Depression is the most common emotion associated with chronic back pain. The type of depression that often accompanies chronic pain is referred to as major or clinical depression and is a serious medical condition. While most people understand how chronic pain can cause depression, the reverse is also true. People with depression are much more likely to develop chronic back or neck pain than those who are not clinically depressed. A comprehensive approach is often required to assist patients managing depression, chronic pain, and depression-related sleep issues.