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Chronic Pain And Depression

Pain is an unpleasant sensation that plays an important function in our lives.

When you suffer an acute injury, pain warns you to stop the activity that causes the injury and informs you to take care of the affected body part.

Chronic pain, on the other hand has no time limit, and often has no apparent cause and serves no apparent biological purpose. Some people, often older adults, suffer from chronic pain without any definable past injury or signs of body damage. Common chronic pain can be caused by headaches, the lower back, and arthritis and sometimes there is little evidence to explain such pain.  Emerging scientific evidence is demonstrating that the nerves in the spinal cord of patients with chronic pain can undergo structural changes.

Emotional and social issues often magnify the effects of chronic pain. People with chronic pain frequently report a wide range of limitations in family and social roles, like the inability to perform household or workplace chores, take care of children, or engage in social activities. In turn, spouses, children, and co-workers often have to take over these responsibilities. These changes often lead to depression, anxiety, resentment, and anger for the pain patient and can lead to stress and strain in family and other social relationships.

How is depression linked with chronic pain?

Depression is the most common emotion connected with chronic pain. It is found 3 to 4 times more in people with chronic pain than in the general population. The combination of chronic pain with depression is often associated with greater disability than either depression or chronic pain alone.

People with chronic pain and depression suffer vivid changes in their physical, mental, and social well-being — and in their quality of life. Such people often find it difficult to sleep, are easily agitated, cannot perform their normal activities of daily living, cannot concentrate, and are often unable to perform their duties at work and at home. These changes to quality of life starts a vicious cycle — pain leads to more depression, which leads to more chronic pain. In some cases, the depression occurs before the pain.

Signs and Symptoms

Some of the common signs and symptoms of chronic pain include:

  • Pain beyond 6 months after an injury
  • Pain from stimuli which are not normally painful (Allodynia)
  • Increased pain from stimuli that are normally painful (Hyperpathia)
  • Being overly sensitive to pain (Hypersensation)

Signs of major clinical depression will usually occur daily for 2 weeks or more, and often include many of the following:

  • A feeling of sadness; feeling blue, hopeless, or irritable, often with crying spells
  • Changes in appetite or weight (loss or gain) and/or sleep (too much or too little)
  • Poor concentration or memory
  • Feeling restless or exhausted
  • Loss of interest or pleasure in usual activities, including sex
  • Feeling of worthlessness and/or guilt

What treatments are there for chronic pain and depression?

The first step in coping with chronic pain is to verify its cause, if possible. Addressing the problem will help the pain subside. In other cases, especially when the pain is chronic, you should try to keep the chronic pain from being the entire focus of your life.

  • Stay active and do not avoid activities that cause pain simply because they cause pain. The amount and type of activity should be directed by your doctor, so that activities that might actually cause more harm are avoided.
  • Distraction (redirecting your attention away from chronic pain), imagery and dissociation (detaching yourself from the chronic pain) can be useful.
  • Relaxation training, hypnosis, yoga and meditation can help you cope with chronic pain. Cognitive therapy can also help patients recognise destructive patterns of emotion and behavior and help them modify or replace such behaviors and thoughts with more reasonable or supportive ones.

Involving your family and friends may be helpful with your recovery.