Pain that simply does not go away is termed as Chronic pain. In some cases, it may lasts for even few years. Your regular pain killer does not offer relief in chronic pain.
Chronic pain usually results due to long term disease, injury or infection. However it may result without any apparent reason.
There is no known underlying reason for depression due to chronic pain. However, chronic pain interferes with regular activities of individuals, causes sleep disturbances and reduces quality of life.
As per researchers, chronic pain often leads to worsening of depression symptoms. Moreover, it is one of the risk factors for suicide in depressed patients.
How chronic pain causes depression?
The severity of depression often increases with intensity of pain.
Depressed people have higher levels of cytokines that are responsible for intensity and length of immune system response to any infection.
These cytokines lead to inflammation (body response to infection) and thereby produces pain in the body. Here pain manifests as a sign of inflammation.
Inflammation is thought to play a significant role in depression linked to chronic pain.
Fibromyalgia and Depression
Fibromyalgia is often associated with depression. A patient suffering from fibromyalgia experiences chronic and widespread pain in muscles and multiple tender points on body.
Studies have revealed that patients with fibromyalgia are more prone to mental disorders including depression compared to other normal individuals.
Diagnostic Tests for Depression in patients with chronic pain
The diagnosis of the depression in patients with chronic pain is performed by psychiatrists after thorough medical examination of the depressed patient.
Psychiatrists may ask wide range of questions from the patient to ascertain various possible reasons for depression.
• Full patient medical history
• Physical Assessment
• Thorough evaluation of symptoms
• Standardized questionnaires
Blood Tests and other laboratory tests may be performed for ruling out other causes of depression.
Symptoms of depression in patients with chronic pain
Patients who are suffering from chronic pain may experience various symptoms of depression.
Patient may not observe some of these symptoms; however his/her friends or family members may notice them.
- Feeling of worthlessness, sad mood
- Difficulty in concentrating
- Difficulty in sleeping (too much sleep or too less sleep)
- Loss of appetite
- Tendency to eat more or loss of appetite
- Lack of energy or fatigue
- Lack of interest in enjoying tasks that were once pleasurable
- Difficulty in concentrating
- Suicidal tendency
- Lack of self esteem
- Increasing intake of alcohol, drugs, or tobacco
Treatment of depression in patients with chronic pain
Psychiatrists treat the depression in patients with chronic pain by targeting the underlying cause of
Psychiatrists employ combination of various therapies for obtaining the desired results.
- Medications like antidepressants and antipsychotic medication including Selective serotonin reuptake inhibitor (SSRI) and Serotonin and nor epinephrine reuptake inhibitor (SNRI)
- Cognitive-behavioural therapy/ Psychotherapy/ or talk therapy
- Physical exercise
- Support from families/friends
- Lifestyle changes including regular aerobic exercises that boost the patient’s mood