areas associated with the trauma. This creates ongoing pain.
- Your nervous system struggles to downregulate pain signals. Once pain starts, it’s harder for your system to calm down and reduce the intensity.
- Touch can be painful or uncomfortable even when it’s not meant to be. Your nervous system interprets touch as a potential threat, making even gentle contact uncomfortable.
Somatic therapy works specifically with this body-held trauma. The goal is to help your nervous system recalibrate, to bring down the baseline level of activation so that pain responses become more proportionate again.
Trauma also affects how your brain stores and recalls pain memories. If you were hurt during a traumatic event, your brain can reactivate that pain response when triggered, even without new physical injury. This is why people with trauma histories sometimes experience pain in areas associated with past injuries, even when those areas have healed.
OCD and Sensory Hypersensitivity
OCD doesn’t just create intrusive thoughts. It often comes with sensory hypersensitivity that makes physical discomfort feel intolerable.
People with OCD frequently experience:
- “Just Right” Physical Sensations — Clothes feel wrong, textures are unbearable, tags cause intense discomfort. This isn’t about being picky. Your nervous system is genuinely distressed by these sensations.
- Hyperawareness of Bodily Functions — You notice your breathing, heartbeat, swallowing, blinking. This awareness can create discomfort where none existed before. The sensation becomes the focus, which intensifies it.
- Compulsive Checking of Pain or Discomfort — When you feel pain, you check it constantly, which keeps your attention on it and makes it feel worse. The checking behavior reinforces the pain rather than relieving it.
- Contamination OCD and Physical Discomfort — If you have contamination fears, the feeling of “contamination” can create genuine physical discomfort. Your skin crawls, you feel dirty, you experience real physical distress.
The relationship between OCD and pain is bidirectional. OCD increases sensitivity to discomfort, and experiencing pain or discomfort can trigger OCD symptoms as your brain tries to control or fix the sensation.
Eating Disorders and Pain Perception
Eating disorders fundamentally alter how you experience physical sensations, including pain. Malnutrition, over-exercise, and the psychological stress of an eating disorder all change pain processing.
When your body is malnourished, your nervous system becomes hypersensitive. Everything hurts more because your body doesn’t have the resources to regulate pain effectively. People recovering from anorexia often describe this — as they begin eating again, they become more sensitive to temperature, touch, and pain because their nervous system is recalibrating.
Over-exercise, common in eating disorders, creates chronic pain that becomes normalized. You push through pain that should be a warning signal, which trains your brain to ignore some pain signals while becoming hypersensitive to others.
The psychological distress of body image concerns and eating disorder thoughts also amplifies pain. The constant stress keeps your nervous system activated, which increases overall pain sensitivity.
The Stress-Pain Connection
Regardless of which mental health challenge you’re facing, stress is often at the core of increased pain sensitivity. Chronic stress changes your nervous system in measurable ways.
When you’re stressed, your body produces cortisol and other stress hormones. Short-term, these hormones help you respond to threats. Long-term, they increase inflammation, sensitize nerve endings, and impair your body’s natural pain regulation systems.
Chronic stress also causes:
- Muscle Tension — Sustained tension creates real pain in your neck, shoulders, back, and jaw.
- Digestive Issues — Stress affects your gut, causing genuine stomach pain, cramping, and digestive discomfort.
- Headaches and Migraines — Stress is a major trigger for tension headaches and migraines, which are genuine neurological pain conditions.
- Sleep Disruption — Poor sleep lowers your pain threshold even further, creating a cycle where pain interferes with sleep and lack of sleep increases pain.
The relationship between stress and pain is so strong that chronic pain is now understood as partly a stress-related condition. When you’re under sustained psychological stress, your body can develop chronic pain even without clear physical injury.
What This Means for You
If you’re struggling with mental health and you feel like pain hits you harder than it should, you’re not being dramatic. You’re not weak. You’re not exaggerating. Your nervous system is genuinely processing pain differently.
This doesn’t mean the pain is “all in your head.” That phrase dismisses real suffering. The pain is real. It’s happening in your body. The fact that it’s influenced by your mental state doesn’t make it less valid.
This connection is important for several reasons:
- You Can Stop Blaming Yourself — When you understand that your nervous system is sensitized, you can stop wondering if you’re overreacting. You’re not. Your pain is real.
- Treatment Becomes Clearer — Addressing the underlying mental health condition often reduces physical pain. Therapy helps regulate your nervous system, which brings down overall pain sensitivity.
- You Can Advocate for Yourself — When doctors dismiss your pain or suggest it’s “just anxiety” or “just depression,” you can explain that mental health conditions create real changes in pain processing. You deserve treatment for both the mental health condition and the pain.
- Mind-Body Approaches Make Sense — Recognizing the connection helps you see why treatments like CBT, EMDR, somatic therapy, and DBT can reduce physical pain. They’re working with your nervous system to recalibrate pain processing.
If you’re experiencing increased pain sensitivity alongside mental health challenges, therapy can help with both. At Flourish Psychology, we work with the mind-body connection, understanding that psychological distress manifests physically and that physical pain affects mental health.
We offer individual therapy and specialize in evidence-based treatments that address both the psychological and physical aspects of mental health conditions. Our therapists understand that when you say something hurts, it genuinely hurts. We take that seriously.
Located in Brooklyn, NY, we serve clients throughout New York City and offer online therapy throughout New York State. Whether you’re dealing with anxiety, depression, trauma, eating disorders, OCD, or chronic pain alongside mental health challenges, we’re here to help.
Contact Flourish Psychology at 917-737-9475 or through our contact page to learn more about how therapy can help regulate your nervous system and reduce both psychological distress and physical pain. Your pain is real, and you deserve support for all of it.