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As we enter February, the month of hearts, chocolate and love, I have decided to broaden the topic a bit and look at the effects of Happiness on pain perception.  

Happiness can be defined as “the state of being happy” (Oxford dictionary), where ‘Happy” is a state of feeling pleasure or contentment (Oxford dictionary).  

Do happy people still feel pain?  Of course they do!  But do those that are unhappy, have more pain than those that are happy?  Research shows that the state of happiness may impact pain intensity (1, 2).

What creates happiness?  Let’s dive into this a bit further.  There are many dynamics that can contribute to one’s feeling of happiness (3).  These include: 

  • Genetics have been shown to contribute 30-50% to happiness.  But we must remember that gene expression is dependent on many other factors, many of which include what is listed below.  
  • Culture and society can guide our feelings of happiness depending on a specific cultures’ or societies’ particular view on events, emotions or experiences. 
  • Biochemistry pertains to the amount of those “good hormones” like oxytocin, serotonin, dopamine, endocannabinoids, endorphins, epinephrine, norepinephrine, cortisol and melatonin being released in response to certain events or experiences.  If we lack nutrients or feed our bodies with harmful chemicals, we may not be able to produce these good hormones.  Or there may be conditions in which there are less of these feel good hormones produced naturally.  
  • Neural networking refers to the structure of our nervous system and the connections and pathways our nerves make within our brain and body.  This may be highly dependent on these other factors, i.e genetics provide the genes to produce a structure to produce a certain chemical.  
  • Psychology involves taking the components above to form processes like emotion or thought to create more specific experiences of happiness.  
  • Phenomenology refers to the actual conscious feeling of happiness and what that means and how it is expressed. 

Let us now consider how pain is processed.  Melzack and Wall proposed the Gate Control Theory of Pain in 1965 and has been the main theory on pain for more than 50 years.  They proposed that there is incoming sensory information from several different stimuli (touch, deep touch, temperature, vibration and proprioception) coming to a gate.  The gate can be opened or closed depending on the information coming to the gate from below (outside of the brain) or from above (the brain).  Altering what is coming into the gate can therefore affect whether the gate gets opened.  

A more recent theory has been outlined using the “Bayesian brain model, where the brain is conceptualized as a probability machine that is constantly making predictions about the world and then updates them based on what it actively seeks in the environment using different senses” (4).  In very simple terms, this theory states that pain is the result of the imbalance between the ascending and descending pain inhibitory pathways.  And the balance is under control of the reward system, which also has many influences from other structures in the brain.  With respect to chronic pain, this theory would explain it by switching the sensation of pain from what is not normal to something that has become “normal and predictable”.  The normal methods of inhibiting pain are now harder to control or influence and pain is now chronic or what the brain interprets as the normal sensation.  

Pain can be manipulated through the use of medication.  Pain medication acts as a chemical blocking the pain mediators or prostaglandins that are produced at a site of injury by the cell.  The prostaglandin then would stimulate the nerve ending to send a response indicating pain.  Most over-the-counter pain medication acts to inhibit the production of prostaglandins, and thus diminishing or stopping the stimulation to the nerve.  

But as the Bayesian brain model describes, pain is interpreted when there is an off balance of information that is under control from other processes in the brain.  We can likely find many other ways to influence pain.  Research looking at the effects of facial expression on migraine pain found that viewing positive emotions (pictures of someone smiling) directly reduced pain intensity of the migraine.  Similarly, viewing pictures of negative emotions (scared or crying) increased the intensity of the migraine pain (1).  Similarly, researchers found that pain intensity, worry about pain and pain catastrophizing are all sensitive to changes in mood (2).  In addition to studies done with self-reporting of clinical symptoms, there have been numerous biochemical  studies done to map out the relationship of stress or negative emotions on the production of hormones that influence inflammation and the resulting increased pain intensities (5).  

As stated earlier, the feeling of Happiness is a state of contentment, but can be influenced by genetics, culture and society, biochemistry, neural networks, psychology and phenomenon.  We can find contentment in many aspects of our lives.  For some this is having a partner you love, having family nearby, having no financial stress, enjoying your work environment, feeling fulfilled by the work you do, and this list could go on and on.  When faced with pain, know that we can alter that pain by other neurological processes, in particular, things in our life that make us happy.  

If you are currently experiencing pain from an injury or know someone that can benefit from our help, please book an appointment to discuss further.  If I can’t help you, I will do my best to find someone that can.  

References:

  1. Matamala-Gomez M, Bottiroli S, Sances G, et al. Facial expressions modulate pain perception in patients with chronic migraine. Cephalalgia. 2022;42(8):739-748. https://doi-org.proxy1.lib.uwo.ca:2443/10.1177/033310242210750
  2. Lefebvre JC, Jensen MP. The relationships between worry, happiness and pain catastrophizing in the experience of acute pain. Eur J Pain. 2019; 23: 1358–1367. https://doi.org/10.1002/ejp.1405
  3. Lomas, T., Bartels, M., Van De Weijer, M., Pluess, M., Hanson, J., & VanderWeele, T. J. (2022). The Architecture of Happiness. Emotion Review, 14(4), 288-309. https://doi.org/10.1177/17540739221114109
  4.  Dirk De Ridder, Divya Adhia, Sven Vanneste.  The anatomy of pain and suffering in the brain and its clinical implications. Neuroscience & Biobehavioral Reviews Volume 130, November 2021, Pages 125-146
  1. Straub R. H., Dhabhar F. S., Bijlsma J. W., Cutolo M. (2005). How psychological stress via hormones and nerve fibers may exacerbate rheumatoid arthritis. Arthritis and Rheumatism, 52, 16–26.

https://onlinelibrary.wiley.com/doi/epdf/10.1002/art.20747