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Depression and chronic pain

A person living with chronic pain, or long-term pain, may also experience depression.

As well as seeking treatment for the cause of pain, medications and psychotherapy can help relieve the depression.

What happens with chronic pain and depression?

If you have chronic pain and depression, you’re by no means alone. Depression is one of the most common psychological issues facing people who suffer from chronic pain, and it often complicates the patient's conditions and treatment. Consider these statistics:

  • According to the NHS chronic pain is one of the most significant causes of suffering in the UK.
  • On average, 65% of depressed people also complain of pain.
  • People whose pain limits their independence are especially likely to get depressed.

Because depression in patients with chronic pain frequently goes undiagnosed, it often goes untreated. Pain symptoms and complaints take centre stage on most GP visits. The result is depression - along with sleep disturbances, loss of appetite, lack of energy, and decreased physical activity, all of which may make pain much worse.

Is there a cycle of depression and pain?

Pain provokes an emotional response in everyone. If you are in pain, you may also have high anxiety, irritability, and agitation. These are very normal feelings when experiencing pain. Normally, as pain subsides, so does the stressful response.

But with chronic pain, you may feel constantly tense and stressed. Over time, the constant stress can result in different emotional problems associated with depression. Some of the problems individuals with both chronic pain and depression have include:

  • Altered mood
  • Anger
  • Chronic anxiety
  • Confused thinking
  • Decreased self-esteem
  • Family stress
  • Fatigue
  • Fear of injury
  • Financial concerns
  • Irritability
  • Legal issues
  • Physical deconditioning
  • Reduced sexual activities
  • Sleep disturbances
  • Social isolation
  • Weight gain or loss
  • Work issues

 

Why is there an overlap between depression and chronic pain?

Some of the overlap between depression and chronic pain can be explained by biology. Depression and chronic pain share some of the same neurotransmitters - brain chemicals that act as messengers travelling between nerves. Depression and chronic pain also share some of the same nerve pathways.

The impact of chronic pain on a person's life also contributes to depression. Chronic pain can force you to struggle with tremendous losses, such as the loss of exercise, sleep, social network, relationships, sexual relationships, even a job and income. These losses can make you feel depressed.

Depression then magnifies the pain and reduces your coping skills. While you used to exercise and be active when you felt stressed, with chronic pain you can no longer deal with stress in this manner.

Research has compared people with chronic pain and depression to those who only suffer chronic pain. Those who suffer with both depression and chronic pain report:

  • More intense pain
  • Less control over their lives
  • More unhealthy coping strategies

Because chronic pain and depression are so intertwined, depression and chronic pain are often treated together. In fact, some medications can improve both chronic pain and depression.

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