My primary core belief about chronic pain—in fact, the very foundation of my practice—is how much it is perpetuated by emotion. When I ask my patients about their pain, 80% of the words they use to describe it are emotional. They cite anxiety about the pain, fear of it becoming worse, and anger at having to cope with it. They express related feelings of helplessness, depression, embarrassment, and loss of purpose. Often, they also are experiencing isolation and loneliness due to restricting their activities in order to minimize pain, and feelings of alienation from family and friends.

While these emotions can affect people of all ages, older adults are particularly susceptible as their bodies begin to exhibit the signs of normal wear and tear after decades of use. And because seniors are also at risk of being over-medicated for physical pain by doctors who do not assess its emotional components, I’ll be focusing on that topic in this blog during the next several months, beginning with this article.

I addressed the issue of older Americans and opiate misuse in an interview with USA Today in May and have been following the newspaper’s coverage of senior health care.

In "Aging in America," a special series USA Today published last month, a survey of adults age 60 and older found, perhaps not surprisingly, that those with naturally optimistic attitudes were, on average, in better health than those more prone to worry. The more positive-thinking survey participants indicated generally satisfactory acceptance of their lives and circumstances, and belief in their ability to maintain their health and daily activities throughout their remaining years.

By contrast, survey participants with persistent negative feelings—regrets, fear of change, and financial concerns, for example—were, on average, also dealing with chronic health problems.

An argument can be made, of course, that seniors experiencing chronic pain and other health frustrations—fading vision, hearing, and memory, for example—could easily become consumed with negative emotions; that without the presence of these conditions, these same individuals could be just as positive and optimistic as their healthier counterparts.

But in my experience, I have observed that the reverse is more common; that living in chronic negativity makes a person prone to developing health issues that manifest in painful symptoms.

Consider depression, for example. Weakness, lethargy, loss of or increase in appetite, and the feeling of literally carrying a heavy weight on one’s shoulders are just a few of the physical health symptoms resulting from this common emotional condition.

While most adults look forward to reaching retirement, fantasizing about how they will spend those years, many are not prepared for some of the emotions that can strike unexpectedly at this critical milestone:

- anxiety and regret regarding financial issues;

- guilt and anger about choices made or opportunities missed;

- confusion and resentment over changing social connections; and

- fear and insecurity due to aging bodies that are less flexible and resilient.

All of these emotions, individually or collectively, can challenge seniors and even be overwhelming. And when the mind can’t process all of it, emotional overload flows into the body where it generates physical pain by putting pressure on the nervous system.

One of the biggest emotional threats to healthy aging is loneliness. A new study of 2,100 adults age 55 and older, conducted by the Center for Cognitive and Social Neuroscience at the University of Chicago, has determined that older adults suffering from chronic loneliness have a 14% higher risk of premature death than those who do not feel lonely. Reasons given for this staggering statistic are that chronic loneliness can result in poor sleep patterns, higher blood pressure, increases in depression and the stress hormone cortisol, and an overall feeling of hopelessness.

Additionally alarming results released last year from a study at Duke University Medical Center showed that single people are twice as likely to die prematurely than married people.

Common sense can tell us these discoveries about loneliness are true. Life is just harder when we’re trying to do it all by ourselves. We don’t get the social interaction and support we need to feed our souls. And leaving the TV set on during the day to keep us company doesn’t count—we’re not going to get a lot of love from a television. It’s necessary that we connect with other people. I think, in fact, that is the basis of spirituality.

Fortunately, the loneliness and isolation that create such serious impacts on our health can be relieved if we remember one simple fact: even when we feel like we’re in this world alone, we really aren’t.

If we’re worried about our financial stability, there are professional advisors we can turn to for guidance. If we are harboring sadness over events in our lives, there are support groups we can join to help us heal those feelings. If our social circles don’t feel like the fit they once were, we can find others that better match what we need or who we have become. And if our aging bodies aren’t cooperating with the activities we enjoy, there are fun and therapeutic fitness options adapted to help us regain strength and mobility.

In my next post, I’ll explore how older adults can empower themselves by locating resources for these and other matters that affect our emotional health, and, in turn, our physical well-being.

About the Author

Mel Pohl, M.D.

Mel Pohl, M.D., is a Clinical Assistant Professor in the Department of Psychiatry and Behavioral Sciences at the University of Nevada School of Medicine.

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