Study: Treat Depression, Pain Separately
The 2 Conditions Are Often Seen Together but May Work Independently
May 5, 2005 -- Depression often accompanies chronic pain, but the two
conditions may best be treated separately, a study in May's Arthritis &
The study centered on people with fibromyalgia -- a syndrome characterized
by a history of chronic, widespread pain and tenderness to touch. Many of these
patients also may suffer from depression.
"There is an incorrect impression among many doctors that if you treat a
patient's depression, it will make their pain better. Not so," says
researcher Daniel J. Clauw, MD, in a news release.
"If someone has pain and depression, you have to treat both," says
Clauw. He is a rheumatology professor at the University of Michigan and the
director of the University of Michigan's Chronic Pain and Fatigue Research
It's possible that the findings could apply to other patients with chronic
pain conditions, the news release notes. However, the study only looked at
chronic pain and depression with fibromyalgia. They show that brain regions
activated by pain are different from those activated by depression.
Finding From Fibromyalgia Study
Clauw's study tracked depression and pain in 33 women and 20 men diagnosed
with fibromyalgia and 42 people who did not have fibromyalgia.
Researchers scanned participants' brain activity in regions that process
The findings showed that the existence or level of depression in people with
fibromyalgia did not modulate pain sensation. In other words, the magnitude of
pain was only weakly associated with self-reported depression.
"We have seen that if you give antidepressants to the average patient
with fibromyalgia, they'll come back a couple of months later and say, 'My pain
isn't' any better, but I don't feel so sad about it,'" says Clauw in the
"Our research provides further evidence that these pathways are quite
independent," he says.
"Much has been made of the overlap and similarities between pain and
symptoms of depression, but these and other data suggest it is also important
to identify pain processing mechanisms that are independent of mood," write
The study did not involve prescribing antidepressants for participants.
Widespread Problems; Help Is Available
Depression is extremely common in the U.S., affecting nearly 19 million
adults (or 9.5% of the population) per year, says the National Institute of
Mental Health. Not all of those people also have chronic pain.
"Major depressive disorder is often found in conjunction with chronic
pain, with a prevalence of 30%-54% among tertiary care patients," write
Depression can be treated, and chronic pain can be managed. Asking for help
is the first step; resources include doctors and mental health