Chronic Pain and Depression

chronic pain and depression

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If you’re dealing with fibromyalgia, then you’re in a lot of pain. It may flare up out of nowhere and it may leave just as quickly. Or it may stay for a year. But it’s a regularly occurring and debilitating event in your life. And it has definitely lasted for more than six months. That’s why they call it “chronic pain.” To make matters worse, people with fibro usually have a greater than average sensitivity to pain. In fact, research shows that chronic pain leads to unusually high levels of stress hormones, low energy, mood disorders, muscle pain, and lower-than-normal mental and physical performance. Throw in the added “bonus” of exceptionally painful nights that keep you from sleeping and you have a recipe for chronic pain and depression – if you don’t already have it to start with – and worse pain symptoms.

The Cycle of Chronic Pain and Depression

Many people with fibromyalgia cannot work a traditional job that requires them to leave home. Indeed, many fibro patients can’t even work from home. Why? The pain, depression, and constant side effects can be so debilitating that many feel they have been robbed of their lives. And if you are able to work or simply have no choice, that only exacerbates the problems, especially the pain and depression. Add in caring for children, grand kids, a partner, and even yourself. With or without those people, the pain of fibromaylgia makes you irritable and frustrated. When you feel like your hands are tied and there is no way out, it’s very common to get depressed. And then depression makes your pain worse. It’s a vicious cycle, isn’t it?

A Harvard Medical School publication explains that chronic pain “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.” Because of the connection to pain and depression, they add that nearly every drug used in psychiatry can also be used to treat pain.

Interestingly, after Harvard authors describe the experience of pain in relation to the central nervous system and the body, the article moves directly to fibromyalgia as a noteworthy case: “Fibromyalgia may illustrate these biological links between pain and depression. Its symptoms include widespread muscle pain and tenderness at certain pressure points, with no evidence of tissue damage. Brain scans of people with fibromyalgia show highly active pain centers, and the disorder is more closely associated with depression than most other medical conditions. Fibromyalgia could be caused by a brain malfunction that heightens sensitivity to both physical discomfort and mood changes.” [emphasis added]

Treating Chronic Pain and Depression Together

The Mayo Clinic’s Dr. Daniel K. Hall-Flavin offers four key treatments that simultaneously address chronic pain and depression. As a fibro patient, most of these won’t be surprising to you, but it’s good to hear as a reminder. These treatments have helped so many fibromyalgia patients get their lives back. It usually takes a lot of trial and error and even combinations of treatments. Nevertheless, Dr. Hall Flavin recommends the following for treating chronic pain and depression:

  • Antidepressants: As was just made clear by Harvard Medical School, antidepressants can be highly effective in treating chronic pain as well as their obvious intent of treating depression. That’s due to shared chemical messengers in the brain.
  • Talk Therapy/Psychotherapy: If you’ve ever been to a good therapist or counselor, you know that they are wonderful at pointing out your “automatic” thoughts. Those are the unconscious connections we make that can wreak havoc in our lives without us even knowing. This kind of therapy is designed to reshape your thinking which can have a radical impact on both your depression and chronic pain.
  • Stress-reduction Techniques: Nearly every article related to treating fibromyalgia addresses these techniques. If you’ve never tried them or given up because you didn’t see results right away, reading about them all the time should at least make you think twice. Techniques like physical activity, exercise, meditation, journaling, and learning coping skills are all very effective in addressing many fibromyalgia symptoms, especially depression and chronic pain.
  • Pain Rehabilitation Programs: This might not be a common method you hear about for treating fibro, but it’s a gem! The best kind of programs are those that use a team approach to address your chronic pain holistically and with a team looking out for your mental and physical well-being.

Dr. Hall-Flavin adds that, “treatment for co-occurring pain and depression may be most effective when it involves a combination of treatments.” Again, this make take some more trial and error. What works for me, might not work for you and vice versa.

Have you found a particular medication, natural remedy, or technique that has worked for your chronic pain and depression? Please share it with us!

 

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