Chronic Pain and Depression
Pain is an unpleasant sensation that plays an important function in our lives. When you suffer an acute injury, pain warns you to stop the activity that is causing the injury and informs you to take care of the damaged body part afterwards.
Chronic pain, on the other hand, has no time limit, often has no apparent cause and serves no apparent biological purpose. Some people, often older adults, suffer from chronic pain without any definable past injury or signs of body damage. Common chronic pain can be caused by a range of conditions where there is little evidence to explain how pain is derived.
Emotional and social issues often magnify the effects of chronic pain. For example, people with chronic pain frequently report a wide range of limitations in family and social roles, such as the inability to perform household or workplace chores, take care of children, or engage in social activities. In turn, spouses, children, and co-workers often have to take over these responsibilities. Such changes often lead to depression, anxiety, resentment, and anger for the person with pain and can lead to stress and strain in family and other social relationships.
How is depression linked with chronic pain?
Depression is the most common emotion connected with chronic pain. It is found 3 to 4 times more in people with chronic pain than in the general population. In addition, a higher than average percentage of people with chronic pain will have some type of depression. The combination of chronic pain with depression is often associated with greater disability than either depression or chronic pain alone.
People with chronic pain and depression suffer vivid changes in their physical, mental, and social well-being — and in their quality of life. Such people often find it difficult to sleep, are easily agitated, cannot perform their normal activities of daily living, cannot concentrate, and are often unable to perform their duties at work and at home. These changes to quality of life starts a vicious cycle — pain leads to more depression, which leads to more chronic pain. In some cases, the depression occurs before the pain.
Signs and Symptoms
Some of the common signs and symptoms of chronic pain include:
Pain beyond 6 months after an injury
Pain from stimuli which are not normally painful (Allodynia)
Increased pain from stimuli that are normally painful (Hyperpathia)
Being overly sensitive to pain (Hypersensation)
Signs of major clinical depression will usually occur daily for two weeks or more and often include many of the following:
A feeling of sadness; feeling blue, hopeless, or irritable, often with crying spells
Changes in appetite or weight (loss or gain) and/or sleep (too much or too little)
Poor concentration or memory
Feeling restless or exhaustedLoss of interest or pleasure in usual activities
Feeling of worthlessness and/or guilt
What treatments are there for chronic pain and depression?
The first step in coping with chronic pain is to verify its cause, if possible. Addressing the problem will help the pain subside. In other cases, especially when the pain is chronic, you should try to keep the chronic pain from being the entire focus of your life.
Stay active and do not avoid activities that cause pain simply because they cause pain. The amount and type of activity should be directed by your doctor, so that activities that might actually cause more harm are avoided.
Distraction (redirecting your attention away from chronic pain), positive imagery and dissociation (detaching yourself from the chronic pain) can be useful.
Relaxation training, hypnosis, yoga and meditation can help you cope with chronic pain.
Cognitive therapy can also help patients recognise destructive patterns of emotion and behaviour and help them modify or replace such behaviours and thoughts with more reasonable or supportive ones.
Involving your family and friends may be helpful with your recovery.