Chronic pain and psychological wellbeing are closely linked. Low mood, worry and poor sleep often show up alongside long-term pain.
In a large Australian study, people whose pain interfered with daily life were far more likely to report high psychological distress than people whose pain did not. If that sounds familiar, it is worth raising with your GP. Support for the emotional side of pain can sit alongside medical care.
What is high-impact pain?
High-impact pain is pain that gets in the way of everyday life, including work, housework and time with people you care about. It is different from pain that is present but manageable.
In a study of more than 140,000 adults aged 45 and over in New South Wales, about one in three reported moderate-to-severe bodily pain. About one in eight reported pain that interfered with daily life (Joshy et al., 2026).
Pain is not only a later-life issue. High-impact pain was reported by 11.2% of people aged 45 to 64, 14.2% of those aged 65 to 79, and 18.8% of those aged 80 and over (Joshy et al., 2026).
It was also more common among women, people on lower incomes, and people living in outer regional or remote areas.
How does pain connect with mood and stress?
Among people with high-impact pain, 40.5% reported moderate-to-high psychological distress. For people whose pain did not affect daily life, the figure was 9.0% (Joshy et al., 2026).
Just over a quarter of those with high-impact pain rated their quality of life as fair or poor.
The researchers suggest the link probably runs both ways. Pain can wear down mood, and low mood can make pain harder to live with. These studies are snapshots, so they cannot show which comes first.
Feeling low when pain has taken over your days is not a weakness. It is a very human response.
What seems to matter most for wellbeing?
A Canadian survey of 220 adults aged 60 and over living with chronic pain looked at what shaped their sense of wellbeing (Kohlert et al., 2024). Two factors stood out: how well people could move and function physically, and how much they catastrophised about their pain.
Pain catastrophising means thoughts that magnify pain, dwell on it, or feel helpless about it. It is an understandable reaction to pain that will not let up. The researchers describe it as a pattern that can be worked on in therapy.
Older participants tended to report greater self-acceptance and a stronger sense of meaning, purpose and growth. The age at which pain began did not predict wellbeing.
The authors also caution that good wellbeing can mean distress goes unnoticed, so it is worth speaking up.
Doing what matters, for the right reasons
A US study followed 200 women aged 50 to 75 with daily diaries over two years (Segerstrom et al., 2022). On days when women pursued goals because they enjoyed them or felt they mattered, wellbeing tended to be higher.
On days when goals were driven by guilt or pressure, the pattern was weaker or reversed. Taking on more goals than usual was followed by slightly lower wellbeing the next day. When those goals felt less self-chosen, it was also followed by slightly more pain.
The effects were small, and pain levels in the sample were mostly mild. The message is not to do less. It is that why you do something matters as much as what you do.
Stress and sleep
A small US study of 60 older adults with chronic low back pain found that people who reported more gratitude also reported lower depressive symptoms (Makhoul & Bartley, 2023). Stress, and stress followed by poorer sleep, appeared to explain part of that link.
This does not mean pain should be met with positivity. It suggests that stress and sleep are worth paying attention to.
Pain is a family matter
A Hong Kong study of 150 older adults with chronic pain and their 150 informal caregivers found that carers reported more burden when the person they cared for had more pain interference, more distress, or lower confidence in managing pain (Tse et al., 2025). The study was preliminary and cross-sectional.
If you care for someone in pain, your wellbeing matters too. Support is not only for the person with the pain.
When to raise it with your GP
Pain appointments understandably focus on the body first. The emotional side often does not come up unless someone raises it.
It is worth mentioning if any of these have been present for more than a couple of weeks:
Low mood or loss of interest in things you usually enjoy
Ongoing worry, tension or panic
Poor sleep
Pulling back from people or activities
A sense that pain has taken over your life
You might say: "The pain is affecting my mood and my sleep. Could we talk about whether psychological support would help?"
If pain is new or getting worse, see your GP promptly. Psychological support works alongside medical care, not instead of it.
How a Mental Health Treatment Plan fits in
Chronic pain on its own is not a mental health condition. Medicare rebates for psychology sessions are available when a GP determines you are likely to benefit from structured psychological support and you have a diagnosed mental disorder.
