Living with long-term pain can be a tremendous burden but if you have chronic pain and depression that burden may grow even heavier.
I say that because depression magnifies pain and well, pain intensifies depression —making it tricky to cope with everyday living.
The good news is, these disorders are not inseparable. Effective medications combined with psychotherapy can help relieve your mental health challenges and make your constant physical discomfort more than bearable.
Here’s what you need to know.
Chronic Pain 101
Just about everyone gets hurt from time to time. When you cut your finger or pull a muscle, pain is your body’s way of telling you something is wrong. Once the injury heals, you stop hurting. Sounds simple enough, right? Yes. Except, chronic pain is different. Chronic pain is often defined as an injury lasting longer than 12 weeks.
Whereas acute pain is a normal sensation that alerts us to possible trauma, chronic pain persists —for months or even longer. The feeling of pain comes from a series of messages that zip through the nervous system. When you hurt yourself, the injured area ignites specific pain sensors.
They send a message in the form of electrical signals that travel from nerve to nerve until they reach the brain. At that point, your brain processes those signals —sending out the message, “I’m hurt.” Usually, the signal stops when the cause of the pain is resolved —your body repairs the wound on your finger or your torn muscle.
With chronic pain, the nerve signals keep firing even after you’ve healed.
But where does this type of hurt come from? Well, chronic pain may be the result of a previous injury, trauma; you may have an underlying medical illness or sometimes, there’s no clear cause at all. Other health problems, such as fatigue, sleep disturbance, decreased appetite, and mood changes, often accompany chronic pain. It can also limit your movements, which then reduces flexibility, strength, and stamina.
In short, it’s a domino effect. I say that because chronic pain can prevent sleep, cause insomnia and it can even provoke you to awaken frequently at night. This lack of sleep results in daytime fatigue as well as low productivity. It’s like you want to finish your to-do list but your lack of energy prohibits you from getting anything done —I feel that same frustration.
This ongoing pain most likely will cause additional irritation in other places —making it that much harder to deal with everything else including your loved ones. If you have to care for children or work full-time, chronic pain may make your life seem impossible.
This difficulty in carrying out important or enjoyable activities can lead to disability, depression, and despair.
Depression (major depressive disorder or clinical depression) is a common but serious mood disorder. I was diagnosed with it when I was a kid. From experience, I can tell you that it causes severe symptoms that affect how you feel, think, and handle daily activities, such as sleeping, eating, or working.
Current research suggests that depression is prompted by a combination of genetic, biological, environmental, and psychological factors. That said, did you know that depression is one of the most common mental illnesses, affecting 6.7 percent (more than 16 million) of American adults each year?
The thing is, depression can make some lose pleasure in daily life, can be serious enough to lead to suicide, and can complicate other medical conditions including chronic pain.
What If I Have Both?
If you have a chronic pain and depression diagnosis, you’re in good company.
According to the U.S. Pain Foundation, about 32 million people in the U.S. report having pain lasting longer than one year. There’s more. Roughly half of the American population with a chronic pain disorder tell their doctors they are depressed. Like I said earlier, the two go hand in hand.
On average, 65 percent of depressed patients also complain of pain. With so many of us hurting, you’d think the medical community would actively be doing something about it? And I suppose they are but far too often depression in those with chronic pain goes undiagnosed, therefore, it’s left untreated.
Why? Because it’s easy for physical pain to take center stage on most doctor visits. According to Joseph Garbely, DO, chief medical officer of Friends Hospital in Philadelphia, Pennsylvania, “Depression is not a risk factor for everyone with chronic pain, however, if you have severe or long-lasting pain, then you need to be concerned about your mental health as well.”
He says that major depression is thought to be four times greater in people with chronic pain than the general population.
“Chronic pain is key. Acute pain is not associated with depression, but chronic pain is,” Garbely stresses. It appears that your risk of depression progresses with the severity of your pain. “A 2004 study [illustrates how] major depression increases in a linear fashion. The greater the pain, the higher the depression rate is,” he adds.
But What Exactly is the Link?
When you think about it, it makes sense. Those with chronic pain tend to not get enough sleep. Garbely explicates just how important sleep is. “If you are deprived for periods of time, eventually it’s going to take a toll on your emotions.” He says that this can lead to depression and can even increase your physical discomfort.
But that’s not all. Physical pain often makes people withdraw from regular activities and social interactions, which further drives those feelings of sadness.
Pain can also cause people to withdraw from sex or intimacy, and the inability to work can eventually lead to financial difficulties —all of this exacerbates stress and increases pain.
Other times, the pain medication itself can lead to depression. “Many prescriptions for pain have a dulling or depressive effect,” Garbely acknowledges. “These pills can also impair your memory and concentration, which are both symptoms of depression.”
But I like I said, there’s still some good news.
Effective medication combined with psychotherapy and physical therapy can help relieve your depression while making your constant discomfort a little more bearable.
Here’s How You Fight Back
What I find interesting about chronic pain and depression is that they seem to be closely tied —so much so that when you find depression relief, you may actually find your discomforted symptoms resolve too. Garbely says to start with your general physician.
At a face-to-face appointment, you want to discuss the possibilities of updating some of your medications. Ask him or her about more holistic approaches such as medical marijuana or CBD oil. Next, find out if he or she can refer you to a physical therapist.
A customized physical therapy program can help you return to your prior level of functioning, encourage activities, and promote positive lifestyle changes. Physical therapists are experts not only in treating pain, but also its source. Yours will look for areas of weakness or stiffness that may be adding stress to the places that hurt. They can treat those areas with certain exercises and special equipment.
This will not only ease your discomfort but help you move better.
Then, consider joining a support group or starting talk therapy to help heal your mind. Sharing your struggles can lift a physical weight off of you. I can tell you that for sure. I mean, everything starts in the mind anyway, so don’t hold back. Put it all out there —whether it’s pretty or not.
Chances are, you’re not alone. In fact, I know you aren’t. Plus, learning to self-manage your pain, holds great promise for an everlasting recovery. All I’m talking about here is simply becoming an active participant in therapy (talk and physical) through problem-solving and decision-making. Although self-management programs differ, they all have share common features.
The approach tells us that the person living with pain will need help learning how to think, feel, and do better —despite the persistence of pain. We really can’t do this alone. So improving communication with your healthcare provider and support system are all part of that empowerment.
I mean, who doesn’t want to work out better, eat healthier, and socialize more?
Here’s your chance, guys. New research suggests that the best self-management programs teach patients different ways of thinking about and responding to pain —making your actions to relieve it that much more effective.
As soon as you have an empowering thought, you can start to feel like you have a little bit more control. Yes, your body is damaged. Maybe you’ve had multiple surgeries and take more prescriptions than you’d like to admit. But are you in control? Yes. You absolutely are.