How Pain Tolerance and Anxiety Seem to Be Connected

An article this week about Jo Cameron, who has lived for 71 years without experiencing pain or anxiety because she has a rare genetic mutation, prompted questions from New York Times readers.

The notion that the same gene could be responsible for the way a person processes physical and psychological pain left many perplexed: Aren’t they totally different? Or does her story hint that sensitivity to one type of pain might be intertwined with sensitivity to another?

Childbirth, Ms. Cameron said, felt like “a tickle.” She often relies on her husband to alert her when she is bleeding, bruised or burned because nothing hurts.

When someone close to her has died, she said, she has felt sad but “I don’t go to pieces.” She cannot recall ever having been riled by anything — even a recent car crash. On an anxiety disorder questionnaire, she scored zero out of 21.

Asked about her mental state, she wrote: “No, I have never experienced anxiety. I have always been content and happy.”

Dr. Cox said he believed that Ms. Cameron’s reduced anxiety was “related to increased signaling at CB1 receptors,” or cannabinoid receptors, which are known to help the body deal with stressful situations. (Notably, they are activated by the THC in cannabis.)

Block the cannabinoid receptors and anxiety will increase; boost the cannabinoid receptors and anxiety will fall, studies have shown. The receptors also affect how people experience physical pain.

No, it’s more complicated than that and lots of research is still needed, said Dr. T.H. Eric Bui of the Center for Anxiety and Traumatic Stress Disorders and Complicated Grief Program at Massachusetts General Hospital. What we do know, he said, is that “brain regions that process emotional and physical pain overlap.”

In another example of how mysteriously intertwined the two types of pain can be can be, he noted that acetaminophen (the active ingredient in Tylenol, among other pain relievers) had been shown to decrease the emotional pain that comes with rejection.

Naomi Eisenberger, a professor in the University of California, Los Angeles, psychology department, believes so. Dr. Eisenberger studies the similarities in the way that the brain processes physical pain and the “social pain” that results from rejection.

She said she had repeatedly found that “people who are more sensitive to physical pain are more upset by rejection.”

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