A Pill for Emotional Pain

The over-the-counter (OTC) painkillers you buy at your local drug store without even thinking about them appear to do more than just kill your back pain or bring down a fever — they may actually improve your mood. A review study that looked back over previous research on pain medications like acetaminophen (Tylenol) and ibuprofen (Advil) has found that these drugs, on the shelves of most medicine cabinets, blur the boundary between physical and psychological processes.

After sifting through all the evidence, researchers report that in addition to easing headaches and sore muscles, painkillers have an effect on our emotions and our thoughts.

In one study the authors examined, people were assigned to take either acetaminophen or placebo pills in the morning and at bedtime for three weeks. Every night they filled out questionnaires designed to measure “hurt feelings” and positive emotions. About a week into the study, the people who were taking acetaminophen started reporting significantly fewer hurt or negative feelings than the placebo group did. There was no difference between the two groups when it came to experiencing positive emotions. This may be because acetaminophen dulls the intensity of a our feelings about others more than our feelings about ourselves.

This reduced emotional connection to others also seemed to lower a person’s level of empathy. People taking painkillers were less distressed emotionally and less concerned about a person in a story who was experiencing either emotional or physical pain.

Consumers expect an over-the-counter pain medication to relieve their physical symptoms. What they don't anticipate are painkillers' broader psychological effects.

Another study revealed that women's memories of past betrayals became less painful after they took ibuprofen, compared to women who took a placebo. The same connection wasn’t found in men — in fact, it was the opposite for them. It’s not totally clear why this gender difference exists, but the team suggests it may be that while the medications dulled the women’s emotional pain, “men responded in the opposite manner because the drugs disrupted their default tendency to suppress emotional pain.” More work will definitely need to be done to understand this gender divide more fully.

Painkillers may even make you more generous or at least a little less grasping. When men and women took acetaminophen and were asked how much money they’d need to part with an object, they asked for less money in compensation, again compared to those who took placebo. This seems to suggest that the emotional value of an object may also be reduced when people take acetaminophen.

Taking a pill for pain may not be too helpful when it comes to performing certain tasks well, however. Compared to those who were given a placebo instead of a painkiller, people who took acetaminophen made more errors playing a game requiring them, on command, to perform or refrain from performing a task quickly.

“In many ways, the reviewed findings are alarming,” the authors write. “Consumers assume that when they take an over-the-counter pain medication, it will relieve their physical symptoms, but they do not anticipate broader psychological effects.”

Why would painkillers alter or reduce emotional pain in addition to physical pain? The authors point to a study that monitored what’s happening in the brain: Participants played a game in the lab that asked two players to exclude the third. The excluded participants’ brains were scanned during this time, and it turned out that one area of the brain was more active as they experienced the pain of rejection — the same area that’s active when we’re experiencing physical pain. So it may be that physical and emotional pain are in some ways one and the same, neurologically speaking.

About a week into the study, the acetaminophen group starting reporting significantly fewer hurt feelings.

“[T]his brain imaging work,” the University of California, Santa Barbara team writes, “provided empirical evidence that metaphors linking physical and social pain (e.g., feeling ‘stabbed in the back’ when one is betrayed by a friend) may be rooted in overlapping biological processes.”

It may also explain why a broken heart really feels like your heart is actually breaking.

It’s not clear whether there are any larger or longer-term emotional or cognitive effects from taking OTC painkillers. But despite the possibility that they could offer some relief from emotional pain, it’s probably best to take them as sparingly as you can anyway, since over time they can damage your body.

The study is published in Policy Insights from the Behavioral and Brain Sciences.