Chronic Pain = Clinical Depression

November 12, 2007
by: Sylvia Marten

When pain becomes chronic and does not respond to pain medication and other treatments, the normal response is a combination of fear, anxiety, irritability, anger, and eventually depression. People suffering from chronic pain are four times more likely to suffer from clinical depression than healthy individuals. And the greater the pain, the more likely it is that the person will develop depression.

How does depression develop in people with chronic pain? The cycle is described by Dr. William Deardorff as follows:

"[The development of depression] can be understood by looking at the host of symptoms often experienced by the person with chronic back pain or other spine-related pain."

• The pain often makes it difficult to sleep, leading to fatigue and irritability during the day.
• Then, during the day, because patients with back pain have difficulty with most movement they often move slowly and carefully, spending most of their time at home away from others. This leads to social isolation and a lack of enjoyable activities.
• Due to the inability to work, there may also be financial difficulties that begin to impact the entire family.

• Beyond the pain itself, there may be gastrointestinal distress caused by anti-inflammatory medication and a general feeling of mental dullness from the pain medications.
• The pain is distracting, leading to memory and concentration difficulties.
• Sexual activity is often the last thing on the person’s mind and this causes more stress in the patient’s relationships.

Understandably, these symptoms accompanying chronic back pain or neck pain may lead to feelings of despair, hopelessness and other symptoms of a major depression or clinical depression.

A recent study by Strunin and Boden (2004) investigated the family consequences of chronic back pain. Patients reported a wide range of limitations on family and social roles including: physical limitation that hampered patients’ ability to do household chores, take care of the children, and engage in leisure activities with their spouses. Spouses and children often took over family responsibilities once carried out by the individual with back pain. These changes in the family often led to depression and anger among the back pain patients and to stress and strain in family relationships." (Source: Chronic Pain and Depression).

Helpful Resources:

• Depression Guide
• Living with Pain that just won't go away
• Chronic Pain Message Board
• Depression and Chronic Back Pain