Depression and Chronic Pain are Interconnected

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Depression and chronic (long term) pain are related because they share some of the same nerve pathways. Therefore, when a person is feeling depressed, their level of pain can become magnified. People suffering from depression plus a chronic health condition (such as arthritis, headaches, fibromyalgia, multiple sclerosis, polymyalgia rheumatica, Lyme disease, or backaches) can experience higher levels of pain and discomfort than they would normally experience if they did not also suffer from depression.

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Pain and depression can feed on themselves by altering brain chemistry and nerve function. In addition, people who experience chronic pain sometimes have difficulty getting out of the house to exercise, do their shopping, run errands, or participate in social activities (such as picnics, seasonal festivals, parties, family celebrations, church activities, community events). Isolation can often increase symptoms of depression. When simple daily activities (like brushing one’s hair, making the bed, vacuuming, or doing dishes) turn into painful chores, the thought of merely getting out of bed in the morning can become overwhelming.

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One way to think about it is that a pain pathway can sometimes be like a groove in an old vinyl record. When pain receptors send pain signals along the pathway, the groove can become deeper over time. Feelings of depression make the groove wider. When pain signals are being transmitted every minute of every hour of every day of every week, over the course of months, these pathways get “used to” being stimulated. The groove in the vinyl record deepens and widens into a rut. This pain pathway is now overly sensitive. The smallest stimulus will now rapidly send a signal to the brain that produces a disproportionately large pain response. So any seemingly small trigger will cause a huge reaction by the body.

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The person suffering from chronic pain and depression rarely shows outward signs of illness. To an observer, they might seem to be perfectly healthy and able to participate in normal activities. This often confuses family, coworkers and loved ones who are unfamiliar with chronic pain. If an individual who is suffering from depression and chronic pain is criticized, misunderstood, told that they are exaggerating their illness, or that their condition exists only in their mind, this can increase feelings of hopelessness, frustration, and despair.

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In order to break the cycle, both the depression and the chronic pain need to be addressed at the same time. It must also be understood that once the pain pathway has become so overly sensitive (the analogy of the groove in the vinyl record turning into a rut), it takes additional time for healing to occur. A pathway that has taken years to become ultra-sensitive will rarely heal in a couple weeks. It may also be possible for a person to be receiving the correct combination of treatment (nutrition, chiropractic, counseling, acupuncture, exercise, etc.) for several weeks without noticing improvement because depression has slowed down the healing process.