Examples include adjustment disorder, depression, bipolar disorder, trauma-related conditions, OCD, and anxiety (including generalised anxiety disorder, panic disorder and phobias). Your GP decides whether a Mental Health Treatment Plan is appropriate.
Our referral assistance page explains what a GP referral involves and what to expect from a first session with us.
What the research tells us
About 13% of adults aged 45 and over in a large New South Wales study reported pain that interfered with daily life. Among them, 40.5% had moderate-to-high psychological distress, compared with 9.0% of people whose pain had no impact (Joshy et al., 2026).
In older adults with chronic pain, physical functioning and pain catastrophising were among the strongest contributors to wellbeing, and older age was associated with higher self-acceptance (Kohlert et al., 2024).
Goals pursued for enjoyment or meaning were linked to higher wellbeing than goals pursued out of pressure, in a two-year diary study of midlife and older women (Segerstrom et al., 2022).
In a small study of older adults with chronic low back pain, stress and sleep appeared to explain part of the link between gratitude and lower depressive symptoms (Makhoul & Bartley, 2023).
Carer burden was higher when older adults with chronic pain had more pain interference and distress, in a preliminary Hong Kong study (Tse et al., 2025).
Frequently asked questions
Is chronic pain a mental health condition?
No. Pain is a physical experience that can affect mood, stress and sleep. A mental health condition such as depression or anxiety can develop alongside it, and that is what a GP can assess.
Can a psychologist treat my pain?
Psychological support does not replace medical or physical pain care. It can focus on how pain affects your mood, worry, sleep and daily life, alongside care from your GP and other health professionals.
Do I need a referral to book?
No. You can book a free 20 minute consultation without a referral. Medicare rebates may apply if your GP prepares a Mental Health Treatment Plan.
Is it normal to feel low when you live with pain?
It is common. In the Australian study above, around four in ten people with high-impact pain reported moderate-to-high distress (Joshy et al., 2026). Common does not mean you have to manage it alone.
My parent lives with pain and seems flat. What can I do?
Start with a gentle conversation, and encourage them to mention mood and sleep to their GP. If you are caring for them, your own support matters too.
Ready for your next chapter?
If pain is weighing on your mood, sleep or relationships, talk to your GP about whether a Mental Health Treatment Plan and referral would help. Our referral assistance page explains how it works.
Or book a free 20 minute consultation, no referral needed, and talk through what you would like support with.
Explore your next chapter today.
Book now
References and reading
Joshy, G., Khalatbari-Soltani, S., Soga, K., Martin, M., Brown, S., Blyth, F. M., & Banks, E. (2026). Pain and high-impact pain in community-dwelling older adults in Australia and relation to sociodemographic and health-related factors, including physical disability, psychological distress, and quality of life. BMC Medicine, 24, Article 70. https://doi.org/10.1186/s12916-026-04642-0
Kohlert, A., Gallant, N. L., & Hill, T. G. (2024). Age and psychosocial contributors to well-being among older adults living with chronic pain. Cogent Psychology, 11(1), Article 2320469. https://doi.org/10.1080/23311908.2024.2320469
Makhoul, M., & Bartley, E. J. (2023). Exploring the relationship between gratitude and depression among older adults with chronic low back pain: A sequential mediation analysis. Frontiers in Pain Research, 4, Article 1140778. https://doi.org/10.3389/fpain.2023.1140778
Segerstrom, S. C., Monroe, A. D., & Crofford, L. J. (2022). Pain, goal engagement, and eudemonic well-being: Moderation by autonomous motivation. The Journals of Gerontology: Series B, Psychological Sciences and Social Sciences, 77(3), 493–498. https://doi.org/10.1093/geronb/gbab105
Tse, M. M. Y., Ng, S. S. M., Lou, V., Lo, R. S. K., Cheung, D. S. K., Lee, P. H., Tang, A. S. K., To, K. P., & Tse, P. P.-S. (2025). Informal caregivers' burden and chronic pain in older adults: A dyadic study unveiling the correlation and its impact. Pain Management, 15(3), 123–130. https://doi.org/10.1080/17581869.2025.2467614
