Chronic Pain and Depression


People who have been diagnosed with a medical condition and experience chronic pain because of it are quite likely to develop depression.  Chronic pain is debilitating and can impact everyday life by rendering suffering individuals dependent, powerless, and feeling very sick.  Suffering because of pain is already enough to make someone depressed but the added negative psychological effects pain brings can help deepen feelings of sadness, fear, and hopelessness.

Understanding Chronic Pain

Chronic pain is the condition in which pain from an injury or illness lasts longer than what is considered normal.  Chronic pain causes the body to react negatively, thus contributing to problems in other areas even if these are not related to the original pain source.  A body in prolonged pain can exhibit mood disorders, muscle pain, fatigue, and impaired cognitive and physical functions. Sometimes, chronic pain causes neurochemical changes which increase the body’s sensitivity to the pain.  The afflicted may actually start feeling pain in other areas of his body.

The Pain and Depression Tandem

Chronic pain is difficult to cope with so that many sufferers go into a depression.  Unfortunately, depression can amplify pain; so that the cycle continues…more pain leads to deeper depression and so on.  Depression’s symptoms such as insomnia, lack of energy, loss of appetite, and decreased physical activity are factors that worsen pain.

Depression’s viability as a partner of pain may rest on the fact that both share the same two neurotransmitters: 5-HT and NA.  Neurotransmitters are chemicals in the brain that relay signals to help nerve cells communicate.  These chemicals send the messages for the heart to beat, the stomach to digest, and the lungs to take in air and expel it, among other signals.

Pain and depression often go hand in hand; but, they are not inseparable.  Depression may be treated separately with cognitive behavioural therapy and medication.  Relief from depression can decrease pain as well.

Physical and Emotional Issues Chronic Pain Induces:

A person experiencing chronic pain is often anxious and irritable.  He may also feel:

  • Angry
  • Constantly anxious or panicky
  • Mood swings
  • Low self-confidence
  • Confused
  • Decreased sexual appetite
  • Weight loss; weight gain
  • Physical weakening
  • Sleep disturbances
  • Fear of injury
  • Fatigue

All these symptoms also point to depression which needs to be treated in order to ease a patient’s pain and allow him to live capably with it.


As mentioned, chronic pain and depression touch on the same neurotransmitters and nerve system.  As such, antidepressants can help relieve pain by making the brain change its perception of the pain’s degree while reducing the symptoms of depression as well.  New antidepressants such as Duloxetine HCL and Venlafaxine HCL do not have as much side effects as the older tricyclic antidepressants.

Depression can be further treated separately with talking therapies such as Cognitive Behavioural Therapy.  When depressive symptoms are reduced, the degree of chronic pain also usually decreases.

Physical exercise may also be recommended as part of the treatment plan.  Although it may be the last thing anyone in chronic pain would want to do, exercise is a necessary part of helping the body cope with the pain.  Consistent physical movement helps keep the body fit and less prone to more injuries and worsening pain.  Moreover, exercise helps dampen depression by increasing the very brain chemicals antidepressant drugs are designed to release.  A physician may help formulate a safe and effective exercise regimen for the patient.


Cognitive Strategies for Dealing with Chronic Pain

There are no easy answers for dealing with chronic pain.  The person involved must make a lot of effort to take control of his condition and live successfully with it.  Some of the things a person in chronic pain can do are:

  • Learn as much as he can about type of chronic pain he is afflicted with.  Knowledge can lessen the fear that pain is causing more damage than what it is.
  • Know good sleep hygiene or habits that contribute to better rest and sleep.  Pain can be exacerbated by fatigue and a body that sees little rest.
  • Sidetrack pain or remove the focus from pain by engaging in things you like doing.  Being preoccupied with something of real interest could relegate pain into the background.
  • Knowing what thoughts are unhelpful and switching these for more positive ones in order to improve outlook and mood
  • Indulge in meditation and relaxation therapies in order to decrease overall muscle tension caused by pain.  Muscle tension actually exacerbates pain so a reduction of the tension could also spell pain reduction.

Chronic pain can change one’s life.  It can affect a person’s ability to work and live the way he was used to.  As such, it is important to factor in coping strategies into everyday life so that chronic pain and the depression it drags with it are not given the opportunity to radically lower one’s quality of life.


hiv virus

What is HIV?

HIV or human immunodeficiency virus is a disease that compromises the immune system, gradually leaving the victim defenceless against other diseases.  The virus attacks white blood cells called T-helpers or CD4s and replicates itself inside these.

Different strains of HIV exist and these can coexist in one infected individual.  HIV resides in bodily fluids such as semen, blood, vaginal and anal fluids, and breast milk.  Sweat or urine however are not carriers of the virus and therefore HIV cannot be transmitted through these bodily excretions.

A person can be infected with HIV through:

  • Vaginal and anal sex without condoms –The most common form of transmission from which 95% of cases in the UK in 2013 resulted.
  • Breastfeeding — Infected mothers pass the virus to their babies through breast milk.
  • Injections by contaminated needles or other equipment that pass through skin
  • Unprotected oral sex and sex toy sharing although the risks are very low with 1 in 5,000 chances of transmission

HIV is incurable but people who are diagnosed early on and get good medical treatment can live long lives with the disease.

As of 2014, about 103,700 cases have been diagnosed in the U.K.  About 60% of these cases fall within the age range of 35-54 and the remaining 40% are distributed among the young and senior group.  The highest incidence of HIV in the U.K. is among two groups: gay and bisexual men and black heterosexual men.  Sadly, there are perhaps numerous cases undiagnosed simply because of lack of knowledge.

