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chronic pain and depression

as i have read some of the numerous posts from people, there seems to be one common theme, depression. my pain doctor has a psychologist in his office and this guy works in concert with my pain doctor to treat depression in chronic pain patients. there are also meds that can help with depression. remember it is not the pain that causes depression, it is the circumstances with pain that causes it. for example the inability to work, or do family things, or loss of friends and on and on.for people who have problems coping with chronic pain i would suggest making an appointment with a chronic pain psychologist. he works specifically with chronic pain and depression and he also can dispense meds that can help with depression. one still will have chronic pain but along with the psycologist and the meds, depression can be easier to deal with. so ask your doctors or pain doctors for a referral to a chronic pain psychologist. it can not hurt and maybe your inability to cope will be less of a problem
I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.


  • All too often, our ability to cope with the pressures of family, work and health issues can become overwhelming, especially when dealing with a definative change in how we expected our lives to turn out.......working with a trained psychologist who can help us come to terms with our lives as they are currently, and help to develop coping mechanisms, can also add yet another tool to the toolbox of treating chronic pain and can increase our overall effectiveness of managing our new lives.
  • There is such a stigma attached to mental health in our countries. I think that stops a lot of people from getting the help they really need. When my PM suggested making an appointment with his psychologist my gut reaction was anger "I'm in pain, not crazy!" (of course I thought this, I didn't say it out loud) but as soon as I met with her I realized that chronic pain psychologists have so much more to offer.

    I've always concentrated on alternative methods to control my pain & she was an expert. We discussed the hardest physical things for me to deal with & developed mental exercises to help me cope. I admit I do look like a crazy lady, playing my imaginary piano when I'm sat in the car school queue but that's better than crying & trying not to throw-up from the pain! She was educated in so many 'tricks' not just the usual visualization & meditation, to handle my pain.

    I only had a couple of appointments with her & they were covered by my insurance, unlike many alternative treatments. PM docs often don't have the time or training to really discuss everything we're dealing with. The clinic psychologist communicated with my PM & I could feel a positive change in our relationship after my appointments. If this service is offered I'd highly recommend giving it a try. As Sandi says, we can "add another tool to our toolbox of dealing with chronic pain"..that's always a good thing :-)
    Osteoarthritis & DDD.
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  • I think this could be useful for ANYONE in pain, depressed or not. Anything to help with mind and body could be very beneficial. I'm glad this discussion was brought up.
    Progressive DDD
    Chronic S1 Radiculopathy
    Discectomy L5-S1 2002
    Discectomy, Laminotomy/Foraminotomy L3-S1 January 2014
    Bilateral SI Joint Fusion and 2 level spinal Fusion October 2014
  • apparently i never considered myself for a candidate for depression. i don't feel depressed over chronic pain and considering, i am pretty happy person. my gp was the one who suggested the meds and for me to contact my pain guy. she said people who are depressed sometimes don't feel that way and considering the changes from pain i might be a candidate. anyway she said a lot of the meds for depression actually help chronic pain and to talk to my pain guy about them.personally even though she says i might be a candidate until i feel depressed i might stay away. one reason is that i don't want any more meds than i am on now. for me, it is the less the better. i think too many meds might make things worse for me at least. i try to keep things simple.
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • what you talking about is reactive depression ,I myself suffer with it as do many on here ...but probably aren't aware of it ,,like you i also suffer with long term pain and its effects and its the effects that can be as bad as the pain .i have a friend a very high flying young lady that worked in finance .she was very attractive very articulate and then BANG !! from out of the blue a STROKE !! at 28 ..this is a non smoker and mild drinker and a keep fit thin girl .then rheumatoid arthritis then BANG another 2 strokes .BANG when the high end job .along with the home /car/husband .....he decided don't to do the in sickness bit !! and left her in hospital ..alone ..scared ...as she was a friend of my ex wife and not mine i only heard this second hand and incorrectly i thought she had passed away .....one day about three years ago i took my dog to the park and to my amazement ran in to this girl .shes alive !! ..we both stopped and our dogs ran after each other ...i was stunned and we just hugged and then came the tears ! from both of us ....we are good friends now and always stay in touch .BUT illness has taken its toll on her big time ..she has lost her looks and due to the strokes her personality .when i am having a bad day i always think of her and wonder how does she manage to live on her own ..the truth is she is not coping with life and i just hope that it doesn't end badly ..anyway that her
    now on to me
    the other week i was having a check up at the hospital {nothing to do with my back} and the consultant who i have known for many years and knows my complex history ..just asked ..one question .....he said how are you ??? that's all

