Gloria Pope, director of advocacy and public policy for the Depression and Bipolar Support Alliance, suffers excruciating migraine headaches and says she can feel them fueling her depression.



“I go all week under stress, and when it’s the weekend, the headaches smack me,” says Pope. She says she loses the equivalence of two to three days of her free time each week — she doesn’t make plans because she’s afraid she’ll be hit with a massive headache. As summer and nice weather approach, she’s says it brings her down to be stuck inside, “sick as a dog.”

Chronic pain and depression are intimately connected — so much so that doctors often aren’t quite sure which condition causes the other. Depression occurs at least three times more frequently in people who deal with chronic pain than in those who don’t. Research indicates that if all patients with chronic pain were screened for depression, many cases of previously undiagnosed depression would be found.

The Depressing Side of Pain
According to researchers, there are a number of reasons why chronic pain and depression are so closely linked:
  • Chronic pain takes an emotional toll. When you’re in pain all the time, you’re not able to take care of your day-to-day responsibilities as easily and your relationships with family and friends may become strained. Not surprisingly, studies have found that the degree of pain a person experiences directly influences symptoms of depression — more physical pain simply takes a bigger toll on your mood.
  • The same regions of the brain regulate pain and depression. Researchers have found that the same areas of the brain are responsible for processing both pain and feelings of depression. Another study showed that the part of the brain that works to diminish pain was sluggish in the depressed subjects. The brain uses many of the same chemicals responsible for regulating mood, including serotonin and norepinephrine, to transmit pain signals. Chronic pain and chronic depression both have similar effects on the nervous system as well, often intensifying perceptions of pain. It’s no coincidence that many medications prescribed as antidepressants are effective in treating pain, too.


Treating Pain and Depression Together
A combination of therapies is usually necessary to treat chronic pain that occurs in association with depression. The physical source of your pain must be treated as well as your feelings of depression.
Therapies your doctor might recommend to help you deal with pain and depression include:
  • Pain medication
  • Antidepressants
  • Massage
  • Meditation
  • Biofeedback
  • Hypnosis
  • Cognitive-behavioral therapy
  • Psychotherapy
A person experiencing chronic pain and depression may also benefit from treatment at a pain management center. Specialists at these centers are skilled at combining the therapies listed above to help break the cycle in which symptoms of pain and depression feed off each other.

Successful treatment of chronic pain and depression can be a lengthy process. You may need to try several different therapies before finding one that deals with your depression and helps alleviate your pain. Be patient and keep in mind that both conditions can be managed effectively.