Chronic Pain & Depression
Chronic Pain and Depression: A Chicken or the Egg Story By Rosalyn Carson-DeWitt, MD
A variety of recent medical studies have drawn a strong association between chronic pain and a diagnosis of major depression. The two conditions seem to go hand-in-hand in a large percentage of unfortunate patients, who suffer the debilitating effects of both chronically painful conditions and persistent mood problems.
Researchers still don’t know whether there is a cause-and-effect relationship between chronic pain and depression, and if there is, which condition causes the other. Some research suggests that insufficiently treated, ongoing pain may cause changes in the chemical environment of the brain, thereby increasing the likelihood of depression. Similarly, other research suggests that insufficiently treated, ongoing depression causes changes in the chemical environment of the brain such that it increases an individual’s perception of painful sensations.
Some patients are at increased risk for both chronic pain and depression. For example, women and elderly patients are more likely to report both symptoms of chronic pain and symptoms of major depression. (Older adults, however, tend to report somatic or physical symptoms of depression rather than typical symptoms.) Researchers don’t fully understand why this is true.
Patients whose pain interferes with their independence, their mobility, or their ability to actively participate in their usual social activities are at a particularly high risk for depression.
Symptoms of Chronic Pain and Depression
Certain areas of the body are more likely to cause painful symptoms in patients with both chronic pain and depression. The types of chronic pain most commonly reported by depressed patients include:
* Headache
* Neck and back pain
* Pain in the musculoskeletal system (muscles, bones)
* Stomach pain
* Chest pain
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