In this post and Wednesday’s post, I’ll look with you at pain and depression.  Depression is one of the very serious issues related to pain.  At times, with serious depression, there can even be suicidal thinking.  In writing this post, I’m trying to get this serious issue on the table, so we can prevent depression, and treat depression if it’s there.

What are some of the symptoms of depression?  In addition to feeling sad or blue, other symptoms of depression include (remember these symptoms of depression by the mnemonic SIG-E-CAPS):

• S: sleep problems (either sleeping too much or insomnia)
• I: decreased interest in things
• G: feeling guilty about things
• E: decreased energy
• C: difficulty concentrating
• A: problems with appetite (either increased or decreased)
• P: psychomotor (which means body movements) slowing or agitation
• S: decreased sexual interest

Some of these symptoms of depression can be caused by other things.  For example, your pain may be causing you to have trouble sleeping, rather than depression.  Or, medication may be causing you to have problems concentrating, rather than depression.  So if you have some of these symptoms, or you’re concerned you might be depressed, it’s very important to talk with your medical doctor, or a psychiatrist who’s familiar with pain problems, to get the right diagnosis and treatment.

Depression is common in pain disorders.  Here are the percentages of patients with various pain problems who also have depression:

• Irritable bowel syndrome…. 61%
• Fibromyalgia…. 57%
• TMJ (a jaw problem)… 39%
• Chronic low back pain… 30-40%
• Migraine… 20-30%
• Phantom limb pain… 20%

Why do patients with pain get depressed?  Reasons include:

• coping with the severe and/or chronic physical feelings of pain - pain hurts!
• feeling you have no control over your pain
• coping with the consequences of a pain disorder
• pain interfering with work
• pain interfering with being with your family
• pain interfering with enjoyable activities
• pain interfering with social activities

Science has also started to show that the physical changes in your brain that happen when you’re in pain may, all by themselves, contribute to depression!  So in addition to the above reasons for feeling depressed, your pain itself may be causing depression directly in your brain.

Thankfully, there are many treatments for depression, including therapy and medications.  (Some medication even helps with both pain and depression.)  So, again, if you think you might be suffering from depression, talk with your doctor or a therapist.  Help is available.