"It's probably like a web": complex relationships between pain and mental health among bisexual+ women with chronic pain.

Introduction: Bisexual+ women experience higher rates of both mental illness and chronic pain when compared to either straight or lesbian women. Their experiences of the relationship between their mental health and chronic pain remain underexplored. This article presents an intersectional Interpretive Phenomenological Analysis of the experiences of six bisexual+ women with chronic pain. Methods: Each woman completed two semi-structured interviews. Interviews were analyzed with Interpretive Phenomenological Analysis, beginning with in-depth case study analysis of each person's interviews before moving to comparison across cases. Results: Results indicated a complex web of multidirectional relationships between mental health and chronic pain. These relationships were fraught because of the cultural context which often dismisses women's pain as "in their heads". Pain could worsen mental health but also offer insights. Mental unwellness could worsen participants' ability to care for their pain. Sociocultural stressors, trauma, and relationship stress were described as worsening both mental health and chronic pain. Emotional release could sometimes help with pain relief. Discussion: Results are discussed in the context of minority stress and embodiment frameworks. Chronic pain can be a manifestation of minority stress in the bodies of bisexual+ women with chronic pain, and bisexual+ women themselves feel and identify these links between sociocultural stressors and pain. Participants highlight the importance of believing bisexual+ women with chronic pain, as well as the need for both holistic medical care and social change.