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Insult to Injury: When Chronic Pain Causes Anxiety or Depression

We all experience aches and pains. For some of us, however, the pain doesn’t go away. Chronic pain, whether it’s caused by cancer, arthritis or another condition, changes the way you live life. It can be difficult for you to work, enjoy activities you used to love, or even get out of bed in the morning. The profound effect it has can contribute to the development of mental health conditions, like depression or anxiety.

Chronic Pain and Anxiety Link

While anxiety is normal, anxiety so serious that it has an impact on your life is not. Pain typically acts as the body’s warning system, alerting us that something is wrong. When the body experiences chronic pain, it stays in flight-or-fight mode. Physically, the muscles tense, which can further increase feelings of pain. Emotionally, the anxiety creates a constant state of alarm and worry. Your focus becomes centered on the pain: how much you feel and how much you can do based on how severe it is. In fact, chronic pain has been shown to change certain functions in the brain that deal with fear.

Chronic Pain and Depression Link

Researchers are still trying to identify exactly how chronic pain is linked to depression. Body aches are a common depression symptom. This may be because people with the mental health disorder have higher levels cytokines than those without depression. Cytokines are involved in sending messages within the body related to how the immune system responds to infection and damage. In someone struggling with depression, their overabundance may promote inflammation as an immune response, and that inflammation causes pain. However, chronic pain also increases the likelihood of depression. The presence of persistent pain can make you feel alone and isolated. Depending on the condition you’re living with, you may even be immobile and need to rely on others to do tasks you used to do yourself. Research supports the idea that chronic pain contributes to depression. One review of numerous studies found that chronic pain patients report higher levels of depression than healthy controls. In particular, the painful condition fibromyalgia may be closely linked to depression. While researchers are still trying to pinpoint the exact cause, some evidence suggests that people with the disorder, which causes muscle pain and tenderness, have heightened sensitivity in the brain to both emotional changes and physical discomfort.

Chronic Pain, Depression and Suicide

Each of these conditions on its own can increase the risk of suicide. However, when the constant physical pain and symptoms of depression come together the overall sense of powerlessness can become unbearable, making treatment that much more important.

Chronic Pain and Treatment for Depression or Anxiety

The most effective way to manage these conditions is with what’s sometimes called a “whole life” approach to treatment. The goal of this strategy is to treat symptoms of the disorders as well as treating their root causes. Therapy: Cognitive behavioral therapy (CBT) is an effective treatment for depression and anxiety. It works by helping you change the negative thoughts and feelings that trigger symptoms. You’ll also learn more constructive ways to handle those thoughts and emotions to reduce or prevent depressive or anxious thoughts from taking over your life. Therapy also reduces pain by rewiring the brain to think about it differently. For example, a skilled therapist will use CBT to teach you to reduce negative thoughts (“Right now I’m in the worst pain of my life!”) that create stress and, as a result, contribute to pain. The therapist will work with you to create a problem-solving attitude that rejects feelings of helplessness and fear. Medications: Prescription drugs work in conjunction with therapy to relieve symptoms. Antidepressants are used to alleviate feelings of depression, but they may also reduce the perception of pain. A physician might prescript serotonin or norepinephrine reuptake inhibitors or, in some cases, tricyclic antidepressants. Anti-anxiety medications can also reduce physical symptoms of anxiety disorder. However, anti-anxiety drugs do have the potential for addiction, so a physician will only prescribe them if he or she feels they’re necessary for treatment. Exercise: It can be hard to work out when you’re suffering chronic pain. However, exercise keeps the body in shape and reduces the risk of injury. It also releases the body’s natural neurotransmitters called endorphins, which raise mood levels and reduce pain. Talk to your physician about finding a fitness program that is safe and doable for you. You may be able to ease into low-impact exercise, such as walking, yoga, or Tai Chi, which is an adaptable exercise that focuses on joining the mind and body. A review of studies found that Tai Chi has been an effective pain management therapy for fibromyalgia, rheumatoid arthritis, low back pain, and headaches. Alternative therapies: These health practices are intended to improve and maintain the body and mind. For instance, deep breathing and meditation techniques release pain-causing tension and lower stress levels. Biofeedback is another alternative therapy that will teach you to consciously control automatic body functions, like reactions to stress or anxiety. Acupuncture may also help relieve pain because it’s believed to release endorphins that block feelings of pain. Always talk with your physician to make sure alternative therapies won’t interfere with conventional depression, anxiety, or chronic pain treatments you’re receiving. Sleep solutions: Chronic pain, depression, and anxiety all interfere with healthy sleep, which, in turn, can make symptoms for the disorders worse. Talk to a health professional about finding relief for insomnia and other sleep problems. Medications may offer a short-term solution, but other strategies, like cognitive behavioral therapy for insomnia, will create the good sleep habits that lead to long-term relief. Whether your chronic pain is causing depression and anxiety or the other way around, the only path to feeling better is to treat each disorder. Consult a mental health professional today to start a treatment plan that helps you reclaim your life.

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