Major depressive disorder is a serious mental condition that can lead to suicide if left untreated. Over 3% of people with this condition will attempt suicide and over 60% of people who commit suicide suffered from major depression or another related mood disorder. A frequent component of major depressive disorder, either as a cause, symptom or both, is the presence of physical pain.
Pain that Causes Major Depression
The brain uses a complex system of electrical and chemical signals to manage pain in the body. In a healthy person this system allows for the recognition of pain in order for the source of that pain to be addressed and remedied.
A system of naturally occurring chemicals such as dopamine, serotonin and norepinephrine allow the brain to manage and even ignore certain levels of pain. But individuals who suffer from long-term, chronic pain often develop a range of psychological symptoms, including the following:
- Sleep disorders
- Self-medication through substance abuse
- Self-destructive behaviors
- Emotion management problems
- Despair or hopelessness
Depression is often triggered by imbalances or deficiencies in the chemicals the brain uses to manage pain, emotional responses, memory, impulse control and overall mood.
Long-term pain can disrupt this system significantly and cause serious and even dangerous depression. This type of pain-related depression is common among sufferers of diseases such as cancer, fibromyalgia and multiple sclerosis.
Pain as a Symptom of Major Depression
Major depression can also be a cause of pain, or at least a cause of the brain’s inability to tolerate it. The term “depression” is often used ambiguously to describe a bad mood, melancholy or even boredom. Major depressive disorder, however, is directly connected to the aforementioned chemical balance in the brain and is recognized by the following symptoms:
- Persistent emotional numbness
- Regularly sleeping too much or too little
- Significant appetite changes (either eating too much or not enough)
- Relentless feelings of hopelessness or helplessness
- Frequent feelings of illness
- Loss of ambition
- Avoiding important relationships or previously enjoyable activities
- Inappropriate feelings of personal guilt
- Inability to concentrate
- Agitation or irritability
- Increased sensitivity to light, discomfort and pain
For a seriously depressed person, a relatively low level of physical pain may be intolerable. Self-medication of pain and other depression symptoms through substance abuse is common and extremely dangerous.
Effectively Treating Pain and Major Depression
Treating chronic pain and major depression often involves a combination of psychological counseling and medical treatment. A wide range of antidepressant medication is available, but some have very serious side effects and must be used with great caution.
The most effective programs use comprehensive and holistic treatment regimens to address all aspects of the patient’s physical and emotional health. If the pain is treated without addressing the depression, a full return to health is unlikely. Likewise, treating depression without addressing the cause of persistent pain is unlikely to be successful. Only a fully integrated approach will provide the relief that is desired. Any co-occurring disorders, such as anxiety disorders, personality disorders or addiction must also be addressed alongside the depression and pain symptoms.