The “chicken-and-egg” relationship between pain and depression

Fifty percent of people with chronic pain also have depression, pain management experts say. And more than 75 percent of patients with depression report pain-related symptoms (such as headaches, stomach pain, neck and back pain), according to the World Health Organization. The pain/depression connection raises a lot of questions for some people who experience both: Which came first: pain or depression? Does one cause the other? How can they be treated? We’re exploring the link between mental and physical health and what your community has reported on PatientsLikeMe. “Completely intertwined” Chelsey Engel, a writer for The Mighty, says the vicious pain/depression cycle is a mystery that she’s not sure how to solve. Chronic migraines, neck and shoulder pain caused her to stop doing yoga, which she previously practiced to help manage her mental health. “So not only are you missing the things that once gave you life, you’re also missing yourself,” she says. “You also now have two conditions to treat – pain and depression – that are separate in one way but completely intertwined in another. The New York Times also recently shed light on the overlap of mental and physical health, and found that modern medicine often falls short in treating both together, so it’s sometimes left up to patients and caregivers to ask questions and connect the dots for their doctors and therapists. Explore some options for treating both. “Keep in mind that human beings are not divided into two different organisms: a physical one and an emotional one,” Jane E. Brody writes. “Mind and body are a single construct with two-way communication, and what happens in the body below the head can – and often does – affect the brain and vice versa.” In fact, studies have shown that depression symptoms may interfere with our nervous system pathways and allow more pain sensation to reach the brain. On PatientsLikeMe Everyone’s experience of pain mingling with depression is different, but there are some interesting findings in the PatientsLikeMe community. Our Data Science Team recently shared these insights:

• For nearly all conditions on PatientsLikeMe, pain and depressed mood show some positive correlation – more severe pain and more severe depressed mood tend to happen together.
• For some frequently reported conditions on the site (such as migraine and Crohn's disease), this association is relatively high.
• For some others (like PTSD), there’s an association, but it’s relatively low.
• Some conditions like lupus are in between the extremes.

Of course, the relationship between these pain and depressive symptoms is not easy to understand. Pain could cause a downturn in mood, but both symptoms could have some other root cause. Have you experienced chronic pain “intertwined” with depression? Share your experiences here and join the community to talk about your your condition, symptoms and treatments. Share this post on Twitter and help spread the word.