Treating Chronic Pain and Depression: A "Whole-Life" Approach
Chronic pain and depression can affect a person's entire life. Consequently, an ideal treatment approach addresses all the areas of one's life affected by chronic pain and depression.
Because of the connection between chronic pain and depression, it makes sense that their treatments overlap.
The fact that chronic pain and depression involve the same nerves and neurotransmitters means that antidepressants can be used to improve both chronic pain and depression.
"People hate to hear, 'it's all in your head.' But the reality is, the experience of pain is in your head," says Feinberg. "Antidepressants work on the brain to reduce the perception of pain."
Tricyclic antidepressants have abundant evidence of effectiveness. However, because of side effects, their use is often limited. Some newer antidepressants are prescribed by doctors to treat certain painful chronic syndromes and seem to work well, with fewer side effects.
Many people with chronic pain avoid exercise. "They can't differentiate chronic pain from the 'good hurt' of exercise," says Feinberg. But, the less you do, the more out of shape you become. That means you have a higher risk of injury and worsened pain.
The key is to break this cycle. "We now know that gentle, regular physical activity is a crucial part of managing chronic pain," says Thorn. Everyone with chronic pain can and should do some kind of exercise. Consult with a physician to design an exercise plan that's safe and effective for you.
Exercise is also proven to help depression. "Physical activity releases the same kind of brain chemicals that antidepressant medications release -- [it's] a natural antidepressant," says Thorn.
Mental and Spiritual Health
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.
"When somebody begins to take on the identity of a 'disabled chronic pain patient,' there is a real concern that they have sunk into the pain and become a victim," says Thorn.
Fighting this process is a critical aspect of treatment. "People with chronic pain end up sitting around," which leads to feeling passive, says Feinberg. "The best thing is for people to get busy, take control."
Working with a health care provider who refuses to see you as a helpless victim is part of the formula for success. The goal is to replace the victim identity with one of a "well person with pain," according to Thorn.
Treating Chronic Pain and Depression: Cognitive Therapy for Chronic Pain
Is there such a thing as "mind over matter"? Can you "think" your way out of feeling pain?
It may be hard to believe, but research clearly shows that for ordinary people, certain kinds of mental training truly improve chronic pain.