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The mind-body connection is undeniable, especially for people living with chronic pain and depression. Research shows that one in five people experience chronic pain and up to 85% of patients with chronic pain are affected by severe depression. Taking a holistic approach that treats chronic pain and mental health together is critical for relief and overall healing.
Nearly 65 percent of people who seek help for depression report at least one pain symptom.
“As a society, pain is often viewed as a physical experience, and depression is viewed as an emotional experience,” said Lauren Cunningham, PhD, senior manager of clinical quality at Lyra Health. “But clinical studies demonstrate that chronic pain and mental health concerns are actually closely related.”
Depression and chronic pain can create a cycle of both physical and emotional distress. Living with persistent pain can lead to psychological symptoms, including frustration, anger, irritability, and feelings of helplessness. Constant discomfort, limitations in daily activities, and a diminished quality of life can trigger or worsen depressive symptoms.
Likewise, depression can involve physical symptoms that worsen chronic pain. Common symptoms of depression like fatigue, inactivity, and difficulty practicing self-care may make the body less resilient to injury or pain. Depression may also cause changes in brain chemicals involved in pain perception, leading to greater sensitivity to physical pain. “All of these neurological processes pull double duty—they’re tied to pain sensory pathways as well as emotional pathways. So there’s a lot of overlap between those two spaces,” said Dr. Cunningham.
Some common pain conditions that correlate with depression and other mental health conditions include:
Arthritis is inflammation of one or more joints. The pain and decreased mobility that accompany arthritis can limit your day-to-day functioning, which can fuel depression.
Fibromyalgia (FM) is a chronic, multi-symptom disease affecting pain signal processing. A touch or movement that doesn’t cause pain for others may cause pain for someone with FM. Women with FM have been found to have a higher risk of certain anxiety disorders such as obsessive-compulsive disorder (OCD), particularly stemming from efforts to avoid certain physical stimuli.
Multiple sclerosis (MS) is nerve damage that disrupts how the body and brain communicate with each other. People with MS are nearly twice as likely to experience major depressive disorder and are also more likely to develop some form of anxiety in their lifetime.
People living with persistent back pain are at increased risk for major depression and experience major depressive symptoms longer than those without pain.
Migraines that someone experiences for 15 days or more a month or for more than three consecutive months are considered chronic. The unpredictability of these migraines can spur anxiety for those worried about when one might strike and disrupt their day.
Pain during menstruation affects many people, but those living with endometriosis and uterine fibroids may face extreme pelvic pain. Many times they feel alone in their struggles and experience a sense of helplessness that can lead to depression. The unpredictability of the menstrual cycle and not having feminine products on hand can also cause anxiety for some people.
Because ongoing pain can lead to depression, and vice versa, treating the body and mind holistically is key to disrupting the chronic pain cycle. An integrated treatment approach to chronic pain and depression may include the following.
Behavioral therapies like cognitive behavioral therapy (CBT) teach people how to identify and change thoughts, behaviors, and emotions associated with chronic pain and depression. This might include challenging certain thoughts like, “I can’t do anything because of my pain,” or “My pain will never improve.” CBT can help people manage their reactions to chronic pain like frustration, anger, sadness, and worry.
Questions someone might answer through CBT are:
Stress and anxiety can lead to muscle tension and tightness, which can exacerbate pain. Relaxation techniques, such as deep breathing or progressive muscle relaxation, can help alleviate tension and reduce pain.
Lifestyle changes can also complement medical treatments and therapy for depression and chronic pain. These may include eating nutritious food, getting enough sleep, exercising regularly, practicing mindfulness, and limiting substance use.
Medication can help with both chronic pain and depression symptoms. To maximize their effectiveness, medications for depression and chronic pain should be paired with behavioral therapy. It’s important to talk to a qualified medical provider about medication options before beginning any treatment for chronic pain, even if it’s over-the-counter. You want to make sure you’re using those medications safely and appropriately.
Chronic pain and depression can impact both employees and entire organizations. In addition to the personal toll on health, relationships, and quality of life, these conditions can lead to higher health care costs, absenteeism, and turnover if workers can’t access proper care or manage their conditions effectively.
If you’re living with chronic pain and depression, here are some ways you can manage your symptoms while at work:
Some ways employers can support workers with chronic pain and mental health are:
Changes like these signal to employees that you’re committed to their long-term well-being. But employers must go beyond just offering benefits. “Talk about those resources and encourage employees to use them well before it gets to the point that your team members are struggling,” says Dr. Cunningham. “Caring for your team members is central to productivity.”
Depression and chronic pain can feel overwhelming, but they don’t define you. With treatment, you can live a healthier life that’s enjoyable and fulfilling.