It is estimated that 1 in 4 of us will experience some kind of mental health problem during our lives, with depression being the most commonly diagnosed mental disorder in the United Kingdom. Mentally and physically draining, depression can seriously reduce the quality of life when left untreated, and there are now links to suggest that depression could lead to other health problems such as chronic pain.
According to the National Institute of Mental Health, depression can cause us to feel more intense pain, and chronic pain can worsen the symptoms of depression, creating a vicious circle for those who are diagnosed with one or both of these conditions. While scientist have yet to identify the link between depression and chronic pain, these illnesses frequently occur together, and so many doctors believe that there is a very real connection between the two.
Pain & Depression Link 1: Cytokines
Cytokines are a group of proteins called ‘signalling molecules’ that are secreted in the immune system. Developed naturally by the body to regulate immunity, inflammation and haematopoiesis, cytokines communicate messages between the cells, causing pain by inflammation when we have an accident or injury.
Research shows that people with depression have higher levels of cytokines, and so they are more prone to inflammation and the pain that it causes. Only further research will help doctors better understand this link, but it’s a positive step in the right direction for those with depression.
Pain & Depression Link 2: Brain Structure
The brain has nine main ‘pain centres’ that are involved in the experience of pain, and six of them have been identified as locations where mental disorders such as anxiety and depression develop. Stressful experiences can cause brain chemical levels to increase, and the brain reacts by causing pain, thus linking the two together.
While scientists are still working on this link with sophisticated Brain Imaging, PET Scans and fMRI Scans, it is evident that recurring depressive episodes have a serious impact on the brain structure, and when the brain structure is compromised, pain signals are released.
Pain & Depression Link 2: Brain Function
Neurotransmitters are chemicals in the brain that tell our body what to do. The brain uses neurotransmitters to keep our hearts beating, or lungs breathing and our stomachs digesting, but they also process pain signals and regulate our moods. If there is any kind of chemical imbalance in the brain caused by either stress or injury, neurotransmitters are released, and this leads to pain, anxiety and depression.
There are two main types of neurotransmitters, Serotonin and Norepinephrine, both of which are listed as the main ingredient in many anti-depressants and prescription painkillers. Many Prescription Doctors prescribe Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) to treat both depression and chronic pain, which again links the two conditions.
When it comes to managing pain and depression, many doctors believe that both conditions must be treated simultaneously, with emphasis on the condition that occurred first. If you are feeling depressed as a result of chronic pain, or experiencing unexplained physical pain as a result of your depression, it is time to seek medical advice. Only once both conditions have been correctly diagnosed can your doctor prescribe the right medications for your particular illness, but neither depression nor chronic pain should be ignored, and it is never too late to ask for help.
When you consider the points above, it seems very probable that depression and chronic pain are linked, and with ongoing research, we can determine that connection and find a better way to treat the symptoms caused by these two very complex but common conditions.