Battling Chronic Back Pain & Depression
Medical experts commonly describe “chronic back pain” as discomfort that lasts for longer than three months. In some circles, pain may be considered chronic if it simply lasts for longer than the typical recovery time. However, either way you slice it, chronic back pain doesn’t always begin and end at the physical level. In fact, it is often cited that 30 – 50% of people with chronic pain also suffer from depression and anxiety.
Depression often magnifies the sensation of pain, and vice versa. To be more specific, people with chronic pain are three times as likely to develop the symptoms of depression. Likewise, people who suffer from depression are three times as likely to develop the symptoms of chronic pain. Both of these problems share similarities at a very intrinsic level. For example, much like chronic pain, depression often causes unexplainable neck pain and headaches. In turn, symptoms of chronic pain often mirror symptoms of depression. A person with chronic pain may have horrible insomnia, increased anxiety, or feelings of worthlessness. As you can imagine, this creates a vicious cycle that often calls for the aid of trained doctors and therapists.
Symptoms of Chronic Pain & Depression
As mentioned previously, chronic back pain is any back pain that lingers for a period of three months or more. This pain may range in severity depending on the individual’s case. Additionally, there are many other medical problems that may lead to chronic pain aside from depression. These causes of lower back pain can be difficult to pinpoint. Over time, chronic pain often gets worse as the body becomes more sensitive to it. This alters a person’s pain perception and they may start to hurt in places that were previously fine.
One of the main concerns with chronic pain is that it snowballs in severity over a period of time. For example, chronic back pain may disrupt sleep, which may lead to a loss of productivity and decreased daily function. If this goes on for long enough, then a person will become irritable and have trouble socializing with others. It may make life seem too challenging and instill feelings of worthlessness.
Depression is extremely complicated, often misunderstood, and hard to treat. The main reason why depression can be so difficult to resolve comes from the fact that the average person does not seek professional help soon enough. In fact, it is most common for a person to suffer from depression for 10 years before seeking help for their condition. If you have the following symptoms, you may need professional guidance:
- Inflammatory cytokines (cytokine production is linked to both depression and pain)
- Anhedonia (loss of interest in activities that used to be pleasurable)
- Difficulty focusing
- Loss of appetite
- Excessive hunger
- Social withdrawal
- Excessive crying
- Constant irritability
- Constant feelings of worthlessness or despair
- Suicidal ideation
Depression & Stigmatization
Many people feel ashamed to seek out professional guidance for depression, even if they know that they shouldn’t. Depression is irrational. It crosses wires that it shouldn’t and leaves you with symptoms that you feel like you should be able to control—but can’t. However, don’t hesitate to seek out help if you believe you have depression; 14.8 million Americans experience depression each year.
Fibromyalgia & Depression
Fibromyalgia is worth mentioning because it relates closely to the matter of depression-related pain. Patients with fibromyalgia experience widespread pain and body aches that are tender to the touch and may migrate around. This condition occurs in all ages and may vary in severity over time. Now, because of the nature of chronic back pain, people with this condition naturally have a propensity for developing depression. That being said, that is not the only reason that people with fibromyalgia develop pervasive feelings of sadness. Some people do not believe that the condition exists, which creates a cultural stigmatization that may lead to social withdrawal. A similar problem exists with depression itself, with some people believing that the condition is not as serious as it really is. Cultural attitudes like these greatly exacerbate a person’s battle with depression and may prevent someone from seeking out the necessary guidance.
Aside from social factors, depression may occur at a chemical level, specifically through inflammatory cytokines. Cytokines are a large group of proteins that are secreted by certain cells in the immune system. Evidence suggests that these secretions are important for both developmental, as well as normal, brain function. Additionally, cytokines have the ability to influence the neural network, which affects how a person behaves. When cytokines become inflamed, the immune system restructures behavioral responses to promote energy conservation. This usually occurs as a response to some sort of infection or injury. This inhibition of normal behavioral patterns may lead to mental disorders such as depression.
Seeking Professional Help for Depression & Chronic Pain
Patients who suffer from chronic pain and depression need help from a variety of different specialists to achieve the best treatment. In fact, research shows that assembling a team of experts to attack the problem multi-dimensionally is often the best approach. Specialists to consider are:
- Behavioral Therapists: Cognitive behavioral therapy is known to help alleviate the symptoms of anxiety and depression. Additionally, a cognitive behavioral therapist will be able to teach the patient coping skills that will help to reduce symptoms.
- Physical Therapists: Seeing a physical therapist can assist to improve the patient’s mobility and reduce painful symptoms over time.
- Pain Specialists: Pain specialists have a deep understanding of chronic pain and its relationship with depression. They will help the patient devise a treatment plan that best suits their situation.
- General Physicians: Aside from just being able to prescribe medications for a variety of ailments, physicians also provide examinations. Through extensive evaluation, a doctor will be able to educate the patient on the nature of their case.
It is important to note that these are just general examples that most patients should consider. That being said, there are other professionals with specialized skills who may be able to help your case. Occupational therapists and acupuncturists, for example, also provide useful techniques for battling chronic neck pain and depression.
Chronic Pain & Depression Treatment Options
There are many different treatment options for depression that can improve the patient’s quality of life. Some common examples are:
- Cognitive Behavioral Therapy: Sometimes referred to as talk therapy, this treatment method can help prevent negative symptoms from reappearing. The goal of talk therapy is to rewire maladaptive thinking patterns and teach coping mechanisms for unhealthy actions.
- Antidepressant Medications: Usually, doctors prescribe analgesics to relieve chronic pain and antidepressants to alleviate depression. Medication is a tricky business, as it is may take a few tries to find the perfect treatment. In addition, some patients do not respond very well to certain medications and there is no way of knowing what side effects will emerge beforehand. Speak to a doctor if you are considering using antidepressants or pain relievers.
- Support Groups: Support groups provide psychological and emotional support for those suffering from chronic pain and depression. Additionally, you can often gain founts of useful information from group sessions. If you can find a support group near you, it never hurts to give it a shot.
- Biofeedback Therapy: This form of therapy teaches the patient to induce feelings of relaxation when he or she is under stress. Biofeedback makes use of electrodes that your doctor attaches to the body and which send signals to a monitor. The patient is able to see their heart rate, respiration, blood pressure, and other stress-associated functions. This allows the patient to experiment with different techniques and receive physiological feedback in real-time. In this manner, the patient can learn which strategies work best for alleviating their set of stress-related symptoms.
- Exercise & Endorphins: Exercising releases endorphins in the brain that enhance the patient’s overall mood and sense of being. Additionally, exercise also serves as a distraction from worries that feed depression and cognitive loops that promote anxiety.
If you experience chronic neck or back pain, please contact The Advanced Spine Center at (973) 538-0900. The Advanced Spine Center is home to a team of highly dedicated, board-certified doctors in NJ who are well-versed in the most modern spine surgeries and conservative treatments. We understand that no two patients are exactly same, and work tirelessly to ensure that you receive the best treatment for your specific needs.