Friday, March 22, 2024

Can Chronic Pain Cause Depression

How Does Physical Pain Affect Mental Health

Depression and Chronic Pain | Kati Morton

As with most mental health conditions, depression is not just one sided.

An articlefrom Harvard Medical School notes that Pain, especially chronic pain, is an emotional condition as well as a physical sensation.

In one of the best, most accurate explanations of the depression-pain connection, the author writes:

In those ways, it resembles depression, and the relationship is intimate. Pain is depressing, and depression causes and intensifies pain. People with chronic pain have three times the average risk of developing psychiatric symptomsusually mood or anxiety disordersand depressed patients have three times the average risk of developing chronic pain.

Chronic Pain And Mental Health

The responsive chemical and physical changes of the brain can have serious impacts on specific functions of the brain. This deeply affects the mental health of chronic pain patients.

Pain and Emotions

Pain is inextricably linked to emotions. In fact, physical pain and emotional pain exist on almost the same circuitry of the nervous system, with common brain systems involved.

For this reason, its not surprising that the presence of chronic pain is often associated with emotional changes.

Chronic Pain and Anxiety

Anxiety associated with chronic pain is real.

As a stressor, the natural response is to escape or flee the pain. However, with chronic pain, this is often not possible.

Even in times where the pain is not present, chronic pain sufferers may experience anxiety surrounding the return of the pain. This anxiety can be crippling and detrimental to the quality of life.

Chronic Pain and Depression

The link between chronic pain and depression is strong, but its not well understood by psychologists.

Some researchers believe this depression as a result of pain may be programmed into our wiring evolutionally. Contextually, it makes sense. Withdrawing from society provides the body with a peaceful environment that is needed to heal. It also creates a safe place away from stressors and possible threats.

However, chronic pain makes this difficult because the threat is internal, not external. The result can be chronic, nagging depression that seemingly has no end.

Who Are At Risk For Depression

No one is immune to depression. The following people would be slightly more at risk.

  • People with a family or personal history of depression.
  • People who take certain medications , such as psychostimulants, steroids, corticosteroids, anabolics, anticonvulsants, or the birth control pill. This is because the progestins in the birth control pill can affect your mood 3 . If so, discuss it with your doctor.

From a sociological point of view, the following groups are more affected by depression.

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Can Therapy Help With Chronic Pain

Certain therapies may help you manage chronic pain, including:

  • Cognitive-behavioral therapy : This counseling method helps you think differently about pain and teaches you ways to cope.
  • Counseling: Talk therapy can help you manage chronic pain, especially psychogenic pain.
  • Occupational therapy: Occupational therapy teaches you how to do everyday tasks differently to lessen pain or avoid injury.
  • Physical therapy: Physical therapy involves exercises that stretch and strengthen your body, which can help reduce your pain.

Treating Chronic Pain And Depression

CAUSATIVE FACTORS OF CLINICAL DEPRESSION  Tunnyvmag

While many treatment approaches focus on alleviating the symptoms of individual diseases or eradicating their underlying causes, some leverage the shared pathways to treat both. Here are the treatments that improve the symptoms of both depression and chronic pain.

Get the most suitable antidepressants prescribed online. Click the button below to book the same-day appointment.

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How Can Physical Activity Help

Many people with chronic pain avoid exercise. But you can get out of shape and have more risk of injury and more pain. Talk with your doctor to design an exercise plan that’s safe and effective for you.

Trips to the gym also help ease depression by releasing the same kind of brain chemicals that antidepressant medications are thought to affect.

Hurting Bodies And Suffering Minds Often Require The Same Treatment

Pain, especially chronic pain, is an emotional condition as well as a physical sensation. It is a complex experience that affects thought, mood, and behavior and can lead to isolation, immobility, and drug dependence.

In those ways, it resembles depression, and the relationship is intimate. Pain is depressing, and depression causes and intensifies pain. People with chronic pain have three times the average risk of developing psychiatric symptoms usually mood or anxiety disorders and depressed patients have three times the average risk of developing chronic pain.

