Pain is the body’s way of signaling that something is wrong. In most cases, pain fades once the underlying issue heals. However, for millions of people, pain becomes a constant companion, lasting for months or even years. This condition, known as chronic pain, not only affects physical health but also has a profound impact on emotional well-being.

Current studies emphasize the strong link between chronic pain and mental illness such as anxiety and depression. Individuals suffering from long-term pain tend to be stuck in a vicious cycle of fear, stress, and emotional distress. But how does chronic pain actually lead to deteriorating mental health, and how can the cycle be stopped?

For over 45 million Americans, chronic pain is a way of life. Although physical pain is the most visible symptom, its impact reaches far beyond the physical body. Chronic pain is frequently accompanied by psychological distress, as many victims experience anxiety and depression caused by their illness.

As per Dr. Ravi Kesari, a general medicine specialist, "Chronic pain and mental illness tend to exacerbate each other. Patients have disturbed sleep patterns, increased mental tension, and depression-like symptoms. This forms a vicious circle in which pain causes emotional distress, which further increases the perception of pain."

This cycle is especially seen in conditions like:

Fibromyalgia – A syndrome of widespread pain, fatigue, and cognitive difficulty.

Irritable Bowel Syndrome (IBS) – A bowel condition frequently associated with stress and tension.

Lower Back Pain – Prolonged pain in the lower back, often accompanied by decreased mobility and depression.

Migraine and Nerve Pain – Prolonged headaches and nerve pain that interfere with daily functioning.

Research indicates that two-thirds of IBS sufferers experience anxiety symptoms, and 65% of patients with depression exhibit chronic pain symptoms. This commonality indicates that mental illness not only heightens sensitivity to pain but also complicates recovery.

How Stress of Chronic Pain Can Rewires Your Brain?

When a person hurts, the body releases stress chemicals such as cortisol and adrenaline to assist in the regulation of pain. Such hormones are helpful during short-term occurrences, but once pain persists over time, continued exposure to stress hormones alters brain chemistry.

"Chronic pain leads to chronic stress, and that changes the neurochemicals in the brain that control mood, thought processes, and behavior," explains Dr. Kesari. "That's why people with chronic pain tend to be irritable, angry, or drained of emotions."

Chronic exposure to stress hormones can cause:

Heightened anxiety and fear reactions, making people excessively careful about everyday activities.

Depression, as serotonin and dopamine levels decrease—two neurotransmitters that produce happiness and motivation.

Cognitive impairment, including problems concentrating, remembering, or deciding.

Pain, Anxiety, and the Fear of Movement

Another very frequent mental impact of chronic pain is kinesiophobia, or fear of movement. Individuals with chronic pain tend to avoid movement for fear of making their pain worse. This avoidance behavior can cause stiffness in the muscles, loss of mobility, and increased pain over time.

For example, a person with chronic back pain might try to avoid exercising, which would further weaken muscles and worsen their condition. This pattern of avoidance and worsened pain begets a spiraling sense of helplessness that further fuels anxiety and mood shifts.

"Anxiety is an understandable reaction to chronic pain," says Dr. Kesari. "People become concerned about what pain will mean for their lives, so tasks that are minor—such as shopping for groceries or socializing—become overwhelming."

Daily Struggles and Self-Esteem Loss

Chronic pain does not only impact mood; it is able to significantly modify the way an individual perceives himself. Most of those who have chronic pain struggle with simple activities such as exiting bed, dressing up, or personal hygiene. Failing to do so by oneself may cause the individual to feel inadequate, frustrated, and socially withdrawn.

As Dr. Kesari describes, "Patients tend to feel ill at ease in social situations because they view their condition as a restriction. This adds to low self-esteem and exacerbates mental illness such as depression."

Considering the complex connection between chronic pain and mental well-being, both physical and emotional welfare must be treated.

Dr. Kesari stresses, "Healthcare providers need to take a whole-body approach to treating chronic pain. That involves coupling conventional pain management with mental health care to break the cycle between pain and emotional distress."

