# Chronic pain and health conditions > How long-term pain and health conditions affect sleep, mood and daily life, and how therapy with Jess, drawing on ACT and CBT, works alongside medical care. Source: https://jess.ac/areas-of-support/chronic-pain-health/ Long-term pain or an ongoing health condition often affects more than the body. Broken sleep and low mood can build over months or years, and everyday tasks may need more planning. Therapy with Jess looks at these effects and at practical ways of living with symptoms. ## How long-term pain and illness affect everyday life Pain is called chronic, or persistent, when it lasts beyond normal healing time, generally more than three months. Conditions such as arthritis, endometriosis or migraine bring their own symptoms, appointments and uncertainty. Sleep is often among the first things affected, and pain and poor sleep can feed each other. Mood can dip too, and some people notice they are flatter or more irritable with those closest to them. Relationships and your sense of yourself can shift as well. Frequent cancellations can mean you stop making plans, and others may not understand what a hard day involves. If you have always been the reliable colleague or the parent who did everything, needing more rest and help can be unsettling. Many people describe grief for the life they had before their health changed. ## Seeing a psychologist does not mean the pain is imagined Some people worry that a suggestion to see a psychologist means their doctor thinks the pain is all in their head. Pain is always real, whatever its cause. It is produced by the nervous system and brain, often as a protective response. In long-term pain that system can become oversensitive, like a smoke alarm that goes off whenever someone makes toast. Stress and poor sleep can turn the sensitivity up, and feeling calmer and better supported can help turn it down. This is one reason psychologists are part of many hospital pain management teams. ## What therapy involves Jess starts by assessing how pain or illness is affecting your sleep, mood, work and relationships, and whether a condition such as depression or an anxiety disorder is also present. From this she develops a formulation of how these difficulties interact, and you agree a treatment plan together. Treatment plans often include pacing, which replaces the boom and bust cycle (three hours in the garden on a good day, then two days on the couch) with a steady, manageable level of activity that builds gradually. Plans may also draw on acceptance, which means noticing how much energy goes into fighting pain and allowing it to be there, so more is left for the people and activities you value. It does not mean giving up on medical treatment. Therapy can also address worry about new symptoms and give you room to take in a new medical diagnosis and what it means for your work and family. ## How Jess works with pain and physical health Jess's clinical psychology registrar program with Canberra Health Services included a rotation through its Pain Management Unit, and she has provided psychological care on general medical wards. Sessions leave room for the physical side of a health condition, such as flare-ups, fatigue and treatment decisions. Therapy sits alongside any care you receive from a GP, physiotherapist or pain doctor. If sitting for long periods is uncomfortable, let Jess know at your first session. ## Things people often notice - Sleep broken by pain or worry - Good days followed by a flare after doing too much - Feeling low, or more short-tempered than usual - Worry about what each new symptom means - Pulling back from friends or things you used to enjoy - Missing the person you were before ## Approaches Jess may draw on - **[Acceptance and Commitment Therapy (ACT)](https://jess.ac/approaches/act.md).** ACT has been studied with long-term pain since the early 2000s and is used in many pain programs. Sessions often include brief mindfulness exercises and planned steps towards activities you value. - **[Cognitive Behaviour Therapy (CBT)](https://jess.ac/approaches/cbt.md).** CBT has been part of pain care since the 1980s, and research suggests it can help some adults with long-term pain feel less distressed and do more day to day. It includes pacing, relaxation and strategies for poor sleep and worry about symptoms. - **[DBT skills](https://jess.ac/approaches/dbt-skills.md).** DBT skills, including paced breathing and soothing the senses, offer practical ways through intense moments such as a bad flare or unsettling test results. ## For children and teenagers Ongoing pain or illness in children and teenagers, such as recurring headaches or juvenile arthritis, can mean missed school and sport. Therapy is practical, with age-appropriate explanations of how pain works and play or drawing for younger children. Goals are specific, such as returning to one training session a week. Parents are usually involved, since how a family talks about pain can shape how a child copes. ## Questions ### Does seeing a psychologist mean my pain is in my head? No. Psychological therapy is part of pain care because pain, sleep, mood and stress affect one another, and sessions focus on what might make pain easier to live with. ### Will therapy make my pain go away? Therapy is unlikely to remove pain on its own. Research shows that approaches such as CBT and ACT can help some people feel less distressed by pain and do more of what they value. You and Jess set realistic goals as part of the treatment plan. ### Can I have sessions by telehealth if travelling is difficult? Yes. Jess offers telehealth as well as in-person appointments, and some people with pain or fatigue find it easier on harder days. Reception can explain what you need set up at home. ## Further reading - [Chronic pain](https://www.healthdirect.gov.au/chronic-pain) (healthdirect) - [Supported self care](https://www.painaustralia.org.au/find-support/right-care/supported-self-care) (Painaustralia) - [Management of chronic conditions](https://www.healthdirect.gov.au/management-of-chronic-conditions) (healthdirect)