Pain Management: Chronic Pain and Depression

Depression is one of the most common problems experienced by people with chronic pain. It is no wonder -- chronic pain can significantly affect a person's quality of life.

If symptoms of depression are related to pain or side effects of a medicine, doctors can make adjustments in medications to alleviate these symptoms. If the depression is a separate problem, it can be treated on its own.

Treating Pain and Depression

Most people with depression can be treated successfully with medicine, psychotherapy, or a combination of both.

Antidepressant Therapy

In addition to being a primary treatment for depression, some antidepressants are effective in the treatment of many chronic pain syndromes, such as nerve-related pain disorders (for example, pinched nerves, or sciatica, or herniated disks).

Antidepressant drugs work by altering the functioning of brain regions that are controlled by chemicals in the brain called neurotransmitters, which are responsible for transferring messages between brain cells. One particular brain chemical messenger that seems to play a role in both depression and pain is norepinephrine.

Some antidepressants include:

 

  • amitriptyline (Elavil)
  • desipramine (Norpramin)
  • venlafaxine (Effexor)
  • bupropion (Wellbutrin)
  • duloxetine (Cymbalta)

 

Psychotherapy

Psychotherapy, sometimes also called talk therapy, refers to a variety of techniques used to treat depression. Psychotherapy involves talking to a licensed professional who helps the depressed person:

  • Focus on the behaviors, emotions, and ideas that contribute to depression
  • Understand and identify the life problems or events, such as a major illness, a death in the family, a loss of a job, or a divorce, that contribute to depression, and help them understand which aspects of those problems they may be able to solve or improve
  • Regain a sense of control and pleasure in life

Early Treatment Is Best

Early diagnosis and treatment for depression can help reduce distress, as well as the risk of complications and suicide. People who get treatment for depression that occurs at the same time as chronic pain often experience an improvement in their overall medical condition, a better quality of life, and are more easily able to stick to their treatment plans.

WebMD Medical Reference Reviewed by Joseph Goldberg, MD on April 19, 2019

Sources

SOURCE: Mayo Clinic.

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