Some strategies that have been found to be effective are:

Cognitive Behavioral Therapy (CBT) – A type of psychotherapy that enables people to deal with negative thought processes and respond to pain.

Physical Therapy & Movement-Based Practices – Gentle exercise, like tai chi or yoga, decreases pain and alleviates fear of movement.

Medication Management – Painkillers can be beneficial, but only as part of a combination of holistic therapies to prevent dependency.

Stress-Reduction Techniques – Techniques such as meditation, deep breathing, and mindfulness assist in balancing stress hormones.

Social Support & Therapy Groups – Sharing experiences with others who live with chronic pain has been shown to combat the sense of isolation and offer emotional support.

Chronic pain is not merely a physical condition—it has a powerful impact on mental health, causing anxiety, depression, and extreme lifestyle constraints. But knowledge of the interlinkage of pain and emotional health can encourage proactive measures toward improved general well-being.

Dr Ravi Kesari is MBBS, MD- General Medicine at Apollo Spectra Hospital, Bangalore in India

Reading non-fiction books is not my cup of tea, while they are informative and important to read, when I read for pleasure, I want to immerse myself in a world that could never be. Reading fiction books like the Harry Potter series, Percy Jackson books and others like the Dragon Rider, were the reason I enjoyed reading. Often using these books as a means to escape difficult feelings, I never even realized how reading these books transformed my mental health, along with my perspective.

Reading plays an important role for your mental health; books offer numerous advantages for one's mental well-being. Whether the preference lies with short stories or lengthy novels, colorful picture books or digital formats, various forms of literature can provide valuable benefits. This piece will explore several key reasons why reading is so beneficial for mental health.

How Does Reading Impact Mental Health?

According to a 2022 PLoS One study, reading fiction can improve people's mental well-being. The researchers conducted five different studies to see how various ways of engaging with fiction affect individuals. These methods includes recalling past fiction reading experiences, being instructed to read fiction, discussing fiction in comparison to non-fiction, and discussing different types of fiction.

The research shows that books had a positive influence on people's mood and emotions. However, it appears that simply reading fiction might not lead to an immediate improvement in mental well-being. The brain seems to require a period of processing and understanding the story before positive effects can be observed.

Ways Reading Can Affect Your Mental Health

Mental Health First Aid England, a social enterprise that offers guidance and training for mental health in workspaces, explains that whether the preference lies with short stories or lengthy novels, colorful picture books or digital formats, various forms of literature can provide valuable benefits. Here are some ways it helps us.

Reading captivating books brings joy and immersion, making time disappear. Finishing a good story can evoke sadness or eagerness for more, highlighting reading's positive impact.

Reading as a Stress Buster

Engrossing oneself in a book for just six minutes can significantly reduce stress by lowering heart rate and easing tension, outperforming other relaxation methods.

Acts as a Coping Mechanism

Reading offers an escape from the real world, providing a coping mechanism, especially in childhood. This immersion can be transformative, influencing how we interact with the world.

Building Empathy

Reading fiction enhances empathy, improving the ability to understand others' feelings and thoughts, temporarily boosting this crucial social skill.

Keeping Your Brain Sharp

Lifelong cognitive activities like reading slow down memory loss and reduce mental decline in later life compared to less stimulating pursuits.

Finding Support and Healing in Reading Groups

Discussing books in reading groups can significantly improve mental health, aiding concentration, emotional understanding, self-awareness, and meaningful discussions.

Boost Your Sense of Control and Offer a Safe Space

Discussing books fosters a sense of control and independence, benefiting mental well-being. It provides a positive and safe way to process challenging topics.

Understanding Adulthood

Reading for pleasure in adolescence enhances academic performance, social engagement, and personal development, offering insights into adult life.

Boosting Your Intelligence

Research confirms that reading increases intelligence, leading to a larger vocabulary, broader knowledge, and improved verbal skills.

