Depression and Chronic Pain
Why Is There an Overlap Between Depression and Chronic Pain?
Some of the overlap between depression and chronic pain can be explained by biology. Depression and chronic pain share some of the same neurotransmitters -- brain chemicals that act as messengers traveling between nerves. Depression and chronic pain also share some of the same nerve pathways.
The impact of chronic pain on a person's life also contributes to depression. Chronic pain can force you to struggle with tremendous losses, such as the loss of exercise, sleep, social network, relationships, sexual relationships, even a job and income. These losses can make you feel depressed.
Depression then magnifies the pain and reduces your coping skills. While you used to exercise and be active when you felt stressed, with chronic pain you can no longer deal with stress in this manner.
Research has compared people with chronic pain and depression to those who only suffer chronic pain. Those who suffer with both depression and chronic pain report:
- More intense pain
- Less control of their lives
- More unhealthy coping strategies
Because chronic pain and depression are so intertwined, they are often treated together. In fact, some medications can improve both chronic pain and depression.
Is There a "Whole-Life" Approach to Treating Pain and Depression?
Chronic pain and depression can affect a person's entire life. Consequently, an ideal treatment approach addresses all the areas of your life that are affected by chronic pain and depression.
Because of the connection between chronic pain and depression, it makes sense that treatments for these conditions overlap.
How Do Antidepressants Help Both Chronic Pain and Depression?
Because chronic pain and depression involve the same nerves and neurotransmitters, antidepressants are used to treat both chronic pain and depression. Antidepressants work on the brain to reduce the perception of pain.
There is abundant evidence of the effectiveness of tricyclic antidepressants such as Elavil and doxepin. However, because of side effects, their use is often limited. Newer antidepressants known as serotonin and norepinephrine reuptake inhibitors (Cymbalta, Effexor), on the other hand, seem to work well with fewer side effects.
How Can Physical Activity Help Both Chronic Pain and Depression?
Many people with chronic pain avoid exercise. But, if you don't exercise, you get out of shape and have an increased risk of injury and worsened pain. Consult with a physician to design an exercise plan that's safe and effective for you.
Exercise also helps ease depression by releasing the same kind of brain chemicals that antidepressant medications release.
Why Is Taking Control Important for Healing?
Chronic pain affects your ability to live, work, and play the way you're used to. This can change how you see yourself -- sometimes for the worse as you feel victimized by the pain and depression.
Getting busy and taking control of your life is important. Working with a health care provider who refuses to see you as a helpless victim but sees you as a healthy person with pain is important.