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Pain and Depression: How the Two are Linked

October 9, 2017
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Depression is like a civil war between your body and mind; you either win or you die trying. As back pain warriors, giving up is never an option — so you fight. Sometimes you want to stop. The moment you want to throw in the towel is the moment you will see the fruits of your labor — you just have to wake up and get there, but how?

"It does not matter how slowly you go as long as you do not stop."- Confucius

Living with chronic back pain and it's exactly as it sounds — never ending. Do you ever wonder if that deep sadness you feel can cause actual physical pain; if physical pain causes depression? Look no further. BackerNation is here to talk about all things back pain and depression.

(PS: This is for us too.)


What Causes Depression?

There isn't just one perpetrator of depression but potential causes may include:

  • Genetics: Maybe you have a family history of depression
  • Personal Trauma: If you recently broke up with a significant other, job loss, or underwent a life change
  • Social Isolation: As the result of a conflict with family and friends
  • Medications: Such as high blood pressure medication, have depression listed as a possible side effect.

The Harvard Medical School classifies pain, "Especially chronic pain, [as] an emotional condition as well as a physical one. It is a complex experience that affects thought, mood, and behavior and can lead to isolation, immobility, and drug dependence."

Many times, pain and depression create a vicious cycle where your pain increases the symptoms of depression, and depression increases your feelings of pain — makes enough sense.

How Depression Causes Physical Pain

Depression doesn't just affect the mind; it also affects the body. According to the Mayo Clinic, “In many people, depression causes unexplained physical symptoms. This kind of pain may be the first or the only sign of depression.”

Physical effects may include:

  • Back pain
  • Headaches
  • Erratic sleep habits
  • Loss of appetite (or increased appetite with atypical depression)
  • Constant fatigue
  • Muscle aches
  • Digestive problems
“Pain and the problems it causes can wear you down over time and affect your mood,” the experts at the Mayo Clinic explained. “Chronic pain causes a number of problems that can lead to depression, such as trouble sleeping and stress. Disabling pain can cause low self-esteem due to work, legal or financial issues.”

Emotional Indicators of Depression

Not only can depression increase your back pain, but it can also affect your feelings and how you think. 

The emotional symptoms of depression include:

  • Withdrawal from socializing
  • Loss of interest in previously enjoyed hobbies
  • Constant irritability or sadness
  • Constant pessimism
  • Feelings of inadequacy and self-loathing
Having chronic back pain is the opposite of fun. So, it really is no surprise that a back condition can affect not only your mental health but your physical health too.

Physical pain leading to depression.

How Physical Pain Causes Depression

There's only so many times you decline plans that you actually wanted to attend before it starts affecting you and your moods. Being in so much back pain, the thought of getting ready and going out can be far from reality. Maybe you truly want to be social, but the pain prohibits you. 

Dr. Joseph F. Goldberg, director of the Affective Disorders Research Program at Silver Hill Hospital in New Canaan, Connecticut, reported, “Pain provokes an emotional response in everyone. If you have pain, you may also have anxiety, irritability, and agitation. These are normal feelings when you're hurting. Usually, as pain subsides, so does the stressful response.

“But with chronic pain, you may feel constantly tense and stressed. Over time, the stress can result in different emotional problems associated with depression.”

An estimated, 65 percent of depressed Americans complain of some form of pain. Individuals whose pain limits their independence are more likely to get depressed.

The depression then magnifies your pain, therefore reduces your ability to live with it and enjoy life. It becomes seemingly impossible to stay active in order to reduce stress, stay healthy and happy.

“Research has compared people with chronic pain and depression to those with only chronic pain,” Goldberg explained.

Those with both depression and chronic back reported:

  • More intense pain
  • Less control of their lives
  • More unhealthy coping strategies
Because chronic pain and depression go hand-in-hand, it helps to treat them together. In fact, some treatment options can improve both at the same time.

"If you have stomach pain and there's an ulcer, that's an explanation for it. But often, physical ills occur for no apparent reason and depression could be a likely cause," advised study researcher Robert D. Keeley, M.D., of the University of Colorado Health Sciences Center.

"Yet unless they are specifically screened for depression, it's hard for some doctors to pick up that it may be depression, especially in the primary care setting."

What are My Options?

It's clear that your chronic back pain and depression affect your entire quality of life. Consequently, the ideal treatment options should address all the areas of your life that are affected by them. To get symptoms of pain and depression under control, you may also need to separate treatment for each condition.

"Since the 1990s, evidence suggests that patients with depression do better when the treatment is matched to their preference," Keeley said. "For instance, patients who have physical symptoms with no explanation appear to prefer a counseling approach as opposed to getting antidepressants."

Treatments that may help with both include:

  • Antidepressant Medications may relieve both pain and depression because of their shared chemical messengers in the brain. Some antidepressants may reduce your perception of pain.
  • Pain Rehabilitation Programs typically provide a team approach to treatment, including medical and psychiatric tests to treat the whole picture rather than just one or the other.
  • Psychological Counseling (psychotherapy), may be effective in treating both conditions. Goldberg explained, “In cognitive therapy, a person learns to notice the negative "automatic thoughts" that surround chronic pain.

    “These often are distortions of reality. Some time with a therapist can teach you how to change these thought patterns and make you feel better. It's also a proven treatment for depression and can reduce symptoms of anxiety in those with chronic pain.”
  • Support Groups. “Peer groups have some theoretical advantages over some other forms of therapy. For example, peer groups provide patients with a sense of helping others with similar problems, and there’s also a sense of cohesiveness, a connection to group members,” said Paul Pfeiffer M.D., lead director of the department of psychiatry at the University of Michigan.

    “One of the participants said it was a great message of hope to know that the educator was once suffering and had made it over the other side of the fence.”
  • Stress-Reduction Techniques help ease depression symptoms by releasing the same kind of brain chemicals that antidepressants are thought to. Learning coping skills and other strategies may help — your doctor will be able to pinpoint what works best for you.

Examples of Stress-Reduction Techniques Include:

  • Physical Activity: Soak up that Vitamin D by going for a leisurely walk
  • Exercise: Whatever your body can handle, try to stay active by working out in any fashion
  • Meditation: You can take five minutes or five hours — just zen out and say namaste
  • Journaling: You may be surprised that writing your thoughts down on paper, can take away their power and maybe your emotional pain

Learning to mentally cope with chronic pain.

If you have chronic back pain and depression, get help before your symptoms worsen. Don't be embarrassed or ashamed. You don't have to be miserable, either. Life can be worth living again. It's all about finding a treatment that works for you. So pick up your swords and fight back.

As Abe Lincoln once said, “There’s no honorable way to kill, no gentle way to destroy. There’s nothing good in war except its ending.”

Armor up because it's time for battle, Backers. Who's ready to win this civil war? We are and so are you!

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