Charting the Depths

Reflections on the science of depression.

by Jonathan Rottenberg, Ph.D.

Physical Pain and Emotional Pain: More Similar Than You Think

Tylenol for Hurt Feelings?

Published on December 23, 2009 by Jonathan Rottenberg, Ph.D. in Charting the Depths

New research led by psychologist C. Nathan DeWall of the University of Kentucky and reported in the journal Psychological Science suggests that physical pain and emotional pain may be more similar than you think.

In a first experiment, volunteers were randomized either to take 1,000 mg/day of acetaminophen (the equivalent of 2 extra strength Tylenol) or a placebo (inert tablets). Participants completed measures of hurt feelings. The researchers found that particants who were taking acetaminophen tended to report less hurt feelings over time relative to participants who were taking placebo.

A second experiment brought these ideas into an fMRI scanner. Here the researchers had the volunteers take a larger daily dose of acetaminophen (2,000mg) for three weeks. To allow the researchers to examine neural responses to social rejection, participants went into a scanner and played a computer game in which they were rejected. Brain regions associated (in other studies) with both social pain and physical pain were more active in the placebo subjects when they were rejected than in the acetaminophen group. In other words, acetaminophen dulled the brain's reponse to rejection.

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Early media reports have naturally seized on the consumer implications of this study. Those implications are timely! Should you take a prophylactic Tylenol before your overbearing relatives arrive for Christmas dinner? Your Uncle Lou is in particularly rare form, perhaps a double dose is needed?

I am more intrigued by the scientific implications.

From the patient's perspective, the pain caused by rejection is as every bit as real as the pain caused by a stiff joint. In interviewing depressed people, I've often been struck by the tremendous blurring between physical and emotional pain. In depression, everything hurts. Now we have a demonstration that our bodily systems for registering social and physical pain overlap in their response to a common household drug.

We usually talk about emotional and physical pain in different terms. And we conventionally take a different drug for a wounded ego than for a wounded arm. But emotional and physical pain may be more similar than you think. This observation makes good sense if we assume that evolution is a conservative force.