Pain and Depression: Stopping the Downward Spiral

When you’re in pain it’s hard to feel like much is right with the world. So it’s hardly surprising that ongoing pain takes a toll on your mood, and can even lead to feelings of depression. While depression is often a symptom of chronic pain, the opposite is also true. Yes, you read that right: depression can cause physical pain. In fact, about half of people who suffer from depression also experience physical pain.

The pain-depression, depression-pain link can be a dangerous ongoing loop. But you don’t have to stay trapped in this negative whirlwind. Let’s take a look at some strategies you can implement into your daily routine to weaken the link between pain and depression.

Exercise: Get Moving

It’s no secret that exercise is good for body and mind, but that couldn’t be truer when it comes to breaking the link between pain and depression. Exercise is probably the single best thing you can do because it has antidepressant, anti-inflammatory and anti-pain effects.

Exercise has actually been shown to have more of an antidepressant effect than depression medications. Exercise releases endorphins, which are natural, feel-good chemicals, in the brain.

Endorphins are also one of the body’s natural painkillers. “The less you move, the more pain and fatigue you’ll feel,” said Maura Daly Iverson, PT, DPT, SD, MPH, spokesperson for the American Physical Therapy Association. Staying active can not only reduce pain in the body, but also makes you feel more physically capable, which can improve your overall sense of well-being.

Pain Resource Tip: If you’re having trouble getting motivated, start slow. Try a stationary bike and set the goal of biking for five minutes. Bring a book or magazine to keep your mind occupied. Then, gradually increase the length and intensity of your workouts.

Consider Antidepressants with an Open Mind

We’re not just talking about pain medications. There’s another type of drug on the market that’s surprisingly effective at relieving pain: antidepressants. Serotonin-norepinephrine reuptake inhibitors (SNRIs), such as Cymbalta (duloxetine) and Effexor (venlafaxine), are known to have painkiller properties independent of their antidepressant effects. For example, tricyclic antidepressants are used to treat migraines and low back pain, while SNRIs are given for neuropathic (nerve) pain, such as diabetic neuropathy or fibromyalgia.

After reviewing 18 randomized, controlled clinical trials, researchers in Germany concluded that antidepressant medications are associated with considerable improvements in pain, as well as depression, fatigue, sleep disturbances and quality of life among people with fibromyalgia.

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When prescribed to pain patients, antidepressants are used with the goal of relieving pain; however, if that patient is also depressed, relief from depression becomes the second most important goal.

Pain Resource Tip: It can take up to four weeks for antidepressants to work, so you may not notice an immediate change in how you feel. Just as important, there is no one size fits all pill – each person is unique. With that in mind, certain medications might not work as well for certain people. If the first pill that you try doesn’t seem to be working, that’s OK. Try to keep an open mind and stay in contact with your doctor about trying different prescriptions until you find the pill that’s right for you.

Try Mindful Meditation

Since we can’t control outside factors that cause pain or depression, it’s important to control what we can; namely, how we respond. To that end, it helps to practice relaxation techniques regularly to quiet the limbic system in your brain, which will help with both depression and pain.

Mindful meditation is an excellent way to quit the mind and relax. Researchers at the University of Louisville followed 91 women with fibromyalgia, and found that those who participated in eight weekly two-hour meditation sessions experienced a significant improvement in depressive symptoms. Meanwhile, researchers at the University of Pittsburgh found that older adults with chronic backaches who participated in an eight-session mindful meditation program had significant improvement in their pain tolerance and physical function.

With mindfulness meditation, the goal is to sit in a quiet, comfortable spot, clear your mind of thoughts and focus on your breathing. When thoughts do come to mind, observe them as if they were clouds floating across the sky, without judging. Then simply return your attention to your breathing.