The connection between chronic pain and thoughts of suicide is a strong one. Studies have shown that as many as 50% of people with chronic non-malignant (non-cancer) pain have thought about suicide. In the late 1990’s there were two well-publicized cases of people with chronic pain (one had arthritis and one had fibromyalgia) who were apparently assisted in suicide by Dr. Kevorkian. While those cases triggered a lot of discussion about the ethical, moral and legal issues related to suicide, they also speak to the very real issue of chronic pain and suicide.
There is a close association between chronic pain and depression, which is very understandable in light of the chronic drain in emotional and physical energy that comes with chronic pain. There are also, of course, the losses; of income, relationships, and ability to engage in the activities you used to enjoy.
So what triggers that leap from depression to suicidal thoughts? Research has identified two primary factors:
1) Feelings of Hopelessness that makes relief seem impossible.
2) Catastrophic Thoughts that anticipate the worse possible outcome.
The risk of suicide in chronic pain has been documented all over the world. A study of farmers in Finland showed that there is a clear connection between chronic back pain and suicidal ideation. There was also an increased risk for people with chronic migraine headaches. As you would expect, the longer the pain had gone on, the greater risk of suicide.
What Can Be Done
The problem of suicidal thoughts in people with chronic pain can be addressed in two ways.
Better accessibility of treatment for depression.
Most people with chronic pain have depression, but too few can access treatment for it. Cognitive behavior therapy has been shown to help depression, decrease suicidal thoughts. and improve overall pain management.
Better treatment for chronic pain.
Sometimes a person’s feelings of hopelessness about their pain is all too real. Years of looking for a doctor who will listen, trying multiple medications that may not work, and problems getting an accurate diagnosis all contribute to poor medical outcomes, and poor emotional ones. If you or someone you know has chronic pain, encourage them to make sure they are getting all the treatment they need, including psychological support.