Chronic Pain and Depression

By: | Tags: | Comments: 0 | November 29th, 2010

Pain is a very important mechanism we have that helps us know that something was wrong and needs to be examined.  Acute pain tells us we need to stop the activity we are doing and take a break.  Chronic pain on the other hand can last months or years with what seems like no cause.

Because chronic pain is defined as pain lasting longer than expected with no known cause, people have often been told it is “in their head.”  This is unfortunate because we know that all pain is real (except in the most extreme and rare cases of psychosis.)  Emerging scientific evidence is demonstrating that the nerves in the spinal cord of patients with chronic pain in a specific area undergo structural changes.  Wide spread chronic pain can have more complicated underlying causes including neurologic changes, wide spread toxins, and imbalance of hormones that is not extreme enough to come up on normal blood tests.

Chronic illness can be very hard for people to handle; not only the pain, but the emotional stress of not being able to always do what you want or socialize.  Depression is the most common emotion associated with chronic pain.  It is thought to be 3 to 4 times more common in people with chronic pain than in the general population.  In addition, 30 to 80% of people with chronic pain will have some type of depression.  The combination of chronic pain and depression is often associated with greater disability than either depression or chronic pain alone.

Here are signs and symptoms for chronic pain given by the American Chiropractic Association:

  • Pain beyond 6 months after an injury
  • Allodynia—pain from stimuli which are not normally painful and/or pain that occurs other than in the stimulated area
  • Hyperpathia—increased pain from stimuli that are normally painful
  • Hypersensation—being overly sensitive to pain

The American Chiropractic Association also gives signs of major clinical depression that will occur daily for 2 weeks or more:

  • A predominant feeling of sadness; feeling blue, hopeless, or irritable, often with crying spells
  • Changes in appetite or weight (loss or gain) and/or sleep (too much or too little
  • Poor concentration or memory
  • Feeling restless or fatigued
  • Loss of interest or pleasure in usual activities, including sex
  • Feeling of worthlessness and/or guilt

Some treatment options include chiropractic management for physical pain, acupuncture for both physical and emotional pain, and using a psychologist for the emotional stress alone.

Other tips include:

  • Stay active and do not avoid activities that cause pain simply because they cause pain. The amount and type of activity should be directed by your doctor, so that activities that might actually cause more harm are avoided.
  • Relaxation training, hypnosis, biofeedback, and guided imagery, can help you cope with chronic pain. Cognitive therapy can also help patients recognize destructive patterns of emotion and behavior and help them modify or replace such behaviors and thoughts with more reasonable or supportive ones.
  • Distraction (redirecting your attention away from chronic pain), imagery (going to your “happy place”), and dissociation (detaching yourself from the chronic pain) can be useful.
  • Involving your family with your recovery may be quite helpful, according to recent scientific evidence.

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