    and that's all it took to make me break down in his office i was having a bad day anyway but i did not realise just how small my world has become ..i spend up to 20 hours a day on my own in a dark room {i keep the curtains closed as the light hurts my eyes ..it always has done ..even as a child ..every photo i am wearing shades ..}i watch tv and sometimes come on the laptop for a bit but my wife works full time and due to my illness and lack of mobility i don't spend much time with her at night or weekends as i can't keep up with her .so we do our own thing .we even have independent electrical adjustable beds ..again due to my health ...so no social no sex life no walking the dog no swimming just pain and tv ..i am 47 when i think of how full my life was only 17 years ago and only 7 years ago i could still get about a lot more ,,,,,the thing is ..healthy people don't want you in there lives .most employees don't want you and in my case i have had to turn down a dream job again due to health ..it was working with the guy that trained me to be an electrician .he wanted me to be the go to guy for his jobs he wanted me to order the kit and deliver it on site and keep the stores sorted and help out on installations ....it was stuff like CCTV at the time i thought about it but declined because i was not the guy that he once knew and i knew ..{at the time } there would days when i would let him down } and i would not want that ..in the end i am glad that i did as my health is now so bad ..so reactive depression ..yes i have it and its very bad ..but different from the depression that people suffer with that tend to commit suicide .{i am not saying that people like us don't do that but they may also be suffering with the other depression too ..i know about this ..first hand as two family member have committed suicide one a young man age 18 and one an older man 71 ..both out of the blue ..but on reverse analysis the clues were there on both men ...very sad
    even on bad days i always think about reason to keep going on ..my wife//my ex wife and daughter .are all good reasons for living despite the pain and hell that we go through every day and night .i don't want out ..i want to be my old self ..but i know that i will only get worse .and i need to keep adjusting to compensate for the grim reality that is reactive depretion
    that is hard for anyone ..
    1997 laminectomy
    2007 repeat laminectomy and discectomy L4/L5
    2011 ALIF {L4/L5/S1}
    2012 ? bowel problems .still under investigation
    2014 bladder operation may 19th 2014
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  • thanks tony
    i think a resolution of my so called depression will be when i retire in june. as you are aware of if you have read my posts in the past are the issues with respect to work. HR has my back and a list of accommodations and has warned my administrators not to make an issue out of my back or meds. she has been very good here but it took me some time to complain and to lodge a complaint. before, all of my troubles with administrators started after my back surgery and when i had multiple surgeries, that is when the fit hit the shan. admin did not want to hear about it,talk about it or deal with it. in fact a fellow teacher started rumors that i had my last fusion because i wanted to get out of being evaluated, never mind that my disc broke and that is another story. so long story short, no more school, no more books no more teachers dirty looks. too bad because i love to teach and work with kids and the kids for the most part like me. it is just the teachers that i have issues with. so retiring will get rid of one source of depression. and when i start to sub, i don't have to go to my school only, i can go to different schools and levels and also different districts.
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • dilaurodilauro ConnecticutPosts: 11,348
    Like Peanut butter and Jelly.

    I believe there are two distinct phases of Chronic Pain and Depression

    When you first experience chronic pain
    There are so many things going around in your head. You start to think that you can not longer provide for a family or establish a relationship. You start to dwell on horror stories about all the things that you will no longer be able to do.
    You feel that you cant go out with your friends anymore, you feel you are going to become isolated.

    All of those feelings can be described as forms of depression and if left unchecked can led ti deeper depression

    Long time Chronic Pain sufferers
    Yes, they have learned how to deal with this, learned about disappointments along the way. Many have also developed a positive attitude towards the future and will do what ever it takes to do what they want to do. But in the deep night, perhaps lying in bed, darker thoughts surface. Almost like a hopeless purpose, you know you can't change what was, and you are getting tired of getting up every day having pain, then just repeating this every day.

    In either situation, when depression starts to take a stronger hold, its time to seek professional help. Trouble is, many folks in these situations can not recognize that they are in a depressed state.

    Our family and/or friends need to help us here.

    Ron DiLauro Veritas-Health Forums Manager
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I have a lifetime of chronic pain, but I denied my limitations and stayed very active; which brought me to the condition today. Now I am forced to accept limitations that I didn't imagine. Coming to that realization that my body was breaking down was depressing, but I didn't know I was depressed until my doctor suggested a pain and anti-depressant med. It didn't do much for the pain, but I felt much better about my attitude towards the pain and my life.

