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Depression and Chronic Pain

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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.

How Does Talk Therapy Help Chronic Pain and Depression?

Research clearly shows that, for many people, certain kinds of mental training can help improve chronic pain.

Cognitive therapy is one approach. In cognitive therapy, a person learns to notice the negative "automatic thoughts" that surround the experience of chronic pain. These thoughts are often distortions of reality. Cognitive therapy can teach a person how to change these thought patterns and improve the experience of pain.

Cognitive therapy is also a proven treatment for depression and can reduce symptoms of anxiety in those with chronic pain.

What's the Best Way to Manage Chronic Pain and Depression?

The best way to approach managing chronic pain is to team up with a pain specialist or even your family doctor to create a treatment plan. When chronic pain and depression are combined, the need to work with a doctor  is even greater.

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