Nowadays, everyone is dealing with some kind of pressure, such as job pressure or financial pressure. And this pressure leads you to severe depression.
Do you know that severe depression can also cause chronic pain in your body? If not, then read this article to learn about the link between severe depression and chronic pain.
Both are related to each other and sometimes occur together, affecting a person’s quality of life and mental health.
That’s why the number of suicide cases is increasing day by day due to intolerable pressure.
In short, depression can cause pain, and long-term pain can cause depression and deteriorate the person’s life, making they feel hopeless.
The Unknown Link Between Severe Depression and Chronic Pain
In this paragraph, you will get to know how severe depression is related to chronic pain or how it leads to pain like headaches, back pain, and others.
You must have realised that a pain stays for a long time, it affects your mood, and causes mood swings. As a result, you don’t take an interest in anything, such as not participating in social activities. This makes you feel alone and fall into severe depression.
Understanding the Scientific Link Between Twos in Brief
Shared Symptoms or Biological Connection
There are some overlapping symptoms in both, such as fatigue, sleep disturbances, and changes in appetite or psychomotor activity.
Vicious Cycle
Both severe depression and chronic pain can trigger each other. This worsens depressive symptoms, and contrarily, depression can strengthen the perception and experience of pain.
Inflammation
C-reactive protein has the potential to drive both chronic pain and depression due to increased inflammation.
Neuroplasticity
According to Researchers, pain and depression can induce changes in brain structure and function, particularly in areas related to reward processing and pain perception.
Biological Connection
Chronic pain and depression share some of the same neurotransmitters (like serotonin and norepinephrine), which affect both mood and pain perception.
Behavioral Changes
Both conditions impact your behaviour a lot. It can limit physical activity, sleep, work, and social life. As a result, depression gets fueled.
Psychological and physical symptoms of comorbidity
Psychological Symptoms
These reflect the emotional and mental health burden of dealing with both conditions:
- Persistent Sadness or Hopelessness
- Irritability or Anger
- Anxiety
- Social Withdrawal
- Low Self-Esteem or Guilt
- Cognitive Impairments
- Suicidal Thoughts
Physical Symptoms
These often overlap or feed into both conditions of severe depression and chronic pain:
- Chronic Fatigue
- Sleep Disturbances
- Appetite Changes
- Muscle Tension and Headaches
- Reduced Physical Activity
- Increased Pain Sensitivity
Cycle of Comorbidity(Severe Depression and Chronic Pain)
Pain → Emotional stress → Depression → Less activity → Worsened pain → More depression
(And so on…)
How to manage comorbid Severe Depression and Chronic Pain?
You have to follow multiple approaches to deal with comorbid severe depression and chronic pain:
1. Psychotherapy (Talk Therapy)
The Therapy helps in reshaping negative thoughts, improving coping skills, and hence reducing both severe depression and chronic pain.
- Cognitive Behavioral Therapy (CBT)
CBT is the most effective therapy for both conditions. It reframes the negative thoughts. It breaks down the cycle of pain-depression-pain by teaching coping strategies for both physical discomfort and emotional distress.
- Acceptance and Commitment Therapy (ACT)
It helps in accepting pain so that it can’t dominate your life, and live a value-based and meaningful life.
- Mindfulness-Based Stress Reduction (MBSR)
It includes meditation, breathing techniques, and yoga that reduce stress, improve mood, and lower pain perception.
2. Medications
When used appropriately, medications can help interrupt the brain–pain–mood cycle.
- Antidepressants
Treat both mood symptoms and help modulate pain signals.
SNRIs: Duloxetine, Venlafaxine (effective for fibromyalgia, nerve pain)
TCAs: Amitriptyline, Nortriptyline (low doses for neuropathic pain)
SSRIs: Fluoxetine, Sertraline (less effective for pain, but helps with mood)
- Anticonvulsants (for nerve pain)
Gabapentin, Pregabalin: Reduce overactive nerve signals.
Analgesics (Pain Relievers)
NSAIDs or acetaminophen: For mild-to-moderate pain.
Opioids (with caution): For short-term or severe pain, under strict supervision due to addiction risk.
- Muscle Relaxants or Sleep Aids
Used temporarily to improve sleep or reduce tension in chronic pain conditions.
Note: Always consult a physician. Some medications can interact with or worsen one condition while treating another.
3. Lifestyle Modifications
Making some changes in Lifestyle can work best alongside therapy and medicines.
- Physical Activity
Doing Regular exercise improves not only your mood and reduces anxiety, but also enhances pain tolerance and physical function. It is the most effective way to manage fibromyalgia.
- Quality Sleep
Get a consistent sleep schedule. For a good sleep, limit screen time before bed and avoid stimulants.
- Healthy Diet
A healthy diet plays a key role in comorbid chronic pain and depression, such as taking anti-inflammatory foods: fruits, veggies, whole grains, and omega-3s (like fish).
Avoid processed foods, sugars, and caffeine.
- Stress Management
Meditation, deep breathing, and journaling can help manage your stress.
- Social Connection
To avoid loneliness, stay connected with family, friends, or support groups. Sharing thoughts with them will help you a lot.
How is Tramadol Useful in Severe Depression and Chronic Pain?
Tramadol is a dual-action drug as it acts both as a pain reliever(analgesic) and an antidepressant.
Analgesic Action: It is prescribed by doctors to treat Moderate to moderately severe pain.
Antidepressant-Like Effects: Tramadol acts on serotonin and norepinephrine and thus, shows antidepressant and anxiolytic properties
Risks and Side Effects of Tramadol With Severe Depression and Chronic pain
Here are some side effects of Tramadol:
Common Side Effects
- Nausea, vomiting
- Dizziness, drowsiness
- Constipation
- Sweating
- Dry mouth
- Headache
Serious Risks
- Seizures: High doses or with other drugs like antidepressants can cause seizures.
- Serotonin Syndrome: A life-threatening condition caused by excessive serotonin, particularly if combined with SSRIs, SNRIs, or MAOIs.
- Dependence and Addiction: It is weaker than other opioids but has the potential to be habit-forming.
- Respiratory Depression: Rare, but possible at high doses or in sensitive individuals.
- Withdrawal Symptoms: When you stop taking Tramadol suddenly, you may feel Flu-like symptoms, anxiety, restlessness, and insomnia.
Warnings
- High risk of dependence and abuse, especially with long-term use.
- The risk of seizures increases at high doses or when combined with certain drugs.
- Sudden stoppage can cause withdrawal symptoms, including anxiety, insomnia, sweating, and flu-like symptoms.
Controversies
- Misleading Safety Perception carries serious risks.
- Off-label Depression Use
- Rising Misuse
FAQs(Severe Depression and Chronic Pain)
Can physical pain occur with depression?
Yes, physical symptoms like headaches, back pain, joint pain, and stomach issues can cause depression due to changes in brain chemistry and stress responses.
What would be the symptoms when both occur together?
Fatigue, sleep problems, mood swings, irritability, low motivation, appetite changes, and increased pain sensitivity.
When should I go to the doctor?
When your daily life gets interrupted due to severe depression and chronic pain or involves suicidal thoughts, then you should go to the doctor immediately.
