The Connection between Chronic Pain and Depression

Pain is one of the most common problems known to humans. All of us have had a mild twinge here or a sharp pain there. However, for some individuals, the pain never really goes away; rather, it becomes an ever-present part of life. Whether it stems from an injury or a medical condition, such as neuropathy or fibromyalgia, chronic pain makes it hard to work or participate in the activities you once enjoyed. As a result, many individuals with chronic pain end up suffering from depression as well.   

As many as half of those who suffer from chronic pain also struggle with symptoms of depression. Depression negatively impacts a person’s mood, causing symptoms that may include a loss of interest in normal activities, increased irritability, a profound sense of hopelessness, difficulties sleeping, and low energy. It’s a serious disorder that’s also been associated with an increased risk of substance abuse, addiction, and suicide.

How the Conditions Are Linked

The connection between chronic pain and depression is complex, and it’s likely that a number of factors contribute to whether a person with persistent physical pain will develop depression. For example, some individuals are naturally more vulnerable because they have a family history of depression. Substance abuse, including the misuse of prescription painkillers, also heightens the risk for experiencing symptoms of depression. In addition to those risk factors, chronic pain itself raises the chance for depression in the following ways:

Biological Connection

Depression and chronic pain may be linked through proteins called cytokines.  Cytokines serve as chemical messengers that interact with the immune system. Studies suggest cytokine overproduction promotes inflammation, which, in turn, triggers pain.  People who suffer from depression have cytokine levels that are higher than normal. This explains why aches and pains are common in individuals diagnosed with depression. It’s possible this reaction has a reinforcing effect: chronic pain leads to depression, resulting in even more pain, which further exacerbates depression.  Sadly, it can quickly become a vicious circle.

Emotional Connection

Living in constant pain causes a great deal of emotional strain, which increases your vulnerability to depression. For example, chronic pain is isolating, especially if it limits mobility and keeps you confined to your home. When pain makes it impossible for you to work, it’s not uncommon to feel that you’ve lost your sense of purpose or that you’re worthless. It’s sometimes tough to find the energy or motivation to do anything, including essential activities like bathing, attending physical therapy, or keeping up with doctor’s appointments. Another negative emotion that contributes to depression is anxiety. It’s hard to feel positive when you’re constantly worried about what the future holds – for your health, as well as for your life in general.

Relationship problems often play a role in depression as well. Loved ones, such as your spouse or your children, may feel the strain that comes with taking on tasks you’re no longer able to perform. Furthermore, they may not understand what you’re going through. They may even be skeptical of what you’re experiencing, as pain is highly subjective and its presence impossible to prove with blood work or other medical tests. These conflicts trigger negative emotions that can persist for a long time, even after the chronic pain issue has been resolved. If you’re weighed down with stress, anxiety, guilt, anger, or frustration over how a relationship has changed, you’re more vulnerable to depression.

Frustration and feelings of helplessness are also common among those living in constant pain. Like many, you may be frustrated that medical professionals haven’t been able to do more to alleviate the pain. Perhaps every doctor you’ve seen has told you that there are no pain treatment options that will help.  In some cases, you’re left feeling as though you’re consigned to a life filled with pain.

Suicide Risk

While suicide risk is higher in patients dealing with depression, it’s also higher in those suffering with chronic pain. For example, studies suggest fibromyalgia patients have higher rates of suicidal behavior. One study found that nearly 50% have thought about committing suicide. Chronic pain as the result of an injury also increases suicide risk, particularly for those who have been unable to return to work. In addition, research found that unemployed, disabled chronic pain patients were six times more likely to consider suicide. The risk of suicide is a serious concern, making professional treatment vital for both conditions.

Treatment for Chronic Pain & Depression

If you’re suffering from chronic pain and depression, there are several things you can do to improve your situation.

The Connection between Chronic Pain and DepressionTalk to a mental health professional. Psychotherapy, or talk therapy, is an important part of treatment for depression. A psychologist or other mental health therapist can help you identify the negative emotions that play a major role in depression. He or she will then guide you toward thinking about those feelings in new, healthier ways. Some, but not all, cases of depression are treated with antidepressants in addition to therapy. These drugs, which typically take several weeks to begin working, help rebalance the brain’s chemistry to reduce symptoms.  Medication doesn’t help everyone, and often involves trial and error before finding one that works effectively with the least amount of side effects.

Stay connected to others. Depression often causes people to withdraw socially. Feeling lonely or isolated also increases the potential for depression, so it’s essential to stay connected to others. If your mobility is limited by your pain, arrange for friends or loved ones to visit you regularly.  Even if you don’t have local connections, you can still avoid isolation. Regular phone or Skype conversations with those you love can help ease the sense of isolation when distance prevents face to face contact.  Social networks, like Facebook, are a great – and surprisingly easy – way to stay in touch as well. Ask a loved one to help you set up a profile if you’re not tech savvy. Additionally, online forums, like those specifically designed for individuals with chronic pain, are a good place to connect with others who understand the challenges you face.

Exercise regularly. Chronic pain makes working out difficult for some individuals. Yet regular exercise is vital to maintaining both good physical and emotional health. Working out provides stress relief that’s critical for keeping symptoms of depression at bay. In addition, exercise also causes the release of endorphins, which are brain chemicals that naturally improve your mood. Work with your physician or a physical therapist to develop a safe and doable exercise routine.

Seek pain management treatment. You owe it to yourself to have your chronic pain treated by specialists familiar with all treatment options, including the newest therapies. For example, some pain is treatable with medications you might not expect, like antidepressants. Other therapies include pain-blocking injections, electrical stimulation (also called TENS), pain pacemakers, and spinal drug pumps. Managing your pain properly will reduce your risk of depression.

If you struggle with chronic pain and depression, don’t wait to reach out for help. A combination of proper mental health care, pain management, and lifestyle changes can help reduce symptoms so you’re able to live a fuller and happier life.


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