Does Your Child Often Complain About Stomachaches or Pain?
Does your child have chronic pain and associated depression and anxiety? Learn about the relationship between chronic pain syndromes and mental health disorders in children.
As a parent, it can be challenging to recognize your child’s pain — especially because children react differently to pain than adults do.
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Some children don’t want to discuss pain because they don’t want to visit the pediatrician. Younger children may not have developed the vocabulary to clearly express their pain in terms of location and how it feels.
There are also a variety of possible causes for chronic pain in kids, including a medical condition or mental health condition, such as depression or anxiety.
“Many times, pain syndromes come along with depressive and anxiety symptoms and if you first resolve any underlying medical issues, it helps with the depression and anxiety,” says psychiatrist Veena Ahuja, MD.
Chronic pain in children frequently manifests as headaches, including migraines; stomach pain or other gastrointestinal distress; or pain in the back or in the arms and legs.
Listen to your child carefully and watch for signs of pain, including:
In these cases, identifying and treating the medical cause of the pain allows the pain to subside and your child to relax and act more like himself.
Chronic pain often goes misdiagnosed or undiagnosed, especially in children. If it’s not treated, or not taken seriously, it can disrupt family routines and interfere with your child’s school and extracurricular activities.
It differs from acute pain, which lasts for a short time and has a distinct purpose. For example, if place your hand on a hot stove, the burn you feel causes you to quickly pull your hand away (preventing further damage).
Chronic pain, on the other hand, can linger and be more difficult to pinpoint. It may come from physical trauma, a disease or disability, surgery or another medical procedure.
If your child has a medical condition causing chronic pain, he or she may also struggle with related depression and anxiety. He or she may struggle more at school while trying to manage medical symptoms.
Not all chronic pain has an underlying physical cause.
“Depression and anxiety can cause a child’s chronic pain, and the symptoms are different than those associated with pain that has a medical cause,” says Dr. Ahuja.
Kids who struggle with chronic pain arising from depression and anxiety do not move into a more normal psychological state even when not having a pain crisis.
“In these cases, chronic pain is an invisible disease, leaving no visible markers for evaluation,” says Dr. Ahuja. “This often causes the child’s family and physician to view the child’s complaints with skepticism.”
If the doctor finds no medical cause for the pain (e.g., chronic nausea, headaches) you may suspect your child is faking the symptoms to avoid school or other things he views as unpleasant.
But a pediatrician who understands how chronic pain works in children will recognize that your child’s complaints may arise from an underlying mental health problem.
In this case, the pediatrician will likely refer your child to a psychologist for evaluation. “Depression and anxiety are both surprisingly common in children and, left untreated, can cause them to experience debilitating chronic pain,” says Dr. Ahuja.
Encourage your child when preparing to visit the psychologist. Let him know you take his pain seriously.
Help him better express his pain by going over words that clarify how it feels, such as:
Help your child point to the body part that hurts and ask him to trace the pain’s pathway if not localized. Talk about how to explain emotions as well. Is he sad, anxious, afraid?
It’s up to you to act as your child’s advocate when it comes to treatment and pain management. Ask doctors to help manage your child’s pain even as they are trying to identify its source.
You may want to seek out a pediatric pain management program, Dr. Ahuja says. These programs specialize in helping children and their families cope with chronic pain. They are especially geared for children and teens whose pain interferes with normal activities.
A comprehensive pediatric pain management program treats children who suffer from chronic:
A pediatric pain program treats the physical pain while the mental health physician works to treat the depression and anxiety that accompany it.
Not only do they have medications that can help control pain, but they also give children and teens access to coping skills and other methods of pain control, including biofeedback techniques, cognitive behavioral therapy and hydrotherapy.
If left unaddressed, chronic pain can impact children in ways that will follow them into adulthood and even old age. Advocate for your child or adolescent by ensuring that his or her chronic pain and any associated issues receive specialized treatment.
As doctors learn more about the interplay between pediatric pain and mental health disorders, they are able to offer more help for these young patients.