The Disabling Interaction of Pain and Depression

Although it is commonly known in the professional mental health community that symptoms of depression include body pain, researchers have been finding that individuals diagnosed with chronic pain syndrome often feel more intensified pain if they concurrently have depression.

Dr. Matthew J. Bair of the Roudebush VA Medical Center in Indiana studied a group of 500 pain patients, on average 59 years of age, who were diagnosed with chronic pain syndrome. He looked at associations between pain and depression, pain intensity, pain-related disability and quality of life. His findings were that patients diagnosed with both chronic pain and depression/anxiety felt more intensified pain, were more often unable to participate in usual work or home activities, and overall had a lower health related quality of life than those patients who only suffered from chronic pain.

Dr. Bair has voiced that “depression and anxiety may be unrecognized among patients with chronic pain…(and) left untreated these conditions can have a devastating and profoundly negative impact on people with chronic pain.”

Overall, researchers have found that depression is 4 times greater in people with chronic pain than in the general population (Sullivan, Reesor, Mikail & Fisher, 1992). In other studies, it was discovered that the more severe an individual experienced their pain, the greater their depression rating. (Currie and Wang, 2004). The combined effect of chronic pain and depression was associated with greater disability than either of the two impairments alone.

This may seem obvious to some, but there are specific reasons that studies have explored to explain why pain and depression have such a disabling interaction. One reason is that people suffering from pain find it hard to sleep and this causes fatigue and irritability during the day, thus increasing symptoms of depression. Also, individuals who have chronic pain find it difficult to move or sustain physical activity, and so they end up spending most of their time in the house, in bed, and isolated from others. Social isolation often exacerbates depression. Pain medications have side-effects which include an overall mental dullness, and that can also cause a depressed state in individuals.

An abundance of research has found that chronic pain and depression tend to act together and cause a more intense total disability. Hopefully, with heightened awareness of these two conditions and their detrimental interaction, better treatment options can be explored to assist those suffering from these impairments.