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Mental Health

Chronic Pain and Its Connection to Depression

11/08/2007

Question:

My mother, 71, has chronic pain in her back and hip due to fibromayalgia and degenerative arthritis. Lately she seems to not be coping well with making decisions, remembering things, or solving problems. I am concerned that her chronic pain has pushed her into a depression. Would it be useful for her to be evaluated? Who is the health care specialist she should consult?

Answer:

Chronic pain and depression often go hand in hand. First of all, someone with chronic pain experiences daily frustration as the pain interferes with activities, work, hobbies, and sometimes even basic self-care. Then there's the frustration and disappointment of seeking a diagnosis so you can finally understand the pain and hopefully treat it. All this frustration certainly can result in negative, hopeless thinking. Such negative thinking couples with functional impairment, limited pleasures, and social isolation to develop clinical depression.

Depression can be difficult to recognize. The primary symptoms of depression include feeling sad, down, depressed or experiencing lost pleasure in activities one used to enjoy.

Other symptoms may include:

Anyone with suicidal thoughts should seek immediate help.

The symptoms you mention your mother experiencing (indecisiveness, memory problems, and difficulty solving problems), may certainly be symptoms of depression. However, she would also experience a sad mood and/or loss of pleasures in order to be considered clinically depressed. It is also possible these symptoms may be related to other conditions, such as dementia, that should be evaluated.

Consulting a psychologist or psychiatrist for evaluation of these symptoms would be appropriate, as would discussing these symptoms with her primary care provider. If your mother is diagnosed with depression, psychotherapy and antidepressant medications have both proven effective in treating depression most of the time. As depression improves, many people report their chronic pain and functional impairment also improve.

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Response by:

Suzanne J Smith, PhD Suzanne J Smith, PhD
Clinical Associate Instructor of Psychiatry
School of Medicine
Case Western Reserve University