A major new study has revealed just how closely chronic pain is linked to mental health struggles like depression and anxiety — and the numbers are striking.
Researchers at Johns Hopkins Medicine analyzed data from more than 375 previously published studies involving over 347,000 adults from 50 countries. They found that around 40% of adults with chronic pain also experience clinically significant symptoms of depression and anxiety.
Published March 7 in JAMA Network Open, the study paints a global picture of the hidden mental health burden that comes with long-term pain. Chronic pain, defined as pain lasting more than three months, affects more than 50 million adults in the U.S. alone, according to the CDC.
Despite growing awareness of the pain-mental health connection, this study is one of the most comprehensive efforts to measure how often these issues overlap — and it suggests the overlap is far more common than many realize.
“We’ve known for decades that pain and mood are closely linked, but the scale of what we found is deeply concerning,” said Rachel Aaron, Ph.D., the study’s first author and an assistant professor of physical medicine and rehabilitation at Johns Hopkins University.
“Nearly half of people with chronic pain are also struggling with their mental health. And yet, our current healthcare system rarely treats both together.”
Among the key findings:
39% of patients with chronic pain showed clinical symptoms of depression
40% showed clinical symptoms of anxiety
Rates of formal psychiatric diagnoses (based on DSM-5 criteria) were also high:
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- Major depressive disorder: 37%
- Generalized anxiety disorder: 17%
- Panic disorder: 8%
- Social anxiety disorder: 2%
- Persistent depressive disorder: 6%
The study showed that certain groups were more vulnerable than others. Women, younger adults, and people with fibromyalgia — a condition characterized by widespread pain — were especially likely to have depression or anxiety alongside their pain.
Despite these findings, people with chronic pain and co-occurring mental health conditions are often overlooked or excluded from clinical care and research.
“Many pain clinics still don’t routinely screen for depression or anxiety, and many studies testing new pain treatments exclude patients who are also depressed or anxious,” Aaron explained. “This siloed approach ignores the reality that pain and mental health are deeply connected.”
The researchers also noted that while chronic pain can worsen mental health, psychological distress and trauma can also increase the risk of developing certain kinds of chronic pain — especially nociplastic pain, which is linked to changes in how the brain and spinal cord process pain signals. This suggests a two-way relationship between pain and mental health.
Still, the study also delivered a hopeful message: most people with chronic pain do not have depression or anxiety. This challenges the harmful stereotype that chronic pain always leads to poor mental health and highlights the resilienceof many people living with ongoing pain.
Aaron and her team are calling for:
Routine mental health screenings in chronic pain treatment settings
Integrated care models that treat both pain and mental health conditions together
Innovative therapies tailored to people with both conditions
More inclusive research that reflects real-world patient experiences
“This is a significant public health issue,” Aaron said. “But it’s also a reminder that we need to meet people where they are. Effective treatments exist for both pain and mental health conditions, but we need to stop treating them like separate problems.”
As rates of chronic pain continue to rise globally, the study urges healthcare systems to take a more holistic, person-centered approach — one that sees physical and mental health as inseparable.
If you care about health, please read studies that scientists find a core feature of depression and this metal in the brain strongly linked to depression.
For more information about health, please see recent studies about drug for mental health that may harm the brain, and results showing this therapy more effective than ketamine in treating severe depression.
The research findings can be found in JAMA Network Open.
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