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Ways To Take Control Of Your Depression And Chronic Pain

Depression is an overlooked cause of pain. When both conditions occur together, they can wreak havoc on body and mind.

After having her third child and going back to work full-time, Debbie Norris began feeling sad and overwhelmed by her responsibilities as a mother and a psychologist in Washington, DC. One day she woke up with severe muscle pain all over her body. She couldn’t lift her infant son, open a door, or even hold a book, and the pain kept her up at night. After 8 months, Norris was finally diagnosed with fibromyalgia, a condition affecting the muscles and joints. By then, she felt hopeless. “The doctor suggested I get a wheelchair while I could still walk,” she says. “That was an all-time low.”

That wasn’t the worst of it. As her pain persisted, her mood darkened further. Two years later, she was diagnosed againthis time with major depression. Norris had become one of the thousands of people whose twin afflictionschronic pain and depressionare so intertwined they don’t know where one begins and the other ends.

As many people with chronic pain attest, it’s easy for the condition to wear you down. What has become increasingly clear is that the converse is also true: A declining mental health state can lead to chronic pain.

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Pain and depression can be so intertwined that people who are dealing with both don’t know where one begins and the other ends.

Chronic Pain Can Be Both Emotional And Physical And It’s Often Difficult To Determine Which Came Firstthe Pain Or The Depression

Chronic Pain and Depression

Chronic pain is a term used to describe pain that lasts beyond the typical time it takes for an illness or injury to heal. Sometimes chronic pain is also described as pain that lasts longer than three months. Research suggests that anywhere from 30 to 50% of people with chronic pain also struggle with or .¹

Chronic pain isnt just a physical conditionits an emotional one as well that has tremendous influence over a persons thoughts and moods. People with chronic pain may isolate from others or be unable to achieve mobility they once had. Chronic pain isnt just associated with physical injuries either, as it can stem from conditions like heart disease, arthritis, migraines, or diabetes.

Sometimes it can be difficult to assess whether chronic pain has led to depression, or vice versa. People with chronic pain are three times more likely to develop symptoms of depression or anxiety, and people with depression are three times as likely to develop chronic pain.² Depression frequently can cause unexplained pain, such as headaches or back pain, and people who are depressed might struggle to improve or maintain physical health. In turn, chronic pain can lead to trouble sleeping, increased stress, or feelings of guilt or worthlessness associated with depression. These influences can create a cycle that is hard to break.

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How To Treat Chronic Pain Safely Without Drugs

Prescription pain pills work very quickly to block pain messaging. This has become the preferred method of treating people who suffer from chronic pain. For some people, though, pain pills can swiftly lead to addiction. For this reason, people in recovery must avoid these meds if possible.

So what are some methods to manage chronic pain without the use of drugs? Here are some drug-free options:

NSAIDS.

These are anti-inflammatory drugs, such as Aleve and Advil that help manage pain.

OTC meds.

A recent study published in JAMA showed that ibuprofen and acetaminophen were used to treat severe pain. Within an emergency department setting, these were compared to three opioids. The study found that the OTC drugs worked just as well as the opioids to reduce the pain levels.

Chiropractic.

When our spine is out of alignment it can cause many types of pain. Getting routine adjustments can help reduce pressure on certain pain points.

Massage.

Using massage can help reduce stress, muscle tension, and toxins. The soft tissue massage will help someone who suffers from chronic pain by releasing the tension in the body.

Acupuncture.

Physical Therapy.

Certain movements are designed by a physical therapist to help stretch and tone muscle groups. This can relieve pain in the problem areas.

Herbal Supplements.

There are a slew of herbal remedies to help manage chronic pain. These include:

Water Exercise.

Meditation.

