Did you know that depression is the fourth leading cause of disability in the world and affects more than 6.7 percent of people age 18 and older in the U.S.? When mental health disorders occur in people with chronic pain, complicated intersections between the conditions can exacerbate symptoms and prolong the already difficult healing process. Not only can depression and anxiety result from the stress of dealing with chronic pain, but mental health disorders can cause pain as well. When combined, these complex conditions often lead to a vicious cycle of stress and disability.

People experience pain in a variety of ways, all of which have significant psychosocial repercussions. Using simply a biomedical approach to chronic pain means leaving mental health disorders untreated, which aggravates patients’ conditions and leads to feelings of powerlessness and confusion. Mental health must be considered in the treatment of chronic pain, as it is part of the numerous factors that contribute to the severity and complexity of one’s pain. Physicians who ignore this are only treating part of the underlying problem. Patients need and deserve more comprehensive care.

The Cycle of Pain and Depression

An article by David Cosio, PhD, ABPP and Lotus M. Meshreki, PhD published in Practical Pain Management found that an average of 65% of patients with depression experienced pain symptoms. Older research also found that 30% to 50% of people with chronic pain suffered from conditions like anxiety and depression. This link is not difficult to fathom when chronic pain is understood on more than just a physical level. Though it is felt in the body, the effects can permeate all areas of an individual’s life, causing additional unforeseen struggles that complicate recovery. Psychosocial factors like a history of abuse, anxiety, depression, self-medication, and more can even be indicators of the likelihood of chronic pain. To not consider any of these variables in a patient’s life is to severely diminish their chances of functional restoration and increased quality of life.

Chronic pain has been known to cause depression and anxiety, while depression and anxiety have been known to cause chronic pain. Without proper comprehensive treatment, these conditions can fuel each other, until a never-ending cycle forms. Patients who have suffered from debilitating conditions like fibromyalgia or have undergone many failed surgeries are likely to feel as though they will never find a solution to their pain. Being unable to participate in activities or perform tasks as one could in the past can take a significant toll on a patient’s outlook, leading them to isolation and a lack of hope for the future. This helplessness can be just as, if not more, exhausting for patients than their pain itself.

Treating Chronic Pain and Mental Health Disorders

It would be irresponsible for physicians to ignore the clear connections between chronic pain and mental health disorders. Cosio and Meshreki also noted in their article that, “Depression and chronic pain exacerbate one another, share biological pathways and neurotransmitters, and respond to similar treatments.” They conclude that for “optimal outcomes” it is vital that depression be considered in the treatment of chronic pain. Mental health counselor Rachel Noble Benner described her patients with chronic pain as “isolated, overmedicated and depressed,” believing their lives to be “devoid of meaning.” Individuals like these have been failed by the forms of treatment most prevalent today. If physicians ever hope to make real strides in the management of chronic pain, they must first stop treating pain as a solely physical problem. A biopsychosocial approach is needed to make any true progress.

At the Institutes of Health, we take a multidisciplinary approach to treating chronic pain, and take into account many different facets of a patient’s life when treating them. Depression, anxiety, fatigue, sleep problems, PTSD, and more are covered in our programs. It is possible to break the cycle of pain and mental anguish. To learn more about our proven, groundbreaking programs, contact us at info@institutesofhealth.org.