The Link Between Depression and Physical Pain

By Lisa Ellis

Reviewed by QualityHealth's Medical Advisory Board

Pain and depression often occur together, making it difficult to tell which one comes first. Therefore, if you’re affected by both problems, you may wonder whether your pain is causing your depression, or if your depression is causing the pain. In some cases, the answer could be a little of both.

Depression is a Very Common Problem

“For adults, the rate of Major Depression (a feeling of hopeless or despair that impacts your daily activities, also sometimes called Clinical Depression) is at about 7 percent and the number appears to be rising,” says Greg Kushnick, Psy.D., a clinical psychologist in Manhattan who runs a health/technology blog at Techealthiest.com. He points out that this statistic doesn’t accurately capture the prevalence of the condition, though.

“In my professional opinion, depression is much more common than people think. Formal statistics don’t accurately capture depression’s omnipresence,” Kushnick says. Part of the challenge in capturing the full extent of the problem is that many people don’t seek help for their symptoms.

The latest research also reveals that women are much more likely to experience depression than men, but Kushnick says that this is also misleading.

“Women are more likely to access their support system to handle depression, and they are more likely to seek professional help,” he says, while men are more likely to turn to drugs and alcohol to attempt to manage depression.

Exploring the Pain and Depression Link

For both sexes, the pain and depression link can be present, although the exact relationship between the two varies according to the person and the situation. “Depression can worsen pain and pain can worsen depression. This cycle can continue without a clearly identifiable pattern,” Kushnick says.

One possible explanation is the connection between inflammation and depression, which has been gaining more attention lately. “Inflammation may at least partially explain some of the overlap between physical illness and depression." But some of the connection may also lie in how you perceive your symptoms and how much they affect you.

“Learned helplessness, a concept introduced by Martin Seligman [commonly known as the founder of Positive Psychology, which is a school of thought that believes people can learn to be happy], refers to the perception that if you believe that there is nothing you can do to change your situation, it’s likely to heavily influence your perception of pain and how depressed you feel,” Kushnick explains.

Further, he says that when depression is amplified, any pre-existing physical condition may be exacerbated. For example, arthritis may be more pronounced during a depressive episode.

Exactly why depression can worsen existing pain “is probably a mix of how closely related the areas are in terms of biology and also the severity of depression, which in its more extreme forms would open the gateway to the experience of pain,” Kushnick says. In fact, this is why people with severe depression are likely to experience pain more intensely.

While you may not be able to prevent the pain and depression combination from occurring, there are things you can do to help yourself feel better.

Taking Control to Manage Pain and Depression

“Patients with depression and pain should try to stay active. Both conditions often promote isolation from others and inactivity but the key is to stay busy and move toward your support network as much as possible,” Kushnick says. This is often easier said than done for people who are in the throes of depression or experiencing a bout of pain that is interfering with their activities. But with the help of a trained professional (and the use of medications as needed), people can often make some small steps that add up to big gains.

“If positive change feels out of your control as a result of depression and pain, try to create a series of small successes during your day,” he explains.

For instance:

Look for tiny victories and write them down so you have a running list that you can look back on.
Seek out the support of others, even if you believe they won’t understand what you’re going through.
Channel your pain and suffering into creative endeavors like photography or drawing.
Practice acts of giving and kindness.
Look for volunteer experiences or other activities that will make you to feel like you’re committed to something worthwhile. This will enable you to step outside your suffering and gain perspective.
Work on your self-talk by repeating phrases that promote a sense of strength. (“I can do this” or “I am in control.”)
Envision yourself taking action to manage either your depression or pain—this is likely to lessen both.

Seeking Professional Help

When depression and pain seem to be getting in the way of your functioning and your symptoms aren’t lessening with some simple interventions, Kushnick stresses the importance of ruling out any other health issues. “You cannot easily tell the difference between depression-related pain and something more life threatening,” he says. “I would recommend seeking professional help from a medical doctor and a mental health professional to help you get a better handle on the severity of the condition.”

Greg Kushnick, Psy.D., reviewed this article.