What does one do with the pain they experience? How do they respond to it, manage it, live through it? What happens when the pain persists?
Patients with chronic pain are forced to contend with these and other such questions, as the physical ramifications of their condition are linked to issues of mental health, as well. Specifically, chronic pain and depression have been found to appear in comorbidity with one another. Read on to find out more about how these two conditions influence each other.
The Persistent Suffering of Chronic Pain
Chronic pain is defined as physical pain that continues beyond the expected time of healing. Normal pain is usually the result of the brain signaling a physical injury has occurred, so that the source of the pain can be avoided and the healing process can begin. With chronic pain, the brain will continue sending out the same alerts, causing a painful sensation even after the source of injury has been dealt with, or the wound has healed.
A chronic pain diagnosis is typically considered after three-to-six months of pain. Conditions of chronic pain are quite common, affecting approximately 20% of the world population, and addressed in 15%-20% of all physician visits.
Pain conditions are usually defined according to a number of parameters:
The perceived location (e.g. headaches).
Etiology (e.g. cancer-related, post-surgical or post-traumatic pain).
The primarily affected system (e.g. neuropathic pain).
Certain pain diagnoses are harder to categorize according to the above parameters (e.g. fibromyalgia).
In addition to its level of severity, chronic pain can appear through different types of pain. These include:
Throbbing
Stinging
Burning
Shooting
A dull ache
Squeezing
Soreness
Stiffness
Chronic pain is not only incredibly common, but can take on many forms and avoid a satisfactory treatment course. As a result, many patients continue to suffer under their condition, and may develop mental health conditions due to their experienced pain.
Depression: Low Mood and a Lack of Joy
Major depressive disorder, or MDD, is a mood disorder that causes a significantly low mood, an inability to feel joy (otherwise known as anhedonia), or both. Patients battling depression often describe it as a heavy and persistent feeling of great sadness, or (as Freud described it) a sense of mourning over the loss of something that remains unknown. The overall experience can be exhausting, frustrating, and severely debilitating.
Additional symptoms of depression include:
Hopelessness.
Emptiness.
Irritability.
Difficulty concentrating.
Low self-worth.
Neglecting one’s hygiene
Lack of energy.
Disturbed sleep patterns.
Self-harm.
Suicidality.
According to the American Psychiatric Association (APA), depression affects about one in 15 adults (or 6.7%). In the US, roughly 17.3 million adults (7.1%) have reportedly faced at least one depressive episode during their lifetime. It is one of the most prevalent mental health conditions across the globe.
The ramifications of major depression are widespread and run deep, with the World Health Organization (WHO) citing depression as the number one cause of years lost due to disability around the world. Due to its detrimental effects on the individual’s well-being, depression is also ranked third in the global burden of disease, and it is expected to top the list by 2030.
Chronic Pain and Depression Comorbidity
Out of the many different mental health conditions, chronic pain is most commonly found in association with depression, anxiety, and personality, somatoform, and substance use disorders. Chronic pain and depression comorbidity is among the highest, with 15%-100% of patients with depression reportedly dealing with symptoms of chronic pain, and 5%-85% of patients with chronic pain reporting symptoms of depression.
The relationship between these two conditions makes sense: as intense physical trauma is considered a risk factor for both chronic pain and depression, a traumatic event can lead to both occurring simultaneously.
Additionally, the overwhelming frustration that one might feel when faced with unending pain could cause them to eventually lose hope that they will ever find relief. As they continue to suffer under their physical condition, an individual first faced with chronic pain may then develop symptoms of depression, or even a full, official major depression diagnosis.
Indeed, patients with both chronic pain and depression could find themselves fighting on both fronts, and exhausting themselves in the process. As with other factors, though, achieving symptom relief in one of these conditions will likely bring about greater overall quality of life, and could have a beneficial effect on the second condition’s symptoms. In this context, it is worthwhile to mention the preliminary work conducted on Deep TMS for chronic pain, which has shown promising results in treating this condition: since mitigating the patient’s physical pain could induce a general sense of relief, successfully treating them for chronic pain could alleviate depressive symptoms they may also be dealing with.
Deep TMS has been proven to offer symptom relief to a number of conditions, and chiefly to major depression. The FDA-cleared, noninvasive medical device treatment utilizes electromagnetic fields to safely and effectively regulate the neural activity of brain structures found to be related to the appearance of depressive symptoms. Deep TMS sessions are roughly 20 minutes long, and do not necessitate the use of anesthesia. This allows patients to fit the treatment into their schedules, while driving themselves to and from each session. As Deep TMS also does not cause any long-lasting or significant side effects, it is considered highly tolerable to patients, making it easier for them to adhere to a full treatment course.
Helping Patients Find Relief
The many patients dealing with chronic pain and depression are eager to find a way to ease their everyday struggle. Turning to medical treatments proven to offer relief can provide them with the possibility to finally find the solace they are searching for, and the strength they need to continue their battle for greater well-being.
Further Reading
Below are a list of clinical studies, analyses, and articles that further explore the connection between Chronic Pain and Depression:
Pain – Depression in patients with chronic pain attending a specialised pain treatment centre: prevalence and impact on health care costs
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