If you have a psychiatric problem, you are in pain. It’s not the pain of a medical illness, but it’s still real. Depression is an awful pain. You feel hopeless and helpless and don’t find pleasure in things.
Anxiety is it’s own kind of pain. For instance, in Generalized Anxiety Disorder (GAD), there’s ALWAYS something to be worried about. GAD is a never ending preoccupation.
While GAD or depression can produce a self centeredness that can push people away, consider the world of Personality Disorders. These folks, by definition, are preoccupied with themselves in unique and, often self destructive ways. They feel pathologically special. Even those who look socially competent, like The Narcissistic Personality Disorder, are really alone.
Their pain pushes them to use people rather than care about them. It’s a lonely way to be.
The origins of such pain is often trauma, or a constitutional sensitivity to rejection or anger – or both. Many people with Personality Disorders are easily triggered, and have evolved a set of defensives designed to keep themselves from pain.
It is exhausting; for them and those close to them.