Living with chronic back or neck pain can lead to depression, feelings of worry, nervousness, hopelessness, as well as other mental health-associated symptoms. Your pain medicine physician or your back specialist may refer you to a psychologist or psychiatrist. Referring you doesn’t mean your physician believes your pain is all in your mind! Rather, he/she is taking an optimistic step in treating you as a whole individual — by treating both the physical and psychological pain.
Chronic Neck & Back Pain Is Complicated
As someone living with chronic pain caused spondylosis, degenerative disc disease, spinal cord injury or some other back problem, you understand pain is a complicated issue, and treatment requires the expertise of a spine specialist. Perhaps your pain management plan features a blend of treatments — medication for neuropathic pain, a periodic epidural spinal shot, a muscle relaxant, or physical therapy. Treatment of stress, nervousness, and depression (there are various types) needs the same level of expertise but from somebody who focuses on managing mental health problems.
Depression & Chronic Pain
Are you aware that depression and chronic pain often go together? Depression is a critical condition, and nothing to be embarrassed of. It has been reported that as many as 50% of individuals with chronic pain are depressed.1 So, if you are depressed, you’re far from being alone.
The signs and symptoms of depression can manifest themselves differently in each individual, but tiredness, sleep disruption, changes in eating habits, listlessness, and feelings of hopelessness are all quite common. Aches and pains are a very common symptom of depression notably, depression can lead directly to neck and long-term back pain.
Treating Depression & Pain
Two classes of antidepressants often used to treat depression in those that experience chronic pain are selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). Generally prescribed SSRIs include and fluoxetine (Prozac) and sertraline (Zoloft), whereas usually prescribed SNRIs include duloxetine (Cymbalta) and venlafaxine (Effexor). These drugs have now been demonstrated to be effective and safe for handling depression in the context of continual pain, but like all medicines, they come with some risk of unwanted effects. As always, be sure to go over these drugs in detail together with your physician before beginning any treatment regimen that includes them, and inform your physician of all of the medicines (including over the counter medicines), herbal remedies, and nutritional supplements you’re currently taking so as to avoid any negative drug interactions.
Moreover, or in addition to medications, other types of treatment may include:
- Talk therapy, more officially called cognitive behavioral therapy (CBT). The focus of CBT is to help the individual manage their situation and may include learning how to problem solve, thus engaging the individual to alter specific thought patterns to your more positive outlook, and conquering fears.
- Practice relaxation techniques such as meditation or breathing exercises.
- Routine exercise might help curb feelings of worry, stress as well as depression. Exercise causes the entire body to release endorphins, which can cause you to feel much better and may reduce pain perception too.
1. Tartakovsky M. Living with chronic pain and melancholy. PsychCentral.com. http://psychcentral.com/lib/living-with-chronic-pain-and-depression/. Got July 30, 2015.