The Pain/Depression Cycle

By: Ryan Lawrence

Over the decades, medical professionals have begun to recognize that depression can have a significant physical impact on our bodies. Studies have shown that depressed people are more prone to suffering from physical ailments, such as heart problems and osteoporosis. That said, above all else, depression appears to be tightly linked to physical pain.

A Complex Relationship

Researchers know that pain and depression have a real but confusing relationship. Physicians often struggle to identify the source of certain physical ailments when they are combined with depression. Like the chicken and the egg, it's not always clear what is causing what. When depressed patients visit the doctor, they often complain of vague, insistent symptoms, such as abdominal pain, headaches, or musculoskeletal pain in the neck, joints and lower back.

This often leads physicians to test for all sorts of ailments before finally attributing the problem to depression. Many times, antidepressants and cognitive therapy help to resolve symptoms of vague, chronic pain. On the other hand, just as often, this treatment strategy proves ineffective, because it's actually focusing on a symptom rather than the source problem, itself.

When Pain Causes Depression

  Years ago, health professionals believed that people who suffered from both pain and depression experienced the former, because they were somehow denying an emotional disorder. Now, more and more experts believe that it's actually pain that makes people depressed in the first place.



According to Dr. Donna Blair, who treats people suffering from temporomandibular disorder, many of her patients have experienced improved mood once they received treatment for the source of their chronic pain.

"I see people whose teeth are worn down to a fraction of the length of what they used to be from years of grinding," she said. "They've been in pain for years, but didn't know that a problem in their jaw joint could have been the cause; and they're amazed at the increase in quality of life that they get when their teeth are restored and their bite is corrected."

An Endless Cycle

  Unfortunately, chronic pain and depression can promote one another. This is especially true when one or the other promotes sleeping difficulties. According to Blair, research has shown that insufficient sleep can promote both pain and depression, leading to a seemingly endless cycle that can send people into a downward spiral.



"Sleep is so critical to our well-being, and when we don't get enough of it, our bodies suffer," she said. "When you add pain to the mix, people have trouble sleeping and it sets a vicious cycle in motion. Depression is just part of what frequently happens in this cycle, but it's one of the signs and symptoms that people are more aware of. Things like increased risk of heart attack and stroke usually go unnoticed until it's too late."

Getting Help

Chronic pain has been proven to keep depressed people depressed, while robbing them of their ability to function in professional and social arenas. That said, when patients receive treatment, they tend to show significant improvement.

When seeking help, patients would be well-advised to seek counsel from physicians who are open to all potential causes, instead of those who are focused on purely physical or psychological catalysts.

Citations:

• Journal of American Medical Association depression study
  

Featured images:

•  License: Creative Commons image source 

Ryan Lawrence writes for Off-Topic Media. Thanks to Dr. Blair for contributing to this story. Dr. Blair treats migranes and other TMJ symptoms at her office in Fresno, California.