The brain is a complex system that processes and responds to enormous amounts of input. Information is received through all of our senses- hearing, sight, taste, touch and smell- and transmitted to the brain through an intricate network of nerves and neurotransmitters.
Neurotransmitters act as chemical messengers in the body to relay messages between neurons or from neurons to muscles. There are about a dozen known small-molecule neurotransmitters and more than 100 different neuropeptides. A subset of neurotransmitters that are intricately linked can develop dysfunctional patterns that contribute to pain, fatigue, and mood disturbances like anxiety and depression.
Neurotransmitters have an especially strong impact on mood, behavior and the perception of sensations such as pain. The most significant ones in pain and fatigue are noradrenaline, serotonin, dopamine, substance P, and glutamate (more on each of these below). These neurotransmitters are directly or indirectly linked to a couple of pathways that are involved in stress, fatigue, and pain.
Neurotransmitters impact mood and pain
Each neurotransmitter has a unique function that activates, inhibits, or changes pathways that communicate with the rest of the body. Many of the medications currently prescribed for depression, anxiety, and pain act to regulate these neurotransmitters that become dysregulated when we develop unhealthy habits.
Healthy habits can modify these pathways
By changing our habits we can actually affect the regulation of these pathways to re-establish healthy firing patterns. Recent studies have shown that practices such as positive thinking, meditation, mindfulness, and gratitude can actually rewire the brain, in part through regulating neurotransmitter release. This means that a daily mindset practice can actually change how we process and interpret our experiences.
1. Noradrenaline
Noradrenaline , also known as norepinephrine, is the primary activator of the sympathetic nervous system and the key neurotransmitter in the fight or flight response. When you come across that mountain lion in the woods, noradrenaline is what’s responsible for increasing your heart rate and blood pressure, and mobilizing blood glucose and fatty acids for fuel.
Studies have found that noradrenaline is also important in modulating the immune system and regulating pain inhibitory pathways. Noradrenaline release is increased in chronic stress states through sensitized noradrenergic neurons, leading to increased excitability of the autonomic nervous system and hypothalamic-pituitary-adrenal axis.
2. Serotonin
Serotonin is known to have a wide variety of functions and is sometimes called the “happy chemical” because of the role it plays in happiness and wellbeing. Serotonin is integral to many bodily functions including mood, social behavior, appetite, digestion, sleep, memory and sexual function. In the brain, serotonin regulates mood, anxiety, and happiness. More recent studies have shown that it also provides inhibitory influence for pain sensation through descending pain pathways.
3. Dopamine
Dopamine is known especially for its role in the motivational component of reward-motivated behavior. It also plays a role in executive function, motor control, motivation, arousal and reinforcement. CSF levels of dopamine and presynaptic dopamine function are reduced in chronic pain states.
4. Glutamate
Glutamate is the main excitatory neurotransmitter in the central nervous system, which means it activates nearby nerve cells. Accumulating evidence suggests that it plays an integral role in communicating pain signals from the periphery to the brain. Lower levels of glutamate appear to be beneficial to reducing pain states.
5. Substance P
Substance P is a neuropeptide that plays an important role in the detection of pain. It co-exists with glutamate, an excitatory neurotransmitter involved in pain signaling. When a painful trigger is experienced, substance P excites or activates nearby nerves located in the spinal cord. Substance P is dysregulated in chronic pain states and increased in response to chronic stress.
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