Chronic Pain and Chronic Depression: Ending A Vicious Cycle

Published by Dr. C.J. DeFabio, D.C. | February 6, 2020

Did you know that the majority of people suffering from depression are also dealing with some form of chronic pain? One study found that an average of 60% of depressed subjects also reported chronic pain symptoms. This begs the question: Are the two related?

New research may have discovered a common link between depression and pain and the vicious cycle that develops between them. Let’s take a closer look at chronic pain, the relationship between pain and depression, and what you can do to alleviate and prevent both.

What is Chronic Pain?

Let’s say you feel soreness after a tough workout or you stub your toe. These are generally short-lived and completely normal types of pain. The inflammation and dull aches will last a few days, but they will typically subside within a week. But when pain lasts far longer than it should – usually three months or more – this is what is known as chronic pain.

People who suffer from chronic pain tend to report similar symptoms, including the following:

• Consistent aches in the muscles, connective tissue, and joints
• Consistent pain, primarily in the connective tissue, joints, and areas such as the lower back
• Difficulty with a normal sleep schedule
• Constant fatigue (from the lack of sleep)
• Mental exhaustion
• Mood swings
• Lack of desire for physical activities involving flexibility and endurance

The longer a person suffers from chronic pain, the condition tends to be more difficult to resolve. For example, what used to be a dull throbbing pain could increase or transition into a sharp burning pain over time.

How Does Chronic Pain Fuel Depression?

There are a few ways that chronic pain can exacerbate depression:

Change of Lifestyle: Chronic pain can dramatically change your lifestyle. Things that were once easy to do, such as bending down to pick something up suddenly, may become a source of anxiety. When you’re trying to avoid making a chronic condition pain worse, you might feel trapped and limited in what you’re able to do. This feeling of helplessness can ultimately worsen depression if this pattern of behavior and thinking is not acknowledged and acted upon appropriately.

Lack of Sleep: A full cycle of sleep – entering the deep stages of restorative sleep – can take between 90 and 120 minutes. Those with chronic pain often find it impossible to get a good night’s rest because switching positions or laying for too long on one side can trigger the pain symptoms. After a day or two of sleeplessness nights, you may begin to experience mental exhaustion, physical fatigue, and mood swings. In some cases, this can lead to depression over time. Studies show a direct correlation between depression and sleep deprivation.

The Pain is a Source: As mentioned above, short-term, low-level pain is normal and expected in response to our body experiencing an injury. But if you are constantly suffering from pain, this in and of itself may be enough reason to influence your mental state. No one wants to go about their day combating difficulties associated with pain. As if the above two reasons weren’t enough; persistent pain is both physically and emotionally exhausting to cope with

The Vicious Cycle of Pain and Depression

So, which came first: the pain or the depression? While scientists are still trying to identify the exact pathophysiological mechanisms, a new study might shed light on how pain and depression overlap in the brain. From this discovery, improved methods of care could be revealed.

A recent study found that many of the sensory pathways in the brain that are correlated with injury are also associated with mood regulation. The following parts of the brain have been identified as essential in both injury and depression:

• Insular cortex
• Prefrontal cortex
• Anterior cingulate
• Thalamus
• Hippocampus
• Amygdala

This discovery, while helpful, isn’t surprising. When you get hurt, there is an emotional response. You might get angry, frustrated, or sad. And in healthy people, an injury produces a reaction that goes away with the pain. But for those with chronic pain, it’s a very different story.

Those with chronic pain always tend to feel stressed and anxious because they want to avoid worsening the pain at all costs. Now imagine this mood and mindset continuing for weeks or months. It’s easy to see how quickly frustration can become anger, confidence can become low self-esteem, and sadness can become depression.

How to Alleviate and Prevent Pain and Depression

As researchers work to better understand the relationship between pain and depression in the brain, there are several things that you can do to alleviate current pain symptoms and help to prevent future ones.