What Medications Can Treat Chronic Pain

Your healthcare provider may recommend certain medications to relieve chronic pain, including:

  • Anticonvulsants for nerve pain.
  • Antidepressants such as tricyclic antidepressants.
  • Muscle relaxers.
  • Nonsteroidal anti-inflammatory drugs or acetaminophen.
  • Topical products that contain pain relievers or ingredients that create soothing heat or cold.
  • Opioids . Opioids can be addictive, and you can build up a tolerance to them over time. Because of this, healthcare providers usually try other pain treatment options before prescribing opioids.
  • Sedatives to help with anxiety or insomnia.
  • Medical marijuana.

Other medical treatments your healthcare provider may have you try include:

  • Transcutaneous electrical nerve stimulation : This procedure delivers small shocks through patches on your skin. The electrical impulses can relieve pain.
  • Nerve blocks: For this treatment, your healthcare provider injects an anesthetic near the site of your pain to reduce feeling in the area. Nerve blocks can also sometimes provide diagnostic information and locate the source of your pain.
  • Epidural steroid injections: This procedure is an injection of anti-inflammatory medicine a steroid or corticosteroid into the space around your spinal nerves known as the epidural space to treat chronic pain caused by irritation and inflammation of spinal nerve roots.

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Chronic Pain Can Be A Cause Of Depression

Chronic pain is a term that describes pain that lasts longer than three months. Sometimes, it also refers to pain that persists beyond the typical time for an illness or injury to heal. Chronic pain isnt just a physical condition. Its also an emotional one that has a huge influence on a persons thoughts and mood. There is a close link between chronic pain and depression, in which chronic pain can cause depression and vice versa. According to recent studies, about 30-50% of people with chronic pain struggle with depression or anxiety. Chronic pain usually aggravates the symptoms of depression, then the subsequent depression makes the pain worse, resulting in a vicious cycle.

Science Shows That Treating These Two Conditions Together Can Bring Relief

Depression and chronic pain in the elderly: links and management chall ...

by Michelle Crouch, AARP, March 4, 2019

Getty Images

En español | When you are suffering from constant pain, it interferes with your sleep, your daily function and your ability to do the things you enjoy so perhaps its not surprising that chronic pain can cause depression.

But the opposite is also true: If youre depressed, you are at higher risk of developing chronic pain.

In one study published in the Archives of General Psychiatry, researchers looked at data from 18,980 people and discovered that 43 percent of those with major depression also suffered from chronic pain, compared with only 17 percent of those who werent depressed.

Its only in recent years that scientists have started to realize just how tightly depression and chronic pain are intertwined, says internist Kurt Kroenke, a professor and pain researcher at Indiana University. If you have one, it is quite common to suffer from the other, he says. It can be hard to know where one begins and the other ends.

About 30 to 50 percent of those with chronic pain also have depression, he says.

Not long ago, Vera Schtakleff, 81, of Torrance, Calif., was one of them. A failed surgery had left her with an aching knee, and arthritis caused pain to radiate into her back when she walked. What’s more, the physical demands of caring for her ailing husband made her back pain worse, with the pain only becoming more severe, she says, after her husband died eight years ago.

Getty Images

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Can Depression Cause Physical Pain

Depression and chronic pain have a common pathophysiological pathway that points to the overlap of their symptoms and close relationship. Both involve the dysregulation of certain brain chemicals and increased central nervous system stimulation. Researchers have identified up to six regions of the brain involved in both chronic pain processing and depression pathogenesis.

Many people diagnosed with depression have unexplained symptoms of physical pain. Vague aches often associated with clinical depression include back pain, stomach upset, and limb or joint pain that often occur together with tiredness and psychomotor activity changes.

Psychogenic pain, in which your brain perceives pain without a physical cause, might also occur with depression. Typically, the pain lingers even after the removal of the damaging agent.

The impact of chronic pain on ones life can contribute to mental health issues such as depression and anxiety. Long-standing back pain, for instance, might force you into a change of jobs or problems in romantic relationships. Disruptions of such magnitude can cause or worsen depression.

When Chronic Pain And Mental Health Collide: Symptoms Causes Diagnosis

A complicated series of reactions explains the connection between emotional and physical pain. For example, the cycle of pain and mental health issues changes your stress hormones and brain chemicals, including cortisol, serotonin, and norepinephrine. ¹As pain moves from being acute to chronic, the number of areas affected in the brain actually expands, Dr. Buday says.

