Chronic pain with depression on the top

Depression and chronic pain commonly co-exist in a vicious circle, compounding disability. Research shows that pain severity tracks with the number of depressive episodes through which one suffers. To add to the joy, people experiencing both depression and chronic pain are more likely to acquire nicotine and other substance dependencies; are more likely to increase their painkiller dosage; are more likely suffer from suicidal ideation and attempts; and are less likely to benefit from antidepressant medications than those with depression alone.

Biologically, this apparently common coexistence of depression and chronic pain has been explained by an overlap between the brain regions involved in pain perception and mood regulation. Additionally, both conditions are known to be associated with decreased amounts of certain chemicals in our brains such as serotonin, norepinephrine, and dopamine. Besides, depending on the point(s) of origin of pain in the body, pain sensations traveling through our spines and nerves can sometimes entirely override pleasure sensations.

Experientially, however, this picture is far more complex than the sterile, factual biological portrait. As probably goes without saying, we will each experience chronic pain, the added blow of depression, and the impact of these entities on our lives, uniquely. It doesn't help that pain and depression can be both "invisible" disabilities and "difficult" to diagnose, let alone that they will naturally intersect with other disabilities, gender, race, queerness, age, and other identities. On living with depression and fibromyalgia (among other conditions), Tamiko Arbuckle relays, "My biggest challenge most days, after managing the pain, is this damn foggy brain. I can't remember a lot of great memories that I have shared with family and friends. Memories that are so meaningful to you are simply gone for me. I am sorry for that. Please understand when I get that blank look on my face that that moment is more painful for me than it is for you." Yet, the aggregate of depression and chronic pain has gained more scientific and holistic awareness than ever before. Treatments previously unheard of now comprise television adverts or dinner table chitter chatter. A quick dive into ongoing research reveals a truly burgeoning interest in deeply probing the efficacy of therapies both well- established and novel; an interest in erasing old myths and paving new paths towards healing.

It would be frivolous to say that living with depression and chronic pain is easy, even in a relative sense. However, many therapeutic avenues that could potentially augment standard pain management and antidepressant treatment now exist. We understand that it most likely has already been a long, exhausting road, but hope that you will feel safe and trusting of our care and encourage you to discuss your experience with us in depth, so that we may help you as best as possible. You are the only expert of your personal experience. We're here to listen and help. Our goal is to form an effective therapeutic partnership with you.

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References:

https://butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory/

https://myfoggybrain.com

Roughan WH, Campos AI, García-Marín LM, Cuéllar-Partida G, Lupton MK, Hickie IB, Medland SE, Wray NR, Byrne EM, Ngo TT, Martin NG and Rentería ME (2021) Comorbid Chronic Pain and Depression: Shared Risk Factors and Differential Antidepressant Effectiveness. Front. Psychiatry 12:643609. doi: 10.3389/fpsyt.2021.643609 Sheng J, Liu S, Wang Y, Cui R, Zhang X. The Link between Depression and Chronic Pain: Neural Mechanisms in the Brain. Neural Plast. 2017;2017:9724371. doi: 10.1155/2017/9724371. Epub 2017 Jun 19. PMID: 28706741; PMCID:PMC5494581.