Could chronic back pain trigger depression? - AmericaNowNews.com

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Could chronic back pain trigger depression?

Depression is one of the most common mental health disorders in the country.

According to the American Psychological Association, an estimated one in 10 adults reports suffering from depression.

Depression is often triggered by a lingering health condition like chronic back pain. In fact, many scientists agree that pain and depression are closely related. Depression can cause pain, and pain can trigger depression.

Kanika Massey, 36, has suffered chronic back pain for more than 10 years.

"I had stomach issues and they said that was contributing to some of the back issues I was enduring," Massey told America Now. 

Her pain has been so intense, it has triggered periods of severe depression.

"There have been so many times I have laid on my bathroom floor and just cried and said I don't want to do this anymore," Massey said. 

Dr. Joe Musacchio is a chiropractor in Matthews, NC, and he has a number of patients like Massey.

"It's hard to function in pain every day--not being able to do the things you want to be doing each day, or to the level that you are used to doing them, and not have it affect your mental state of mind," Musacchio said. "It's absolutely a snowball effect if it's not dealt with, if you don't deal with the underlying problem."

But Massey isn't alone in her suffering.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, 25 percent of adults have at least a day of back pain during a given three-month period.

Furthermore, the American Psychological Association says depression is the most common emotion associated with chronic back pain.

Psychologist Sarah Reiland studies the relationship between chronic back pain and depression. She is an assistant professor in the School of Psychology at Winthrop University in Rock Hill, SC.

"Back pain can contribute to depression in a lot of ways," Reiland said. "First of all, people aren't feeling great. So, they have the pain they are experiencing that brings them down, brings their mood down, and also, often when people are in pain they start to avoid things people, family, friends. The more they withdraw, the more they start to feel depressed and hopeless and helpless about changing the situation."

The Mayo Clinic says a patient may need a separate treatment plan to get both their pain and depression under control. There are some treatments that can help both.

Since there are shared chemical messengers in our brain, antidepressant medications may be able to relieve pain and depression.

Stress-reduction techniques like yoga, meditation, staying active and journaling may also help.

And there's also psychological counseling.

"A therapist can be extremely helpful for just teaching strategies—things you wouldn't normally know and things your physician may not have time to teach you—strategies for how to go about daily activities or how to think about things that can reduce your feelings of pain and feelings of depression," Reiland said.  

Massey said some of her physicians recommended surgeries, but she felt those procedures were too invasive to explore further. 

"One of the things that I think people run into is that they are told there is nothing you can do, you have to take this drug, or you need a surgery, and they just stop and don't look any further, "and Musacchio warned, "They do need to push further."

A friend encouraged Kanika to seek chiropractic care which she says has not only eased her back pain, but also improved her outlook on life.

"When you give up and quit, you really don't have any reason to live," and Massey added, "I refuse to believe that I was created not to live."

Lots of people get massages to help ease their pain, but experts say getting a massage may make you feel better temporarily, but if there is a reason for your back pain that isn't being addressed – that's not going to change. So, the temporary relief of a massage may not translate into long-term benefits.

Copyright 2013 America Now. All rights reserved.

Additional Information:

The following information is from the American Psychological Association in an article entitled "Psychotherapy works?" (Source:  http://www.apa.org/monitor/2012/11/psychotherapy.aspx).

  • Depression is one of the most common mental health disorders in the United States. According to government health agencies, an estimated one in 10 adults reports having depression. Mental health problems lead to more than 150 million visits to physician offices, clinics and hospital outpatient departments each year, making it one of the top three reasons why Americans seek medical treatment. Between 1996 and 2008, the number of prescriptions for antidepressants more than doubled from 55.9 million to 154.7 million.

The following information is from Carolinas Healthcare System in Charlotte, NC.

  • Back pain is one of the most common reasons people visit their doctor.
  • According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, 25 percent of adults have at least a day of back pain during a given three-month period.

The following information is from the Mayo Clinic in an article entitled "Is there a link between pain and depression? Can depression cause physical pain?
"(Source: http://www.mayoclinic.com/health/pain-and-depression/AN01449).

  • Pain and depression are closely related. Depression can cause pain — and pain can cause depression. Sometimes pain and depression create a vicious cycle in which pain worsens symptoms of depression, and then the resulting depression worsens feelings of pain.
  • In many people, depression causes unexplained symptoms such as back pain or headaches. Sometimes this kind of pain is the first or the only sign of depression.
  • Pain and the problems it causes can wear you down over time, and may begin to affect your mood. Chronic pain causes a number of problems that can lead to depression, such as trouble sleeping and stress. Disabling pain can cause low self-esteem due to work, legal or financial issues. Depression doesn't just occur with pain resulting from an injury. It's also common in people who have pain linked to a health condition such as diabetes or migraines.
  • To get symptoms of pain and depression under control, you may need separate treatment for each condition. However, some treatments may help with both.
  • Because of shared chemical messengers in the brain, antidepressant medications can relieve both pain and depression.
  • Psychological counseling (psychotherapy) can be effective in treating both conditions.
  • Stress-reduction techniques, meditation, staying active, journaling and other strategies also may help.
  • Treatment for co-occurring pain and depression may be most effective when it involves a combination of treatments.
  • If you have pain and depression, get help before your symptoms worsen. You don't have to be miserable. Getting the right treatment can help you start enjoying life again.