Chronic pain can change how the brain processes pain signals, like wires that become crossed. Something similar happens in the brain with depression, Dr. Rajneesh adds.

Mental health issues and chronic pain are like a double-edged sword. Anxiety can make a person more sensitive to their feelings of pain or catastrophize their pain. Pain can be isolating, and isolation can worsen feelings of depressiontheres that double-edged sword again.

For people who are catastrophizing, there are three elements at work, according to Dr. Buday: Magnification, or a feeling of something being very overwhelming in a persons life rumination, or spending a lot of time thinking about the pain to the point of not being able to think about other things and feeling unable to control the situation. Catastrophizing magnifies the distress and the physical limitations associated with chronic pain above and beyond what they should be.

Symptoms of depression include:²

Feelings of sadness or hopelessness

Feelings of guilt or worthlessness

Losing interest in hobbies and activities

Gaining or losing weight

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What Is The Prognosis For People With Chronic Pain

Chronic pain usually doesnt go away, but you can manage it with a combination of strategies that work for you. Current chronic pain treatments can reduce a persons pain score by about 30%.

Researchers continue to study pain disorders. Advances in neuroscience and a better understanding of the human body should lead to more effective treatments.

If you have chronic pain and depression and/or anxiety, its important to seek treatment for your mental health. Untreated depression and anxiety can make your pain worse and further lower your quality of life.

Assemble A Treatment Team

Back Injury, Chronic Pain, Depression, and Despair

For starters: A pain specialist, therapist, physical therapist, and psychiatrist. These are all folks that are good to have on your team.

A pain specialist can help you better understand where your pain symptoms are coming from. A therapist can help you develop coping skills to live your life with minimal interruption. A physical therapist can help you work on exercises that reduce your pain. A psychiatrist can prescribe medications that you may need for depression.

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Blues Qs: Can Depression Cause Chronic Pain

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Blues Qs is an advice column covering all things clinical depression, written by Bezzy Depression community guide Sam Dylan Finch. Diagnosed with clinical depression over a decade ago, Sam has seen it all â from medication mishaps to grippy sock âstaycations.â Heâs here to help you navigate your own depression journey with a little humor and a lot of heart.

I donât know about you, but for me, depression is a pain in the neck. And I mean that literally â many times when Iâve been experiencing a depressive episode, itâs been accompanied by chronic, unexplained pain.

I used to think this was just âin my head.â That is until I read about our âfight or flightâ response.

Acute stress, including the stress you might experience related to your mental health, can set off your bodyâs âfight or flightâ response. This response activates us when weâre facing danger â but our brains donât really know the difference between the stress weâre experiencing from our depression versus the stress we experience when staring down a literal tiger.

Anxiety And Depression: Chronic Pain’s Unwanted Companions

Chronic pain, by definition, is any kind of lasting pain that doesnt resolve within six months, according to Kiran Rajneesh, MBBS, a neurologist and interventional pain specialist at The Ohio State University Wexner Medical Center, Columbus, Ohio.

Many different conditions can cause it, and a continual change in the peripheral or central nervous systems can maintain that pain over time, says Sarah Buday, PhD, a clinical psychologist at Washington University Pain Center, Washington University School of Medicine, St. Louis.

The way the brain processes those signals can be complicated. The X-rays of two people might look the same, but the way they experience their pain can be totally different, says Dr. Buday, who specializes in pain psychology. One might feel pain and one might not. Its also true that the mental impacts of pain are very individual. Not everyone becomes depressed or worries about their condition. This different experience of pain speaks to why it can be difficult to treat and even study, Dr. Rajneesh says.

While tens of millions of people experience chronic pain, about 17.3 million adults experience depression in the U.S., according to the National Institute of Mental Health.³ In terms of its closely related cousin, anxiety, about 40 million Americans have those feelings of fear, worry, and impending catastrophe each year, according to the Anxiety and Depression Association of America.

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