Hello, I’m Dr. Andrew Block. I’m a clinical psychologist and director of pain programs at Texas Back Institute. And I’m here to talk to you today about depression and chronic pain.

Chronic pain is a problem that’s experienced by about a third of the population in the United States. And depression is one of the problems that accompany chronic pain very frequently. In fact, statistics show that about 85% of patients who have chronic pain develop some symptoms of depression.

What are those symptoms? The major symptoms of depression include things like sleep disturbance, which is either sleeping too much or too little, appetite disturbance, which is again eating too much or too little, loss of interest in previously enjoyable activities, withdrawal from other people, a foreshortened sense of future or a fear of dying, loss of motivation, and a whole host of other symptoms that make it very difficult to recover from chronic pain. In fact, there’s a lot of indications that chronic pain and depression have primarily the same symptoms and they feed off each other. So that when a person is hurting, they don’t sleep well, they lose their motivation, they lose their enjoyment in life, and that creates depression, which in turn reinforces the chronic pain.

Fortunately, there are many types of treatment available for depression that’s related to chronic pain. Antidepressant therapy can be very helpful for patients who experience chronic pain with depression because the antidepressants not only can help to relieve the symptoms of depression but because the same biochemical pathways are involved in depression and chronic pain, the antidepressant medication can also have a secondary effect of providing some pain relief.

In addition, cognitive behavior therapy can be effective in dealing with depression that’s related to chronic pain. Such kind of therapies involve helping the patient to observe their surroundings so that they find things that are enjoyable in their situation even though they’re in pain. So that they’re able to be optimistic and so that the focus is not so much on the pain but on the gains and good things in the patient’s life that remains.

Often times the antidepressant therapy and the cognitive behavior treatment are combined with physical therapy exercises and rehabilitation in what’s called a chronic pain program. Our chronic pain program here, the CoPE program, has been very effective in helping patients to overcome both depression and chronic pain and helped patients become much more functional and get off pain medications.

So if you’re experiencing depression related to chronic pain, don’t despair. There are many treatments available, ranging from antidepressant therapies, to psychotherapy, and the integrated chronic pain management program that can help you to overcome depression, chronic pain, and get back on with the business of life. Thank You.


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