Blues Qs is an advice column covering all things clinical depression, written by Bezzy Depression community guide Sam Dylan Finch. Diagnosed with clinical depression over a decade ago, Sam has seen it all — from medication mishaps to grippy sock “staycations.” He’s here to help you navigate your own depression journey with a little humor and a lot of heart.
I don’t know about you, but for me, depression is a pain in the neck. And I mean that literally — many times when I’ve been experiencing a depressive episode, it’s been accompanied by chronic, unexplained pain.
I used to think this was just “in my head.” That is until I read about our “fight or flight” response.
Acute stress, including the stress you might experience related to your mental health, can set off your body’s “fight or flight” response. This response activates us when we’re facing danger (to run away or prepare to fight) — but our brains don’t really know the difference between the stress we’re experiencing from our depression versus the stress we experience when staring down a literal tiger.
So our body floods us with stress hormones, namely adrenaline and cortisol. This increases our heart rate and blood pressure, suppresses nonessential systems like our digestive system, and even affects our immune system. All of this can result in various physical ailments that involve inflammation, including pain and digestive issues.
This is a “chicken or the egg” scenario, of course, because you could have a preexisting condition that contributes to your depression or is made worse by your depression. Stress and depression are known to be associated with increased levels of inflammation in the body. And inflammation adds to pain. As many mental health professionals will tell you, pain is depressing, and depression is painful.
Chronic pain has symptoms that can trigger depression. For example, if your pain levels are high, you may find it difficult to sleep. Insomnia, over time, can impact mood and result in depressive symptoms. Similarly, if your chronic pain has been persisting for a long time, you may experience hopelessness and despair as a result of unresolved pain.
Depression and anxiety also impact our neurotransmitters (including serotonin and norepinephrine), which coincidentally are responsible for our pain tolerance. As a result, our pain tolerance may be lower when we’re depressed or anxious, as the same transmitters are implicated in both.
In other words? Depression can impact many systems of the body, with rises in inflammation resulting in physical symptoms and discomfort, and changes in our pain tolerance. Just the same, chronic pain can result in mental and emotional symptoms if left untreated for too long.
So, what can you do if you’re experiencing both chronic pain and depression? Here are a few suggestions.
Speaking with a doctor is the surest way to pinpoint the source of your pain. Finding a doctor you trust, of course, is a whole other story. While some doctors can be dismissive of chronic pain and may assume it’s “all in your head,” don’t be afraid to advocate for yourself. If you can, ask for a referral to a pain clinic if your medical system has one.
There is good news. Because the neurotransmitters involved in pain tolerance are also the transmitters implicated in mood disorders like depression, the medications we use to treat them have significant overlap. If you’re interested in trying medication for one or the other, it’s possible that you’ll see benefits for both.
For starters: A pain specialist, therapist, physical therapist, and psychiatrist. These are all folks that are good to have on your team.
A pain specialist can help you better understand where your pain symptoms are coming from. A therapist can help you develop coping skills to live your life with minimal interruption. A physical therapist can help you work on exercises that reduce your pain. A psychiatrist can prescribe medications that you may need for depression.
How often are you in pain, and how would you rate that pain on a numeric scale? Does your pain coincide with depressive symptoms, or do you have pain even on good days? How effective are the medications you’re taking for managing your symptoms?
All of this is useful information that can deepen your self-awareness and help your clinicians better understand your experience.
If you aren’t sure how to start tracking your symptoms, this resource is a great place to start.
I know it’s annoying to be told to meditate or do yoga, but a crucial aspect of pain relief is trying to mitigate the stress in your life. If you’re looking for pain relief techniques, here is a helpful list.
Whatever you do: don’t invalidate yourself.
It can be a frustrating journey to find the source of your pain. But please remember that all pain, regardless of its source, is technically “in your head.” No type of pain is more valid than another.
Your pain is valid. Whether it’s connected to your depression or not, you’re still in pain, and that pain deserves to be addressed. You deserve relief. You deserve care and comfort. And no matter what you’ve been told — your pain is not your fault.
Medically reviewed on November 17, 2022
Have thoughts or suggestions about this article? Email us at firstname.lastname@example.org.
About the author