The following information is from the National Institute of Mental Health (Source: http://www.nimh.nih.gov/health/publications/depression-and-chronic-pain/complete-index.shtml)

  • Depression not only affects your brain and behavior—it affects your entire body. Depression has been linked with other health problems, including chronic pain. Dealing with more than one health problem at a time can be difficult, so proper treatment is important.
  • Major depressive disorder, or depression, is a serious mental illness. Depression interferes with your daily life and routine and reduces your quality of life. About 6.7 percent of U.S. adults ages 18 and older have depression.1
  • Signs and symptoms of depression include:  
    • Ongoing sad, anxious, or empty feelings
    • Feeling hopeless
    • Feeling guilty, worthless, or helpless
    • Feeling irritable or restless
    • Loss of interest in activities or hobbies once enjoyable, including sex
    • Feeling tired all the time
    • Difficulty concentrating, remembering details, or making decisions
    • Difficulty falling asleep or staying asleep, a condition called insomnia, or sleeping all the time
    • Overeating or loss of appetite
    • Thoughts of death and suicide or suicide attempts
    • Ongoing aches and pains, headaches, cramps, or digestive problems that do not ease with treatment.
  • Chronic pain is pain that lasts for weeks, months, or even years. It often does not ease with regular pain medication. Chronic pain can have a distinct cause, such as a temporary injury or infection or a long-term disease. But some chronic pain has no obvious cause. Like depression, chronic pain can cause problems with sleep and daily activities, reducing your quality of life.
  • Scientists don't yet know how depression and chronic pain are linked, but the illnesses are known to occur together. Chronic pain can worsen depression symptoms and is a risk factor for suicide in people who are depressed.
  • Bodily aches and pains are a common symptom of depression. Studies show that people with more severe depression feel more intense pain. According to recent research, people with depression have higher than normal levels of proteins called cytokines.4 Cytokines send messages to cells that affect how the immune system responds to infection and disease, including the strength and length of the response. In this way, cytokines can trigger pain by promoting inflammation, which is the body's response to infection or injury. Inflammation helps protect the body by destroying, removing, or isolating the infected or injured area. In addition to pain, signs of inflammation include swelling, redness, heat, and sometimes loss of function.
  • Many studies are finding that inflammation may be a link between depression and illnesses that often occur with depression. Further research may help doctors and scientists better understand this connection and find better ways to diagnose and treat depression and other illnesses.
  • One disorder that has been shown to occur with depression is fibromyalgia. Fibromyalgia causes chronic, widespread muscle pain, tiredness, and multiple tender points—places on the body that hurt in response to light pressure. People with fibromyalgia are more likely to have depression and other mental illnesses than the general population. Studies have shown that depression and fibromyalgia share risk factors and treatments.
  • Depression is diagnosed and treated by a health care provider. Treating depression can help you manage your chronic pain and improve your overall health. Recovery from depression takes time but treatments are effective.
  • At present, the most common treatments for depression include:
    • Cognitive behavioral therapy (CBT), a type of psychotherapy, or talk therapy, that helps people change negative thinking styles and behaviors that may contribute to their depression
    • Selective serotonin reuptake inhibitor (SSRI), a type of antidepressant medication that includes citalopram (Celexa), sertraline (Zoloft), and fluoxetine (Prozac)
    • Serotonin and norepinephrine reuptake inhibitor (SNRI), a type of antidepressant medication similar to SSRI that includes venlafaxine (Effexor) and duloxetine (Cymbalta).
  • While currently available depression treatments are generally well tolerated and safe, talk with your health care provider about side effects, possible drug interactions, and other treatment options. For the latest information on medications, visit the U.S. Food and Drug Administration websiteExternal Link: Please review our disclaimer.. Not everyone responds to treatment the same way. Medications can take several weeks to work, may need to be combined with ongoing talk therapy, or may need to be changed or adjusted to minimize side effects and achieve the best results.
  • People living with chronic pain may be able to manage their symptoms through lifestyle changes. For example, regular aerobic exercise may help reduce some symptoms of chronic pain. Exercise may also boost your mood and help treat your depression. Talk therapy may also be helpful in treating your chronic pain.
  • More information about depression treatments can be found on the NIMH website. If you think you are depressed or know someone who is, don't lose hope. Seek help for depression.

The following information is from a website called Spine-Health (Source: http://www.spine-health.com/conditions/depression/depression-and-chronic-back-pain)

  • Depression is by far the most common emotion associated with chronic back pain. The type of depression that often accompanies chronic pain is referred to as major depression or clinical depression. This type of depression goes beyond what would be considered normal sadness or feeling "down for a few days".
  • The symptoms of a major depression occur daily for at least two weeks and include at least 5 of the following (DSM-IV, 1994):
    • A predominant mood that is depressed, sad, blue, hopeless, low, or irritable, which may include periodic crying spells
    • Poor appetite or significant weight loss or increased appetite or weight gain
    • Sleep problem of either too much (hypersomnia) or too little (hyposomnia) sleep
    • Feeling agitated (restless) or sluggish (low energy or fatigue)
    • Loss of interest or pleasure in usual activities
    • Decreased sex drive
    • Feeling of worthlessness and/or guilt
    • Problems with concentration or memory
    • Thoughts of death, suicide, or wishing to be dead
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