On the day of World Malaria Day, as we raise awareness on the dangers posed by this mosquito-borne disease, let's delve a bit deeper into how malaria is different from the other mosquito-borne diseases.

Dengue vs Malaria

Both malaria and dengue are transmitted by female mosquitoes and cause severe illness in humans. There are certain similarities between the two diseases and the mosquito species, which is why the patients and diagnoses are often confused.

As per the co-Principal Investigator, Dr Charles Guissou, for the Target Malaria, a vector control research alliance's Target Malaria Burkina Faso at the Institut de Recherche en Sciences de la Santé, "Dengue and malaria are two very different diseases caused by different pathogens and different mosquito species." “Misdiagnosis between malaria and dengue is common, and this can then contribute to inappropriate medical care.”

Every year, malaria causes 200 million cases worldwide, leading to 600,000 deaths. Many of these cases are from Africa, where children and pregnant women pay the highest price. The World Health Organization (WHO) has also reported that in 2022, Africa was home to 95% of malaria cases and 95% of malaria deaths. The global incidence of dengue has grown significantly in recent decades. Cases reported to WHO increased from 505,430 in 2000 to 6.5 million in 2023.

Dr Ajay Gupta, Head & Director - Internal Medicine, Max Super Speciality Hospital, Vaishali also points out the key differences between malaria and other mosquito-borne diseases. He says, "Malaria is caused by Plasmodium parasites, transmitted through the bite of infected Anopheles mosquitoes. In contrast, dengue, chikungunya, and Zika viruses are transmitted by Aedes mosquitoes. This distinction in the type of mosquito also reflects differences in peak biting times—Anopheles mosquitoes bite during nighttime, while Aedes mosquitoes are daytime biters."

"Another key difference lies in complications and disease progression. Malaria, especially caused by Plasmodium falciparum, can progress rapidly to severe illness with cerebral involvement, anemia, kidney failure, and even death if not promptly treated. Dengue, on the other hand, is known for a sudden drop in platelet count and risk of hemorrhage. Chikungunya commonly leads to prolonged joint pain, sometimes lasting weeks or even months after the infection clears," notes the doctor.

There is also a difference between how the mosquitoes that spread dengue and malaria.

The Aedes Mosquito

It is responsible for spreading dengue and has white stripes down the center of the thorax. It also has a resting position where its body is kept low and parallel to the ground, with the proboscis angled downward. It is slender, and the wings have distinctive white markings.

The Anopheles Mosquito

It is responsible for causing malaria and has long palps. It is dark in color and the resting position follows it abdomen at a 45-degree angle to the surface.

Zika Virus

Zika is a viral infection also transmitted by Aedes mosquitoes, which is the first difference from malaria, in the species of mosquito that causes it. As per the WHO, those with Zika virus do not tend to experience symptoms, and if they do, it includes rash, fever, conjunctivitis, and muscle and joint pain. The symptoms are also what makes it different. They appear from 3 to 14 days after being bitten.

Chikungunya

This is also caused by Aedes mosquitoes, and the symptoms usually appear within 4 to 8 days after infection. The symptoms include fever, joint pain, headaches, and nausea.

Yellow Fever

This is caused by Aedes and haemagogus mosquitoes. People who are infected with this virus do not get sick and experience only mild symptoms. As per the Centers for Disease Control and Prevention (CDC), 12% of people who have symptoms develop serious illness, which includes organ failure and jaundice.

The key difference between all other mosquito-borne diseases and malaria is the species of the mosquito that causes it. While all the others are caused by Aedes, malaria is caused by the Anopheles.

What Else Makes Malaria Different Other Than The Type Of Mosquito That Causes It?

Drinking Beer Could Increase Chances Of Infection

According to the scientists at the University of Emory, in their 2010 study, they found that beer produces an odour in your body that is irresistible to the malaria-carrying mosquitoes.

It Could Take Four Years To Develop Symptoms

There are rare strains of this disease which could in fact take months or even years to get diagnosed. In one of the rare cases, malaria was diagnosed four years later the individuals were infected, reported UK's The Telegraph.

