The Mind-Body Connection: Understanding Chronic Pain And Depression

Katarina Zulak
Written by
Katarina Zulak Chronic Warrior & Health Writer

What Are The Common Signs Of Depression?

The primary symptoms of depression include having a persistently low mood, and losing interest or enjoyment in everyday experiences that usually bring you pleasure (Surah, 2014). You may also feel excessive guilt, fear, or irritability, along with a low sense of self-worth or confidence. If you feel depressive symptoms for longer than two weeks, and they interfere with your normal daily functioning, then you could be diagnosed with depression.

Why Do People Living With Chronic Pain Also Develop Depression?

Between 40-60% of people living with chronic pain also have depression (Surah, 2014). People living with chronic pain are four times more likely to experience depression than people who don’t live with pain (Mental Health America). Why do these conditions often coexist? The mind and body are deeply interconnected. Research shows that depression increases pain sensitivity, and pain is a risk factor for depression.

People who have been diagnosed with depression are more sensitive to pain than healthy people without depression. Almost half of depressed patients report experiencing body pains (Surah, 2014).

If chronic pain interferes with daily functioning, socializing, work, or family roles, sometimes called “high-impact chronic pain,” then you are more likely to experience depression (Mental Health America). These losses create the emotional conditions for depression—grief over your old life and self, losing self-confidence, and social isolation (Surah, 2014). 

Depression And Pain Cause Similar Changes In The Brain & Nervous System

There is significant overlap between the brain regions that are involved in pain processing and the regions that process emotions. So, if you develop pain or depression, then changes in the responsible brain regions may predispose you to develop the other condition (Surah, 2014).

 For example:

“Researchers found that, in a healthy brain, all the regions exist in a state of equilibrium. When one region is active, the others quiet down. But in people with chronic pain, a front region of the cortex mostly associated with emotion… fails to deactivate when it should” (Northwestern University, 2008). 

In addition, the levels of two important chemical messengers in the brain and nervous system, norepinephrine (adrenaline) and the feel-good neurotransmitter serotonin, are reduced in both depression and chronic pain. Antidepressants that increase serotonin and norepinephrine are effective for treating pain and depression, further showing the link between these two conditions.

Treatments That Work For Depression And Chronic Pain

Mind-body strategies that act to change your emotional state or use movement to shift attention and promote mental relaxation can help relieve both pain and low mood (Surah, 2014). Relaxation techniques like  deep breathing, progressive muscle relaxation and guided imagery can reverse brain changes caused by chronic stress. Mindful movement, like yoga, tai chi, and qi gong are also effective at treating both pain and depression.

One of the most effective treatments for chronic pain and depression is a program called Cognitive Behavioural Therapy (CBT) (Mohr, et al., 2001). One of the core parts of CBT is learning to identify and change negative thinking traps, or ‘cognitive distortions,’ which can fuel a sense that bad experiences are catastrophes (catastrophizing). In CBT you learn techniques for challenging these thinking patterns, such as changing the thought that ‘I will always be in pain’ to ‘I can manage my pain’.

Mindfulness meditation programs have demonstrated remarkable benefits for reducing chronic pain, as well as anxiety and depression (Grossman, et al., 2007). Being mindful means intentionally being present with your breath, mind, body, and heart, with acceptance and compassion—instead of dwelling on the past or worrying about the future. Mindfulness emphasizes the temporary nature of our mental and emotional states, which change like the weather. We develop greater self-awareness by paying attention to our mental and physical state.  

Chronic pain and depression show that the mind and body are deeply interconnected, and the best approaches, like mindfulness, understand this relationship.

Katarina Zulak
Written by
Katarina Zulak Chronic Warrior & Health Writer

I am a health blogger, health writer and all-around health nerd. Eight years ago I was diagnosed with fibromyalgia and endometriosis. On my health journey, I’ve learned the power of self-care skills to improve my health and wellbeing. As a writer I am excited to educate and inspire others to be skillfully well, even if they have a chronic condition. From medication to meditation, I started learning that living skillfully improved my wellbeing in all dimensions (mind, body and spirit). It also increased my agency again – the capacity to achieve change in my own life. My focus shifted from being a career-focused humanitarian to a self-care and wellbeing advocate in my own life, and the lives of others who live with chronic pain and illness. Read more at Instagram @skillfullywell Facebook @akatarinaz  Pinterest @akatarinaz

This article is for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek medical advice from your physician or health provider for your specific needs.

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