Up to 85% of people who have chronic pain are also affected by severe depression. The two conditions affect each other. Pain triggers and worsens depression, and depression amplifies sensations of pain. People who have chronic pain may benefit from regular screenings for depression. The connection between these conditions isn’t well understood. However, researchers have made some big discoveries in recent years. 

Have you started experiencing mood symptoms along with chronic pain? There is hope that you can find some relief. Start by seeking medication management from providers who understand both.

In this article, we’ll talk about the pain-depression cycle and how psychiatric care can help break it.

Understanding the pain-depression cycle 

Chronic pain conditions often lead to depression. Research has confirmed that the two share some of the same mechanisms in the brain and body. Sensory pathways that send information about injuries and body pain share the same brain areas involved in mood regulation. Changes in neuroplasticity, or the brain’s ability to change by developing new connections, can play a role in both conditions. The inflammatory response can also trigger changes in neuroplasticity and brain function. 

Conversely, stress may contribute to the development of autoimmune conditions. In this way, difficult life situations may fuel chronic pain.

Symptoms and behaviors associated with both depression and chronic pain can start a spiral of worsening health. Hopelessness and low mood, sleep disruption, avoidance of life activities, and loss of physical conditioning can all add up. Your sense of identity or self-image and your relationships may be affected. Practicing self-compassion by finding ways to care for yourself that feel accessible will go a long way to help you manage your symptoms.

4 ways psychiatric care breaks the cycle of chronic pain and depression

For most people, a primary doctor and a chronic pain specialist are the first steps on the treatment journey. They can help with many of your physical symptoms. Seeing a provider for psychiatric medication can help with depression, improving your overall health. When your depression is under control, it’s easier to care for yourself, stay well and live a meaningful life. 

Psychiatric care can help break the chronic pain and depression cycle in these ways:

• Dual-action medications

Antidepressants help balance neurotransmitters in the brain such as serotonin and norepinephrine. You may know that these are instrumental for your mood. Did you know they also play a role in pain perception? Gabapentinoids, such as pregabalin or gabapentin, are also used to treat nerve pain and anxiety.

Your providers should help you avoid medications that worsen one condition or the other. Certain antidepressants may be less effective for people with chronic pain. Serotonin-norepinephrine reuptake inhibitors (SNRIs) and tricyclic antidepressants are more likely to help with both conditions. 

2. Psychotherapy for pain and mood

Several types of psychotherapy can help with different aspects of living with chronic pain and depression. This includes traditional cognitive behavioral therapy (CBT), adaptations of it, and mindfulness therapies. Essentially, therapy helps you change your relationship to your pain and the ways it impacts your life. A therapist can also help you develop coping strategies to manage both conditions. The main goals of CBT for chronic pain and depression are pain education, increased activity and improved cognitive flexibility. 

CBT is most helpful with depression symptoms, pain acceptance and limiting how pain interferes with life activities. There’s not much evidence that it can help with pain intensity or pain catastrophizing. However, acceptance- and mindfulness-based interventions can have indirect effects on pain intensity. Acceptance and behavioral techniques can also affect pain interference and pain catastrophizing. The acceptance of pain may reduce feelings of stress and the avoidance of certain activities.

3. Sleep and circadian rhythm optimization

Sleep disruption makes chronic pain and depression feel worse. Improving sleep quality can help you feel your best on both fronts. Building good sleep hygiene habits is the most important approach. This includes going to bed at the same time every day and creating bedtime rituals. Start by avoiding backlit screens for an hour before bed each night and doing soothing activities like restorative yin yoga. You might also try using natural remedies like herbal teas or supplements. Some antidepressants cause drowsiness, but not all. Taking certain ones before bed can help you fall asleep.

4. Comprehensive lifestyle and medication coordination

Related conditions like depression and chronic pain have complex relationships. It’s critical for your care team to take a holistic and collaborative approach. Tell each provider about all the medications you’re taking and your health history. Providers who prescribe medications will need to avoid potential interactions and worsening your symptoms. You should also ask for other recommendations to support mental health and pain management (e.g., nutrition, exercise and stress management).

Find comprehensive and personalized medication management at ReKlame Health

Depression and chronic pain work together. Symptoms of both conditions can keep you away from activities that help you maintain good physical health and a positive outlook. You should build relationships with compassionate and experienced care providers you trust. Treating one condition or the other in isolation may not break the pain and depression cycle. With an integrated and personalized treatment strategy, you’ll have a better chance at improving your quality of life. 

At ReKlame, we offer personalized, culturally relevant medication management for complex conditions. We can match you with a psychiatric nurse practitioner who has experience treating depression and chronic pain together. You can expect a supportive relationship with a provider who listens and addresses your concerns. 

Ready to start the conversation? Appointments are available now. Check your eligibility for free online or book an initial appointment online.