A Pill for Social Pain. Really??

This information really caught my eye.

This one really caught my interest!

As a clinical physician far more accustomed to reading and writing about physical ailments than emotional ones, I found myself captivated by an article that recently popped up on one of the medical websites I follow. The article was so interesting I wanted to share details of it in my Psychology Today blog. It’s all about pain – but, more than likely, not the type you’re probably thinking of.

The article, and other articles it referenced, dealt with pain – more specifically two types of pain: physical pain and emotional pain.

We have plenty of reasons to suffer minor physical pain and the first thing 81% of American adults do when faced with simple ailments such as strains, sprains, headaches, backache, hangovers and the such, is reach for a bottle of OTC pain relievers for relief. We rely upon these medications – products like acetaminophen, ibuprofen, naproxen, aspirin – to the point manufacturing them, as of 2019, has become a $19.3 billion industry in the United States. OTC pain relievers are easy to get; cheap and satisfy the needs of over 60 million Americans every year.

But physical pain is not the only type of discomfort commonly used OTC analgesics can relieve. Evidence suggests these drugs may also help relieve emotional pain as well. It’s a type of pain the American Psychology Association refers to as “social pain”.

I must say, that was news to me.

According to an article titled “Can Over-the-Counter Pain Medications Influence Our Thoughts and Emotions?” by Kyle G. Ratner, et al published in Sage Journals, February 6, 2018, recent research suggests drugs like acetaminophen and ibuprofen might influence how people experience emotional distress, process cognitive discrepancies, and evaluate stimuli in their environment – the type of pain which is the subject of the book “Social Pain: Neuropsychological and Health Implications of Loss and Exclusion” edited by Geoff MacDonald, PhD, and Lauri A. Jensen-Campbell, PhD .

According to editors MacDonald and Jensen-Campbell social pain is the experience of pain that results from interpersonal rejection or loss. They site examples of social pain to be the way we feel following life episodes such as rejection from a social group, bullying, or the loss of a loved one. And, according to these writers, this type of emotional pain results from activation of certain neural systems in our bodies that are the same neural systems that transmit physical pain in our bodies.

That’s right. According to their book, social pain or “hurt feelings” and physical pain awareness both seem to share the same neural systems.

In 2010 psychology researchers C. Nathan DeWall, Geoff MacDonald, Gregory D. Webster, et all studied the effect of acetaminophen on test subjects experiencing social pain. They postulated that the two types of pain – physical and social – may rely on some of the same behavioral and neural mechanisms within our bodies. They felt, to the extent social and physical pain processes overlap, acetaminophen, since it acts through the central neural mechanism, may also reduce behavioral and neural responses to social rejection – ie social pain – just as it does for physical pain.

The researchers performed functional MRI studies on test subjects to measure brain activity when given acetaminophen. They found reduced neural responses to social rejection in several brain regions (the dorsal anterior cingulate cortex and anterior insula) after the acetaminophen was consumed. They concluded acetaminophen reduces behavioral and neural responses thus associated with the pain of social rejection “demonstrating substantial overlap between social and physical pain.”

There is further evidence that social pain or “hurt feelings” and physical pain share the same neural system and therefore may react similarly to the taking of OTC pain medications.

One study that showed a relationship between the taking of an OTC pain medication (ibuprofen) and a reduction in social pain was done by Anita L Vangelisti, et al published in Personal Relationships: May 11, 2014. These researchers found ibuprofen, taken by women who had their feelings hurt (social pain) when they were excluded from a particular game, had less a feeling of social pain than women who took a placebo who were also excluded from the game. They concluded: a physical pain reliever such as ibuprofen, can reduce social pain at least in women.

So, what does this all mean? If we feel down, rejected, or a sense of disappointment, should we head to the medicine cabinet and pop a couple of Advil just to feel better? Or should we face our source of disappointment and try to do something about it? The question is up for debate.

Some people are excited such a simple act of taking an OTC medication could help reduce stress. And there’s reason to be excited. OTC pain relievers might help people deal with hurt feelings in the same way that they deal with minor aches and pains. “One could imagine taking acetaminophen after a flubbed work presentation or spousal disagreement,” University of California, Santa Barbara researchers Kyle G. Ratner, et al wrote. “What’s more, further evidence could clarify whether OTC pain relievers might become part of treatment regimens for common mental illnesses like depression and anxiety.”

It’s not all a bed of roses.

There is data that suggests risks of using simple OTC to treat social pain could outweigh the advantages. One risk, besides the obvious potential physical side-effects such drugs potentially have (Gi bleeding, ulcer formation, liver disease) is that using them might reduce a person’s ability to feel empathy.

Empathy helps people build connections and support networks. These are important contributors to emotional well-being. If common use of OTC analgesics decreases the inability to feel empathy, these important networks of emotional wellbeing might be compromised. And for people suffering depression, it’s even possible OTC pain relievers might dampen the ability to feel other emotions such as pleasure, that could worsen their condition even more.

The area has many unknowns and the UCSB researchers recommended that further scientific studies are needed to weigh the risks and benefits of reducing social pain associated with OTC pain relievers.