Depression and Pain: Are They Linked?
The short answer is yes! Depression and pain
are most definitely linked, so if you suspected this, then you are correct! Being depressed can give you various pains, most often in the form of headaches or backaches, and having chronic pain is depressing and can lead to a psychiatric diagnosis. Pain also can cause you to suffer sleep disturbance, appetite changes, and stress, which can further exasperate any depression. So yes, pain is depressing, and depression can cause pain.
We know that people with chronic pain are 3x the average person to develop a psychiatric disorder, usually depression or anxiety. Conversely, we also know that people with depression are 3x as likely to develop some chronic pain. People with multiple sites of pain are 3 to 5x more likely to be depressed than those who do not have pain. The association between depression and pain becomes even stronger as the severity of either increases, so those who experience more pain have an increased likelihood of having depression, and those with more severe depression are more likely to also complain of pain as a symptom.
It is notable when talking about depression and pain that both utilize some of the same neural pathways, including in the limbic region of the brain. Pain messages are brought to the brain where they are divided and sent to both the hypothalamus, where stress hormones are released, and to the limbic system, which processes the emotional and motivational responses to pain. It is here that pain and emotions seem to mostly be linked. Plus, some of the same neurotransmitters are implicated in pain and in depression, namely serotonin and norepinephrine.
When something is off-kilter in this area of the brain, it will result in increased feelings of pain, as well as feelings of sadness, anxiety, and hopelessness. As I’m sure you are aware, these are some of the most common symptoms of depression. Chronic pain, like chronic depression, can alter the way the brain and nervous system function and can serve to increase the pain or depression that you feel, thus perpetuating continued pain and depression.
How to Stop the Cycle of Pain and Depression
For the purposes of this blog, we will look at 3 different ways to treat chronic pain and depression: medications, stress reduction and talk therapy.
1. Medications. Since the opioid crisis, doctors are reluctant to prescribe these as much as they used to be. Now, many of the medications that they use to treat pain are the same meds they use to treat depression. This includes SSRIs, benzodiazepines, anticonvulsants, and mood stabilizers. They work on the brain pathways that regulate mood and the perception of pain, and so they can work to treat both pain and depression. Even ECT or electroconvulsive therapy, which is used to treat severe depression, has been shown to have an analgesic effect.
2. Stress reduction techniques. This includes things such as yoga, meditation, physical activity, exercise, journaling, going out in nature, deep breathing, massage, etc. These types of activities have been shown to be helpful when coping with depression because a stressful situation can trigger depression, and depression can make it harder to cope with stress. Pain also is made worse with stress. This is because stress can cause increased muscle tension, which increases pain. Stress also will increase the cortisol that is released which will cause increased inflammation over time, and the increased inflammation will cause increased pain.
3. Pain rehabilitation programs. Especially ones that take into consideration both the medical and the psychological aspects of the pain.
If you’ve ever wondered if your pain and depression are related, then your beliefs were correct. Pain and depression are interconnected in the brain and because of this, many of the same techniques can be used to help both. If you would like to talk more about this, or receive information about counseling for depression treatment or for coping with pain, please follow the link! I’d love to talk with you.