Depression &Pain Carla Cowley
Pain and depression are closely related. Sometimes,
depression causes unexplained physical symptoms —
such as back pain or headaches. In other cases,
depression may increase your response to pain, or at
least increase the suffering associated with pain.
Conversely, chronic pain is stressful and depressing in
itself. Sometimes pain and depression create a vicious
cycle.
Some research shows that pain and depression share
common pathways in the emotional (limbic) region of the
brain. In fact, the same chemical messengers control
pain and mood. In addition, both chronic pain and
depression are influenced by genetic and environmental
factors.
In some cases, antidepressants can reduce the
perception of pain — as well as improve sleep and
overall quality of life. Other types of mental health
therapy can be helpful as well. Often, treatment involves
both medical and mental health providers.
Unstated
Assumptions
Patients who suffer
from both back pain
and depression work
with their therapists
and doctors to adopt
a more active way of
dealing with pain
through exercise,
work, and lifestyle
changes.
DEPRESSION IS
TREATABLE!
Evaluating
Evidence
 Unfortunately, only about 1/3
of those who are depressed
actually get treatment
DEPRESSION IS
TREATABLE!
Evaluating
Evidence
...While up to 80-90%
who do get treatment
can feel better, usually
within a few weeks!
Daniel K. Hall-Flavin, M.D.
Daniel K. Hall-Flavin, M.D.
Dr. Daniel Hall-Flavin, board certified in general psychiatry and
addiction psychiatry, is a St. Louis native looking to the Internet as
a way to help people improve their health and be more active
participants in their own health care by learning from Mayo Clinic's
experts.
Dr. Hall-Flavin has been a member of the faculties of Cornell
University Medical College, New York Medical College, and The
George Washington University Medical School before joining the
Mayo Clinic staff in 1996. He has special interests in adult
psychiatry, addiction psychiatry, and psychogenomics. He has
served as medical director of the National Council on Alcoholism
and Drug Dependence from 1986 to 1999.

Refutation
Dr. Kurt Kroenke, a
doctor at the Indiana
University School of
Medicine, published a
May 2009 study in
the Journal of the
American Medical
Association
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While it's common for patients with chronic pain to suffer
from clinical depression, it's a lesser-known medical fact
that depression can also cause and exacerbate neck and
back pain. This article chronicles the reasons behind back
pain found in sufferers of clinical depression and examines
some of the possible solutions.
It is recommended that patients who suffer from both back
pain and depression work with their therapists and doctors
to adopt a more active way of dealing with pain through
exercise, work, and lifestyle changes.
The touted better recovery rates for patients who went
through an individualized regimen that touted therapeutic
pain management alongside anti-depressants and
painkillers than those who dealt with the problem in the
usual way--by popping pills and hoping they work.
"It is possible that pain improvement in our trial reflected a
main effect of improved mood ... and that as depression
lifts, patients may experience pain as being less intense
and less disabling. Conversely, it is also possible that the
improvement in depression was mediated by an
improvement in pain ... or that both depression and pain
lessened as a result of treatment effects on a common
pathway," Kroenke wrote.
By eHow Contributing Writer
Symptoms of Major Depression
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Sadness, anxiety, or "empty" feelings
Decreased energy, fatigue, being "slowed down"
Loss of interest or pleasure in activities that were once enjoyed, including sex
Insomnia, oversleeping, or waking much earlier than usual
Loss of weight or appetite, or overeating and weight gain
Feelings of hopelessness and pessimism
Feelings of helplessness, guilt, and worthlessness
Thoughts of death or suicide, or suicide attempts
Difficulty concentrating, making decisions, or remembering
Restlessness, irritability or excessive crying
Chronic aches and pains or physical problems that do not respond to treatment
source: National Institute of Health Publication No. 97-4266 and 99-3561