Anyone who has experienced depression or chronic pain before knows that both illnesses can feel like two sides of the same coin. Depression has a very real physical component to it, with side effects that include frequent headaches and inexplicable muscle aches. Similarly, chronic pain often results in the loss of relationships, mobility, and even employment, which are life catastrophes that are frequently linked to depression. Furthermore, being in pain most or all of the time is depressing. Thus, not only are depression and chronic pain similar, but they often occur together as well.
The following is an explanation of how the two are connected and what you can do to seek relief.
Depression and Chronic Pain: How Are They Related?
Chronic pain causes depression
When you’ve been injured, you may find yourself unable to enjoy many of the activities you used to take for granted. Suddenly, simple life pleasures like falling asleep or exercising become difficult. Socializing can become a strain as well, as you simply lack the energy to make the effort. As a result, friendships and romantic relationships may suffer, and this can lead you to become isolated, lonely and—as is sometimes the case with those prone to depression—clinically depressed.
Just as chronic pain is more than “just a sore back”, depression is more than just intense sadness; it’s an unrelenting and generalized feeling of hopelessness and despondency. While people tend to feel sad when specific tragedies happen (a breakup, the death of a loved one), if that sadness seeps into every aspect of their lives and lasts for weeks, months or years, then that is when it moves beyond mere “situational sadness” and becomes clinical depression. Depression can be mild or acute, but a persistent lack of interest in pleasurable activities and a feeling of physical fatigue and pain are what distinguish it as a mental health disorder.
Depression causes chronic pain
While experiencing chronic pain causes depression, depression can also cause chronic pain. This is thought to be because depression and pain share the same neurotransmitters and neural pathways in the brain and spinal cord. It’s common for those who develop clinical depression to feel unexplainable aches and pains, including muscle cramps and headaches.
Treatment Options for Depression and Chronic Pain, According to Dr. Mel Pohl
The good news is, however, that both chronic pain and depression are treatable. Below, Dr. Mel Pohl, Chief Medical Officer at Las Vegas Recovery Center, explains a few of the available treatment options.
Because pain and depression travel along the same nerves and affect the same neurotransmitters, some antidepressants have been known to simultaneously treat both illnesses. For instance, in addition to treating depression, Serotonin and norepinephrine reuptake inhibitors (like Duloxetine or Cymbalta) have been shown to lessen the pain associated with migraine headaches, herniated disks and other pain syndromes.
You may think that your thoughts and physical sensations operate independently of one another, but the truth is that your thoughts have more of an effect on your perception of physical pain than you may realize. Think negative thoughts and you’re likely to feel pain more intensely than if you think positive ones. A therapist can help you examine the automatic thoughts that may be aggravating your physical discomfort and can aid you in devising a strategy for “talking back” to those problematic thought patterns.
Embrace a Whole-Body Approach to Treatment:
Because your emotions, thoughts and physical sensations are intertwined, to recover from chronic pain and depression, it’s necessary to not only heal the body, but to heal the mind and soul as well. This involves a “holistic approach” to chronic pain recovery that emphasizes natural and painkiller-free treatment methods, such as mediation and exercise.
How to Heal the Body:
Engage in physical activity
Those with chronic pain will often avoid exercise, believing that if they work out, they’ll cause the injury or pain to worsen. However, the opposite is actually true. When you’re out of shape, your muscles become weakened and stiff – this can result in more pain and even the risk of further injury. Not exercising regularly can also cause your depression to worsen, because inactivity can make you to feel less motivated and more sluggish and fatigued (and affects the brain’s neurotransmitters).
Although it’s important not to push yourself beyond your limits, engaging in mild to moderate exercise several times a week will boost serotonin and dopamine levels, which are the same “happy” brain chemicals positively affected by antidepressant medications. To learn more about how to get started, read strength trainer Jason Harper’s interview about exercises for chronic pain.
Research has shown that a healthy diet can decrease pain and improve happiness levels. Studies have demonstrated, for example, that eating more fruits and vegetables and less processed foods can improve overall mental health. Consuming foods rich in Vitamin B6 and serotonin-boosting properties are a natural way to elevate your mood and regulate your sleep.
Serotonin-boosting foods include:
- Sour cherries
Vitamin B6-rich foods include:
- Sunflower seeds
Just as a healthy diet has been known to help with depression, so too can a healthy diet help treat chronic pain. A diet that includes cold water fish, soybeans and veggies like kale and broccoli have been known to decrease inflammation, which can in turn decrease pain. To learn more, read Dr. Pohl’s article: The 7 Best Foods to Eat for Chronic Pain Relief.
How to Heal the Mind:
Take charge of your life
When you’ve been experiencing chronic pain, it can be tempting to fall into the role of victim. After all, chronic pain has likely had a tremendous effect on nearly every aspect of your life; from work and hobbies to friendships and romantic relationships. While it’s natural to feel victimized under these circumstances, if left unchecked, this belief can lead to a limited self-identity. Identifying as a “pain sufferer”, for instance, may feel comforting at first, but it can also result in feelings of hopelessness and resentment as well. To avoid this, surround yourself with friends and medical professionals who will champion you to take charge of your health and will discourage you from seeing yourself as the “helpless victim”.
Keeping busy won’t eliminate your depression or chronic pain, but it can serve as a distraction from the negative thoughts that may exacerbate it. When it comes to tackling your daily “to-do list”, don’t give yourself the chance to investigate whether or not you “feel like it”—Just do it. Your muscles might hurt and your mind may be whispering, “why bother?”, but don’t let the nagging thoughts and feelings deter you. Part of the chronic pain and depression recovery process involves developing routines and habits that will prevent you from sliding further off track.
As the saying goes, “Life is 10 percent of what happens to you and 90 percent of how you choose to react to it.” Though we may not be responsible for causing our chronic pain or depression, we are responsible for the thoughts that we have about it and our current situation. We can choose to worsen the pain and depression by focusing our mental energy on it, or we can choose to move beyond it. This is where meditation can help. By sitting for several moments and focusing on our breaths, we can learn to “quiet the mind” and decrease the mental noise that is aggravating our pain. Our thoughts are incredibly powerful—learn how to catch your automatic thoughts and you’ll learn how to control your pain.
How to Heal the Soul:
Make time for friends and loved ones
When you’re depressed, your instinct may be to isolate. It’s easier to spend your weekends in front of the TV then to force yourself to leave the house and meet up with friends for dinner or coffee. Add chronic pain to the mix and making the effort to socialize can feel near impossible; the energy and physical strength often just isn’t there. But force yourself anyway. A 75-year Harvard study found that more than anything else, the strength of a person’s relationships and friendships is key to determining his or her happiness levels. Make your friendships a priority, even (and especially) when you don’t feel like it.
Dr. Mel Pohl is a pain expert and Chief Medical Officer at Las Vegas Recovery Center. He is also the author of several books on the subject of chronic pain, including A Day Without Pain.