Chronic Pain and Depression
Chronic pain is defined as suffering that lasts longer than six months. As the U.S. population ages, this condition has become disturbingly common, affecting as much as 10 percent of people, and contributing to many other health problems, especially depression.
Most studies report at least 50% of patients with chronic pain also suffer from clinical depression. Individuals with depression also describe a much higher rate of chronic pain than in those in the general population. In addition, at least 20% of chronic pain sufferers experience generalized anxiety.
So what's the relationship between chronic pain and depression? Without question, it can be depressing to feel pain day after day. But the underlying problem is physiological.
Stress is a Killer, Even for Your Brain
The relationship between pain and depression is rooted in the bodily endocrinal system called the HPA axis. The bottom line is that chronic pain creates enormously destructive stresses on the body, especially the brain. The main culprit in the breakdown that leads to depression is the adrenal hormone cortisol.
Click for a more detailed description of the HPA axis and cortisol's role in depression.
The chronic stress of prolonged pain can lead the brain and body to create elevated levels of cortisol. Over the long term, excessive amounts of this "primary stress hormone" can kill your sex drive, suppress your immune system, and literally shrink parts of your brain.
The HPA axis has other hormones that should prevent the elevated amounts of cortisol that are often released due to pain from becoming dangerously excessive. However, for various reasons, this system sometimes fails. Dangerous levels of cortisol flood the brain, bombarding the neurochemical receptor sites that control human mood. The continued excess of cortisol interferes with the normal balance of neurotransmitters in the brain’s mood and pleasure pathways.
Prolonged exposure to cortisol depletes serotonin, and indirectly both norepinephrine and dopamine, all of which are crucial to mood. It also interferes with endorphins, the neurochemicals that help ease pain. So ironically, pain can lead to a depression that worsens pain. In fact, most severely depressed patients report increased sensitivity to pain and greater levels of pain.
Fortunately, the chemistry of stress can be interrupted without drugs. To end the depression, you need to stop the cycle of stress. Many alternative treatments offer ways of interrupting the chemistry of stress in ways that are affordable and even enjoyable.
Alternative Solutions:
- Exercise: Feel-good endorphins can be released even by gentle exercise. If it hurts, don't do it.
- Acupuncture: Numerous studies prove acupuncture's ability to lower pain, decrease stress, and even treat depression. Remember, in China this method is still used in place of anesthetics in surgery.
- Clinical Hypnotherapy for pain release. Ample studies prove hypnotherapy's value in both pain release and recovery from injury. Used in some major hospitals in the U.S. for surgery patients. fMRI brain scans prove hypnotherapy's effectiveness in lessening pain. For depression, advanced hypnotherapy integrates cognitive-behavioral approaches for a deeper treatment than talk therapy.
- St. John's Wort: This proven treatment for anxiety and depression was also traditionally used for nerve pain.
- DHEA: This master hormone blocks the destructive impact of cortisol. Be careful to keep your dose low, and to consult a licensed health professional in its use.
- Massage and Meditation have both been shown to lower cortisol levels in the blood.
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Especially if you suffer from chronic pain and depression, you owe it to yourself to regularly use several different methods of lowering your stress.
Interfering with the HPA stress cycle may help you feel better is two ways: You'll feel less depressed, and you may even feel less pain. Neuron receptor sites and neurochemical balance have been shown to heal themselves after exposure to excessive cortisol is over. And an end to depression often ends the oversensitivity to pain.
"Life is suffering," said the Buddha. Maybe... but that doesn't mean you can't fight back.
Author:
William Prescott is a health researcher and author. |
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