It is easy to miss the onset of HIV because the early symptoms mimic those of the flu.  Symptoms such as joint pain, fever, sore throat, and body rash appear 2-6 weeks after contraction of the disease.  After this period, the symptoms disappear for years; that is why symptoms can be brushed aside as simply indicators of common influenza.

HIV can be asymptomatic for as long as ten years.  The infected person can actually feel healthy and well during this time period.  This is a major reason why there are numerous individuals who remain undiagnosed.  The asymptomatic period is dangerous because the afflicted person does not know that his immune system is gradually being damaged to the point where the body is left defenceless to all sorts of illnesses.  In the advanced stages of HIV, the patient may experience:

  • Weight losshiv uk stats
  • Recurring infections
  • Extreme fatigue
  • Swollen lymph glands
  • Dangerous and life-threatening diseases
  • Skin disorders such as red or purple blotches, rashes, etc.
  • Night sweats
  • Chronic diarrhoea
  • Sores in the mouth, genitals, and anus

What is AIDS?

AIDS or acquired immune deficiency syndrome is an illness that attacks an HIV patient towards the last stage of the HIV infection when the immune system has been rendered helpless against the onslaught of various illnesses.  AIDS is therefore euphemistically known as advanced HIV infection or late-stage HIV.  Because an AIDS patient has no defence against disease, death can result from infections from other illnesses such as pneumonia, cancer, and tuberculosis.  Even mental illness such as depression and dementia can set in with AIDS.  Any sort of illness can invade the body at the AIDS point because the body has been left wide open to health invaders.

The Psychological Impact of HIV and AIDS

Despite the decreasing numbers fatalities because of adequate treatment and increased public awareness, HIV and AIDS remain highly stigmatised diseases.  An HIV diagnosis on the outset is highly traumatic as it not only means that one is harbouring an incurable and possibly fatal illness but it also means the likely possibility of becoming a social pariah.

The stigma of HIV and AIDS has left many feeling isolated and very lonely.  Fear of rejection from potential partners hound many HIV-positive people and these feelings are of especial concern to infected adolescents growing into adulthood.  Shame and embarrassment are also other factors that positively diagnosed individuals feel as the disease is still socially viewed as proof of immorality.  As a result, HIV patients have higher incidences of depression, anxiety, and suicidal tendencies.

Depression in itself causes physical problems with HIV patients.  Depressed people are less likely to stick to their medical treatments, a phenomenon lessening their chances of being able to live long, normal lives with the disease.

An HIV patient does not need to disclose their condition to just anyone; but he or she must have at least one supportive person they trust to talk to about their situation.  There are also organized HIV-support groups to touch base with other people afflicted with the same condition.  Talking to other HIV-positive people can dampen feelings of isolation and rejection.  In addition, professional support from a psychologist, psychiatrist, or social worker may greatly help your mental and emotional condition.

When an HIV patient’s mental and emotional health is addressed, their adherence to their anti-retroviral treatments, reduction of high risk behaviours, and their social engagements become remarkably improved.  Quality of life for an HIV-positive individual need not be severely compromised as long as he takes care of his physical, mental, and emotional well-being.

How a Person Adjusts to Chronic Illness

Dealing with a chronic illness or terminal disease is definitely one of the hardest ordeals a person will ever go through. It might seem a little impossible – but with the right mindset, the help of a professional and full support of his family and friends, a person can live peacefully and happily despite having a compromised health.

mature woman sitting on bed and having stomach ache

Here are some factors which affect how a person copes with chronic illness:

  1. Unresolved grief or anger from the past
  2. Past experiences with illness
  3. Personality before the illness
  4. Lifestyle changes caused by the illness
  5. Familial and individual resources for dealing with stress
  6. Codependency in the family system
  7. Stages of individual and family cycle


Stages of Dealing with Chronic Illness

  1. Denial – This is the first stage in adjusting to chronic illness. Most patients are in a state of shock when learning about the illness for the first time. They even get swayed easily by natural remedies and so-called medical cures on the internet. They also get second or third opinions hoping that there’s something wrong with the first diagnosis. Other patients try to go back to their usual routine and pretend like nothing happened or the disease wasn’t there.
  2. Fear – Eventually, patients realize the unfortunate truth – the disease is real and inside them. This leads them to the second stage which is fear. Patients get numb with fear of the unknown, the unpredictable. They get stuck with questions like what’s going to happen to their bodies, how many days they have left, how are people going to react and a lot more. Most patients will try to gather as much information as possible about their illness.
  3. Anger/Frustration – The third stage is anger or frustration. Most patients ask the questions: why did this happen to me and why me of all people. They hate the fact that they can’t work or live like before and it makes them feel useless.
  4. Grief/Depression – The fourth stage is grief or depression. Patients grieve for the loss of their old selves, old lives and old habits. Because of the illness, everything has now changed and will never be the same again. Patients will no longer be able to follow their original plans, goals and dreams. This is also a grieving process for the family members.
  5. Acceptance – This is the final and last stage of dealing with a chronic illness. It usually takes several years before a patient gets to this stage. In this stage, the patient has fully accepted his compromised health and has learned how to adapt to his new lifestyle and routine. Just like what Bruce Campbell said, “Acceptance involves the willingness to build a new life”.