Mental Defeat and Increased Suicide Risk in Chronic Pain

A recent study, Mental Defeat Predicts Increased Suicide Risk in Chronic Pain: A 12-Month Prospective Study, highlights the connection between chronic pain and heightened suicide risk  (Themelis et al., 2025). 

The findings emphasise that mental defeat—the feeling of being trapped and losing autonomy, identity, and control—is a significant risk factor for suicide in chronic pain, with depression intensifying this risk. 

For those living with chronic pain, the emotional and physical toll can be overwhelming. Pain consumes energy and focus, leaving little room to nurture one’s sense of self or hope for the future. This creates a cycle of mental defeat in which the pain can come to feel insurmountable and the individual’s identity is overshadowed by their suffering.

Targeting mental defeat and depression as drivers of suicidality in treatment may help reduce risk and decrease suffering, particularly in the presence of chronic pain. 

You can begin to understand and address these feelings by exploring ways to help individuals regain a sense of agency. Asking reflective questions can open a path for exploration:

• Does it feel like the pain is bigger than you are?
• What does the pain feel like for you?
• What could help you step outside of the pain so it feels less overpowering?

Themelis and colleagues suggest that cognitive-behavioural interventions can be adapted to help frame the pain as something separate from oneself or problem-solving. 

Individuals can gain perspective and develop skills to live meaningfully alongside their pain. This approach focuses not on eliminating the pain but on reclaiming identity and autonomy despite it.