Chronic Pain

Can Chronic Pain Cause Depression?

Have You Considered That We Always Have An Emotional Response To Pain?

Continuous pain lasting for more than 3 months is called chronic pain.  This type of pain triggers a series of physiologic and anatomic changes in the human body that are not adaptive, but rather, maladaptive (the body is injured by the changes).

One of the most profound maladaptive changes that can occur is the development of depression. Depression is a condition of persistent sadness, hopelessness, helplessness, and loss of interest in things or people previously interested in.


Pain And Depression Are “FIRST COUSINS”

It is well known that depression can amplify the perception of pain, but chronic pain can also cause depression in people who previously were never depressed. Pain and depression are “first cousins”.

Over half of all people depressed also complain of pain and up to 50% of all chronic pain patients are depressed (probably a conservative percentage). 

The neurotransmitters (brain chemicals used to power your brain) in depression and chronic pain are related.  Studies have shown that the same areas of the brain where serotonin and norepinephrine are concentrated seem to be “starved” in chronic pain and depression. Notice the 2 brain scans (the top one shows chronic pain and the bottom one shows depression).  Can you see how both the chronic pain and the depressed brain scan show a reduction in brain activity?


Pain And Depression Have Similar Treatments

Though the treatments for chronic pain and depression can vary…there are certain profound similarities too. Where they are similar is in the therapies that increase norepinephrine and serotonin.It’s not surprising that exercise, prayer, meditation, Cognitive Psychotherapy (changing patterns of thought), and antidepressants can treat both maladies as all these treatments have been shown to increase norepinephrine and serotonin.  

Cymbalta can have a profound effect on both chronic pain and depression (click here to link to my review on Cymbalta).  These effects can take time to reduce your chronic pain or depression.  Overnight cures are rare.  Patience and persistence with your treatment regimen is essential.


Who Will Run This Marathon With You?

The days of most primary care practitioners talking to you for an hour are long gone.Insurance companies have decreased the reimbursement for Doctors counseling their patients.   What does this say to you about the genuine interest an insurance company has regarding the need for counseling?  A 10 minute office visit is the national average in the U.S.. and  that will rarely be therapeutic in chronic pain and depression.

Though you may have to search for him or her, team up with a practitioner that can spend time with you and address all your concerns. Can you think of any good relationship in your life that would result from a 10 minute conversation a couple times a year?  Don’t lose hope.

If you have a question, please leave comment it below. I would love to be of service to you. 

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