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Depression and Chronic Pain

Living with chronic or long-term pain is a tremendous burden. But when you have chronic pain and depression, the burden gets even heavier.

Depression magnifies pain. It makes it more difficult to cope with everyday living. The good news is that chronic pain and depression are not inseparable. Effective medications and psychotherapy can help relieve the depression and make chronic pain more tolerable.

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Physical pain is a common, but often ignored, symptom of depression. A study published in the journal Psychosomatic Medicine found that two-thirds of people starting treatment for depression also reported being in physical pain. The most commonly cited symptoms were frequent headaches, back pain, joint pain, and abdominal pain. What's the connection between pain and depression? Research shows that the two share common chemical pathways. The brain chemicals serotonin and norepinephrine are known...

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What Is Chronic Pain?

Chronic pain is pain that lasts much longer than would be expected from the original problem or injury. When pain becomes chronic, your body may react in several ways. Chronic pain may be characterized by abnormalities in brain hormone, low energy, mood disorders, muscle pain, and impaired mental and physical performance. Chronic pain worsens as neurochemical changes in your body increase your sensitivity to pain. Then you begin to have pain in other parts of your body that do not normally hurt.

Chronic pain can prevent sleep and cause you to awaken frequently at night. This lack of sleep results in daytime fatigue and low productivity. The ongoing pain will cause additional irritation and make it difficult to deal with others. If you have to care for children or work full time, chronic pain may make your life seem too challenging. The overwhelming feelings can lead to irritability, depression, and even suicide for those who feel no hope for relief is in sight.

What Happens With Chronic Pain and Depression?

If you have chronic pain and depression, you've got plenty of company. Depression is one of the most common psychological issues facing people who suffer from chronic pain, and it often complicates the patient's conditions and treatment. Consider these statistics:

  • According to the American Pain Foundation, about 32 million people in the U.S. report have had pain lasting longer than one year.
  • From one-quarter to more than half of the population that complains of pain to their doctors are depressed.
  • On average, 65% of depressed people also complain of pain.
  • People whose pain limits their independence are especially likely to get depressed.

Because depression in patients with chronic pain frequently goes undiagnosed, it often goes untreated. Pain symptoms and complaints take center stage on most doctor visits. The result is depression -- along with sleep disturbances, loss of appetite, lack of energy, and decreased physical activity, which may make pain much worse.

Is There a Cycle of Depression and Pain?

Pain provokes an emotional response in everyone. If you have pain, you may also have high anxiety, irritability, and agitation. These are very normal feelings when you're hurting. Normally, as pain subsides, so does the stressful response.

But with chronic pain, you may feel constantly tense and stressed. Over time, the constant stress can result in different emotional problems associated with depression. Some of the problems individuals with both chronic pain and depression have include:

  • Altered mood
  • Anger
  • Chronic anxiety
  • Confused thinking
  • Decreased self-esteem
  • Family stress
  • Fatigue
  • Fear of injury
  • Financial concerns
  • Irritability
  • Legal issues
  • Physical deconditioning
  • Reduced sexual activities
  • Sleep disturbances
  • Social isolation
  • Weight gain or loss
  • Work issues

WebMD Medical Reference

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