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Breaking the Cycle: Overcoming Chronic Pain and Depression

Breaking the Cycle: Overcoming Chronic Pain and Depression

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.

The link between chronic pain and depression

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.

Chronic pain isn’t just linked to depression. Researchers have also found ties between PTSD and chronic pain, chronic pain and anxiety, and chronic pain and ADHD.

Overlapping chronic pain and mental health conditions

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

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.

Back pain

People living with persistent back pain are at increased risk for major depression and experience major depressive symptoms longer than those without pain.

Chronic migraines

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.

Menstruation-related pain

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.

Treatment for depression and chronic pain

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 therapy

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:

  • In what ways has pain changed my life?
  • Does pain keep me from socializing with family or friends?
  • Do I avoid activities for fear of re-aggravating an injury?
  • Do I overcompensate on “good days” and get as much done as possible? Does that leave me drained afterward?
  • Does my pain increase when I’m stressed, worried, angry, or down?

Stress reduction and relaxation

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

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.

How chronic pain and depression impact the workplace

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:

  • Talk to your manager about your condition so they can accommodate your needs
  • Take short breaks throughout the day
  • Request more flexibility in your work schedule
  • Prioritize self-care 
  • Get treatment

Some ways employers can support workers with chronic pain and mental health are:

  • Provide flexible work hours or remote work options
  • Encourage regular breaks
  • Tackle mental health stigma by discussing mental health openly and modeling healthy behaviors like a positive work-life balance and taking PTO
  • Ensure that mental health benefits are integrated with other benefits programs, so it’s  easier for employees to understand and access the resources available to them

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.”

Take steps toward a better life

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.

Get professional support for your mental health.

You can get started today if your employer offers Lyra.

Sign up now
About the reviewer
Lauren Cunnningham

Dr. Cunningham has over a decade of clinical and administrative behavioral health experience. She received a doctoral degree in counseling psychology from Ball State University and has authored publications on crisis prevention in schools and sexism toward women in the military. Previously, she held several mental health-focused roles in the United States Air Force, receiving many honors including the Air Force Commendation Medal for Meritorious Service and the Air Force Achievement Medal. She also served as CEO of Blackbird Psychological Services, providing and supervising psychological evaluations for the Department of Defense and Veterans.

Clinically reviewed by
Lauren Cunnningham
By The Lyra Team
7 of November 2023 - 5 min read
Mental health treatment
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