Malaria And Its Connection With Snow White

In 1943, Disney was tasked with creating a film to promote public health awareness. The result? The Winged Scourge — a rather unusual PSA where the Seven Dwarfs learn how to fight off malaria-spreading mosquitoes.

Malaria Has Killed Four Popes, And At Least Eight Presidents Have Suffered From It

George Washington battled malaria, and the disease is also believed to have claimed the lives of Pope Leo and Pope Sixtus—just a few of its prominent victims.

Malaria And India

The doctor also points out that diagnosis and treatment also vary. "Malaria is typically confirmed with a blood smear or rapid diagnostic test and is treated with specific antimalarial drugs. There is no antiviral treatment for dengue, chikungunya, or Zika—management is primarily supportive," he says.

In India, we often see a spike in these illnesses during and after the monsoon season, However, malaria control efforts—such as early diagnosis, insecticide-treated bed nets, and vector control—have significantly reduced the burden in recent years.

"Preventive strategies like eliminating stagnant water, using mosquito repellents, and ensuring proper sanitation are universally effective. But recognizing the distinct nature of malaria is key to prompt diagnosis and management," notes Dr Gupta.

In 2022, about 1 in 5, which is around 702,880, people died due to cardiovascular diseases (CVD) in the United States. There are many factors around you that affect your heart health. Things like what food you eat, whether the area you live in is polluted or not and also what kind of lifestyle you lead. There are many risk factors for heart diseases like high blood pressure, high cholesterol levels or smoking, which are key risk factors according to the Centers of Disease Control and Prevention (CDC). The CDC explains about 47% of US citizens have at least one of these three risk factors.

Another risk factor could be the place you live in. A new study published in the European Society of Cardiology April 2025 revealed that the walkability of a neighborhood can play a big role for your cardiovascular health. The study revealed that individuals living in areas with low walkability had a 5% higher risk of developing CVD compared to those in very walkable neighborhoods. Interestingly, even in neighborhoods that improved in walkability over time, the risk of CVD remained about 5% higher for those who started in low-walkability areas, possibly due to the lasting effects of earlier sedentary habits.

What Makes A Neighborhood Walk-Friendly?

To figure out how walkable a neighborhood is, the researchers in the study looked at several things. They checked how many people lived in the area (population density), how many shops were nearby, if there were parks and green spaces, and if there were sidewalks to walk on. They also considered if different types of buildings were mixed together (like shops and homes), if there was good public transportation, and how well the streets connected to each other. All these things together helped them decide how easy it was to walk around in a certain neighborhood.

Researchers studied over three million adults who were at least 40 years old and didn't have any heart problems when the study started. The researchers kept track of how walkable each person's neighborhood was for 13 years. They also checked if the walkability of these neighborhoods stayed the same, got better, or got worse during that time.

The findings of this study support what doctors have known for a long time: moving your body is good for your health, especially your heart. What's interesting is that you don't need to do intense workouts to see the benefits. Even small amounts of activity, like walking your dog in a park or carrying your groceries home from the store, can make a difference. These little bursts of energy throughout the day can add up and help lower your risk of getting heart disease.

Should People Opt For More Walkable Places?

A report from 2023 from Smart Growth America found that less than 7% of people in America actually live in very walkable urban neighborhoods. Interestingly, studies have shown that minority groups often live in more walkable neighborhoods. However, these same groups are also more likely to suffer from heart and blood sugar problems. This might be because even in walkable areas, factors like safety, clean environments, and good sidewalks and parks might not be available in all neighborhoods.

Even if you don't live in a very walkable area, there are still things you can do to move more. You might need to get a little creative! You can try lifting weights or doing yoga while you watch TV. If you drive to the store, park a little further away so you have to walk more. Take the stairs instead of the elevator. Stand up and move around when you're on the phone, have walking meetings if possible, and make sure to get up and stretch every hour.