Pain Management in Psychiatry

🪷 The Importance of Pain Management in Psychiatry

Understanding the connection between physical pain and emotional wellness is so important.

When we think about pain, we often picture something purely physical — an aching back, sore joints, or chronic migraines. But pain is not just a body experience; it deeply affects the mind as well. Over time, untreated or poorly managed pain can lead to depression, anxiety, irritability, and sleep disturbances due to changes it enacts in the brain biochemistry.

In turn, then these emotional struggles can amplify the perception of pain — creating a difficult cycle that’s hard to break.

That’s where psychiatry and integrative mental health care come in. Managing pain effectively isn’t only about easing discomfort — it’s about restoring quality of life, mood balance, and a sense of hope.

🧠 The Mind-Body Connection

Psychiatric providers recognize that pain and mood are closely intertwined through shared brain pathways and neurotransmitters. When pain persists, the brain’s reward and motivation centers become less active, often leading to low energy and depression. Similarly, high stress or anxiety can increase muscle tension and inflammation, intensifying pain symptoms. Thus, this contributes to a downward spiral based on an automatic feedback loop.

This understanding has reshaped how modern psychiatric care approaches chronic pain — not just as a symptom, but as a whole-person experience that deserves comprehensive treatment.

💊 How Psychiatric Providers Can Help

Psychiatric nurse practitioners and physicians are uniquely positioned to address both the emotional and physical aspects of pain. Due to the way that pain can influence the brain and vice versa, pain management is a key aspect of promoting mental health and wellness. Depending on each patient’s needs, treatment plans may include:

1. Antidepressants for pain relief Certain antidepressants, such as SNRIs (like duloxetine or venlafaxine) and tricyclics (like amitriptyline or nortriptyline), can reduce chronic pain while improving mood. These medications influence serotonin and norepinephrine — neurotransmitters that play a key role in both mood regulation and pain signaling.

2. Mood stabilizers and anti-seizure medications Medications like gabapentin or pregabalin are sometimes used to treat nerve-related pain and can also stabilize mood or reduce anxiety in certain patients.

3. Ketamine-assisted and microdosing options For patients with treatment-resistant depression, chronic pain, or mood disorders, ketamine has emerged as a promising and innovative therapy. At Lakeside Integrative NPs in Psychiatry, patients have access to ketamine-assisted therapy as well as ketamine microdosing options prescribed through a compounding pharmacy in New York State.

Microdosed ketamine, typically taken in very small sub-psychedelic doses under medical supervision, may help improve mood regulation, reduce pain perception, and enhance emotional flexibility without producing dissociative effects. When used responsibly in a structured treatment plan, it can complement traditional psychiatric medications and therapy for a well-rounded, evidence-informed approach.

4. Medical cannabis 

Cannabis can be a valuable adjunct for patients struggling with both physical pain and psychiatric symptoms such as anxiety, depression, or insomnia. Cannabinoids (like THC and CBD) act on the endocannabinoid system, which interacts directly with the pain matrix — particularly in the amygdala, insula, and PAG. These compounds help modulate pain perception, reduce inflammation, and enhance mood stability. Many patients experience improved sleep, decreased muscle tension, and reduced emotional distress when cannabis is used responsibly under medical supervision.

Our providers are trained in medical marijuana evaluations and certifications through New York State’s medical cannabis program. We help patients explore whether cannabis might safely complement their current treatment plan.

5. Therapy modalities focused on pain regulation

Psychiatric providers may incorporate or refer for therapeutic approaches that help patients manage the emotional and cognitive components of pain, including Cognitive Behavioral Therapy (CBT) for pain, Acceptance and Commitment Therapy (ACT), and mindfulness-based pain regulation techniques.

These methods can retrain the brain’s response to pain signals, reduce distress, and increase tolerance and resilience over time.

5. Non-traditional and integrative therapies Combining medication management with nutritional counseling, mindfulness practices, or lifestyle interventions can enhance natural pain control and emotional balance.

6. Lifestyle and behavioral strategies Psychiatric care often integrates recommendations for sleep hygiene, movement, stress reduction, and balanced nutrition, all of which can lower pain sensitivity and promote long-term emotional resilience.

🌿 A Holistic Approach to Healing

Effective pain management is not about masking symptoms — it’s about treating the root causes and improving overall function and happiness. Integrating psychiatric expertise with medical and holistic care ensures that patients don’t have to choose between addressing their mental health or their physical pain.

When both are treated together, people often notice better mood stability, energy, and engagement with life.

💬 Final Thoughts

Pain affects every aspect of a person’s wellbeing — physically, mentally, and emotionally. Through thoughtful medication management, collaborative care, and integrative therapies, psychiatric providers play a vital role in helping patients reclaim control and rediscover joy in their daily lives.

If you’re struggling with chronic pain or the emotional toll that comes with it, you don’t have to face it alone. Reach out to Lakeside Integrative NPs in Psychiatry to learn how a personalized, whole-person treatment plan can help you find balance and relief.