    I was in military service for 21 years even though I found out at 15 (1986) I had a deformity in L4-L5 after seeing a Chiropractor and being referred to a Specialist (most likely Orthopedic). I had times when I was too sore to do PT, especially in the last few years. I retired in '13 due to too many and too serious spine issues. In 2003, I started the route of PM with my first sciatica problems. I tried surgery in late 2004, had a CSF leak, then a repair surgery. In 2011, I tried PM again with less success. In late 2011, my arm got weak and I was surprised to have a neck problem also, so I ended up getting fused at C5-C7 last year. In 2013, my leg got weak and I found out I have permanent nerve damage in both legs. So, now I can't walk far and I limp with lots of pain! So, now I walk funny and my 4 kids have a limited

    I am doing everything I can now. Acupuncture, meds, and planning a SCS implant. These all give me hope along with my religion. I think if there is no hope, that is when you feel lost.
    L4-L5 fused at birth (congenital malformity). L-5-S1 bulge/degeneration, L3-L4 bulge/degeneration. Permanent nerve damage L5-S1 and L3-L4. Fused C5-C7.
  • what is the difference between can not recognize depression and won't recognize it. like i said i might be in denial but i really don't feel that i am depressed. but i am not sure if the meds make me kind of flat lined emotionally or is it depression. my emotional level like i said is flat lined and i believe that long term usage of oxy and or xr narcotics make one that way. i know some anti depression meds make people flat lined also. so is flat line emotion depression or just the result of my 13 years of being on oxy? work makes me depressed as i wrote in the above post so i guess i will see on that magic day in june.
    I have 4 fusions from L5-3, the latest last May '12 where they fixed my disc that broke.They went through my side this time. I take 40 mg of oxycontin 4x a day and 4 fenatyl lollipops 300 micro gms 4x a day.
  • Sometimes I wake crying. I can't catch hold of my dreams long enough to know why. I wake silently in the darkness, take my meds & curl down under the covers. I breath deeply, work on relaxing my body, exorcising the pain but the shadowy voice quietly cries "I can't do this, not again", deep down in the darkness I wish I were dead, I yearn for the peace, sweet nothingness, release from the eternal pain. This is my time to silently weep.

    Then the chaos of the day starts. My son is genetically incapable of quietly closing a door (he gets it from his father!) it slams & his little elephant feet thunder down the stairs..he creeps in & whispers to the duvet "can I snuggle in?". I wipe my eyes before pulling the covers back & cuddling him close. It's still agony, but it's my sweet pain. He lays in my arms for moments before his mind starts spinning with all the anticipated excitement of the day & the night is officially over!

    I know its stupid but I used to resent those who are bed ridden. I was angry because no matter how much crippling pain my body was experiencing I still had to drag myself out into the world because of my kids. I dont have a support system to call on, I have no choice. Now I realize what a blessing it is. Forcing myself to keep moving, the endless demands of being a mother & all that entails leaves me with no choice but it also leaves me with no time to dwell on the thoughts of my morning self. I think I've spent so long faking being happy for my family that it's become real more often than not. I truly feel for those who aren't constantly bombarded with distraction. For me it's vitally important to fill as much of my time with manageable activities as I can.

    I took Cymbalta for a couple of years. I remember in the beginning saying that it didn't help with my pain but it did work on my mood. Like others, I reached a point where I felt I was taking too many medications & made the choice to streamline. With my docs help I slowly titrated off of Cymbalta & only then did I realize the emotional fog I'd been living in. Don't get me wrong, it was a great med at the time but I'd moved out of the situational depression I'd been experiencing & it was no longer needed & I wasn't aware of the negative effects it was having on me until I stopped. I titrated very slowly & felt no negative side-effects. If in the future I find myself depressed (or a loved one tells me I am..sometimes we don't see these things in ourselves) I would happily take it again.

    Some others medications have had the side-effect of depression. Savella was terrible, as I titrated up I spent a couple of weeks constantly crying. I'd read others accounts of starting this med & knew this experience was shared by others..it passed as did several other unpleasant effects. I'm not trying to dissuade others from trying these meds..quite the opposite, they can be extremely helpful particularly in managing nerve pain but we should all be aware of the possibility.

    Depression can be deadly. Often we don't know that we are suffering with that 'sickness' & as Ron says we need to rely on those close to us to recognize the signs. I always tell my husband when I'm starting a new medication so he can pay particularly close attention for the warning signs. My brother took his own life. We are a very close family but none of us imagined for moment that it could happen. There's no shame or weakness in asking for help. It's a curse that accompanies chronic pain & we should all be very aware of the deadly consequences of allowing it to fester untreated.
    Osteoarthritis & DDD.
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