Chiropractic Adjustments: Studies show that chiropractic adjustments are especially helpful for releasing tension and inflammation and reducing chronic pain.

Physical Therapy: If you’ve become sedentary due to chronic pain, physical therapy has been shown in studies to effectively improve movement, reduce pain, and help with mood.

Personal Training / Guided Group Fitness: Continuing with the point above, resistance training and general fitness has also been shown to reduce chronic pain while improving mood.

Acupuncture:  acupuncture has shown great promise as a treatment for pain AND depression.

Massage Therapy: Studies show that massage, especially deep tissue massage, can help to reduce chronic pain symptoms while improving overall mobility.

Nutritional Therapy: It might sound cliché, but you really are what you eat. If you’re eating a diet that is causing high levels of inflammation, you could be fueling your chronic pain problem. What’s more nutrition has been shown in studies to influence mood and depression. Getting on the right nutritional track is an excellent first step to less pain and better health.

Get Help for Your Pain

Do you suffer from chronic pain? Not sure where to start? We can help!

Ravenswood Chiropractic is home to an expert team of chiropractors, acupuncturists and massage therapists who all want to help you fight back against chronic pain. If you’re currently suffering from chronic pain and want to learn more about how we can help, give us a call at 773-878-7330.

 

 

References

 

1. Katon W, Schulberg H. Epidemiology of depression in primary care. Gen Hosp Psychiatry. 1992;14(4):237-247
2. Rayner L, Hotopf M, Petkova H, Matcham F, Simpson A, McCracken LM. Depression in patients with chronic pain attending a specialised pain treatment centre: prevalence and impact on health care costs. Pain. 2016;157(7):1472–1479. doi:10.1097/j.pain.0000000000000542.
3. Sheng J, Liu S, Wang Y, Cui R, Zhang X. The Link between Depression and Chronic Pain: Neural Mechanisms in the Brain. Neural Plast. 2017;2017:9724371. doi:10.1155/2017/9724371.
4. Meerwijk E. L., Ford J. M., Weiss S. J. Brain regions associated with psychological pain: implications for a neural network and its relationship to physical pain. Brain Imaging and Behavior. 2013;7(1):1–14. doi: 10.1007/s11682-012-9179-y.
5. Nutt D, Wilson S, Paterson L. Sleep disorders as core symptoms of depression. Dialogues Clin Neurosci. 2008;10(3):329–336.
6. Lefebvre R, Peterson D, Haas M. Evidence-Based Practice and Chiropractic Care. J Evid Based Complementary Altern Med. 2012;18(1):75–79. doi:10.1177/2156587212458435.
7. Coronado RA, Bialosky JE. Manual physical therapy for chronic pain: the complex whole is greater than the sum of its parts. J Man Manip Ther. 2017;25(3):115–117. doi:10.1080/10669817.2017.1309344.
8. Iversen VM, Vasseljen O, Mork PJ, et al. Resistance training in addition to multidisciplinary rehabilitation for patients with chronic pain in the low back: Study protocol. Contemp Clin Trials Commun. 2017;6:115–121. Published 2017 Apr 12. doi:10.1016/j.conctc.2017.04.001.
9. Sniezek DP, Siddiqui IJ. Acupuncture for Treating Anxiety and Depression in Women: A Clinical Systematic Review. Med Acupunct. 2013;25(3):164–172. doi:10.1089/acu.2012.0900.
10. Adams R, White B, Beckett C. The effects of massage therapy on pain management in the acute care setting. Int J Ther Massage Bodywork. 2010;3(1):4–11. Published 2010 Mar 17.
11. De Gregori M, Muscoli C, Schatman ME, et al. Combining pain therapy with lifestyle: the role of personalized nutrition and nutritional supplements according to the SIMPAR Feed Your Destiny approach. J Pain Res. 2016;9:1179–1189. Published 2016 Dec 8. doi:10.2147/JPR.S115068.