If you suffer from chronic pain, you are not alone: there are an estimated 1.5 billion chronic pain sufferers worldwide. In the United States alone, there are an estimated 100 million people—that’s about one in every three Americans—dealing with recurring pain.

The most common complaints? Low back pain leads the pack, followed closely by migraines, headaches, joint pain and stiffness. Arizona-based chronic pain specialist David Tom, M.D. is no stranger to this reality. In many ways, Dr. Tom—a triple-board-certified physician in internal medicine, anesthesiology, and pain medicine—is the medical version of a mystery novel detective: he collects evidence, questions the sources, and studies the myriad pathways in the body that cause of pain so he can address it. By the time a patient walks into his office, they’ve been through everything and seen everyone—chiropractors, multiple specialists—or even had major surgery (sometimes several). In other words, they’re at the end of their rope.

Dr. Tom says that what causes pain can be as diverse as the people he sees, and while there is no single, permanent cure for chronic pain, one thing can make a big difference: resilience.

“It’s vital to the process,” he explains. “I’ve seen patients who, under the circumstances, might want to just give up, but they don’t. In fact, they thrive. Their resilience helps them cope and keep moving forward to find a solution. They say, ‘I’m going to make it no matter what.’”

So what makes a pain sufferer more resilient? Here are four of the hallmarks Dr. Tom has observed that separate the patients who suffer from those who thrive:

1. They may experience depression and anxiety—but they address it
It’s common for those who suffer pain to become depressed or anxious, but the reverse is also true: Those who struggle with depression and anxiety can also experience physical pain. “It’s been clearly demonstrated that someone whose depression or anxiety is not controlled also has a hard time managing pain,” he says.

Dr. Tom makes sure his patients receive treatment for their depression and anxiety concurrently with any other treatment, because mood and mindset can undermine any treatment.

TRY THIS: Seek professional support for any unmanaged mood disorders that are making life feel a lot harder than it should be, particularly if you’re coping with chronic pain. Check out the meQuilibrium Ease Your Chronic Pain skill for more on the stress/pain cycle and what you can do about it.

2. They maintain a strong social network
Without question, patients who have strong relationships with family or friends (ideally both!) have a far easier time coping with physical symptoms. These relationships are key determiners of your quality of life; cultivating them is critical to coping with not just pain, but anything that threatens to throw you off physically, mentally, or emotionally.

TRY THIS: Don’t be a hero! Reach out and let the people in your life know what’s going on with you—and how they can help. At the same time, find ways to be there for them. Being a support for them can help alleviate the fear you may have of being a burden, and helps you fight the feelings of isolation that pain can create.

3. They see movement as medicine
Depending on the severity of your condition, you may not be able to exercise with the intensity that you used to or want to. But if you’ve been avoiding exercise altogether, it’s time to start.

“We used to put patients on bed rest for pain. Not anymore,” says Dr. Tom. “Staying physically active is critical for pain management, as it releases endorphins which can improve your mood and even ease pain.” People who don’t move can get tight muscles, joint pain, muscle strain and spasms, which can worsen existing pain.

TRY THIS: First, check in with your physician. If they clear you for exercise, set a goal to move every day—even if it’s as simple as going for a walk or a swim, and do some gentle stretching. This is one of the best things you can do to manage pain. Start small and slow, and maintain consistency so that you can experience real, long-lasting benefits.

4. They don’t overidentify with their pain
Identifying the source of your pain is one thing. But identifying with or as your pain is something else altogether. This is one of the most harmful ways that pain takes hold, says Dr. Tom: It’s easy to start to think, “This is me, this is who I am,” but that’s a slippery slope to depression and anxiety and does nothing to address the pain itself. Keep in mind that pain is something that happens to you; it is not who you are.

In addition, in our the age of symptom-Googling, it’s tempting to self-diagnose. A little bit of knowledge, as they say, is a dangerous thing, and it can give you a false sense of control over your pain or what makes you tick. Be wary of jumping to conclusions about who you are and what’s possible.

TRY THIS: Bear in mind that your brain can determine how you experience pain, and be mindful of what you tell yourself about it.

One thing to remember is that your body is always changing. Don’t assume that because someone once said you were out alignment that you need to, say, be perfectly symmetrical to oust your pain. (By the way, according to Dr. Tom, no one is perfectly symmetrical. It’s not a thing.)

The most resilient, thriving patients are those who acknowledge that they have pain but accept that their lives can go on in spite of it, who believe that they can surprise themselves, and who know that anything is possible.

Terri Trespicio is a New York–based lifestyle writer. For nearly a decade, she served as a senior editor and radio host at Martha Stewart Living Omnimedia. Her work has appeared in Jezebel, XOJane, Marie Claire, Prevention, MindBodyGreen, and DailyWorth. Find her on Twitter @TerriT