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.