Pain and Depression

Dimitris Papadopoulos MD Fellow Of Interventional Pain Practice (FIPP)

Updated 19 June, 2011


Pain and depression are connected in a complex way. Pain causes depression and depression causes pain. About 30% of patients suffering from chronic pain, suffer also from clinically established pain-induced depression, and almost all patients suffering from chronic pain experience mood changes.

Patients with chronic pain also suffering from depression, are affected more by physical activities compared to those who do not have depression.

It is very important for both the therapist physician and the patient to understand to which high extent emotional and psychological factors affect the degree of pain that the patient experiences.

One of the first steps is to accept that depression frequently accompanies chronic pain and that pain aggravation may be a symptom of depression.


  • Mood changes including irritability, anxiety and depression
  • Decrease of physical activities
  • Sleep disorders
  • Reduced sexual activity
  • Family stress
  • Employment problems
  • Family concerns
  • Low self-esteem
  • Fear of potential harm

Why do pain and depression co-exist so often?

Scientists have been studying this correlation and have drawn very important conclusions. First of all, both depression and the experience of pain originate from the same brain areas. Secondly, the same chemical neurotransmitters are involved in the regulation of both pain and mood processes.

What is it that makes someone vulnerable to depression?

Depression is often a family phaenomenon. So, the emotional pressure experienced with pain may motivate chemical brain changes which might cause depression to individuals that are vulnerable  due to family predisposition (genetically) to manifesting clinically established depression.

However, even if an individual is not vulnerable to depression and with no family history of depression, s/he may be psychologically overwhelmed by the pressure and problems caused by a chronic painful condition.

This way or the other, this psychological overwhelming condition is in essence a biochemical change. Important chemical substances of our body (such as vitamins) that are responsible for pain and mood regulation, get functionally exhausted under such circumstances.

The same drugs that help to treat depression may also treat pain, for they intensify the action of these chemical  neurotransmitters in the brain regulating the experience of pain and mood.


  • Anti-depressant drugs
  • Cognitive Behavioural Therapy (CBT)
  • Stress Management (relaxation techniques, hypnosis etc)
  • Consultation support
  • Family support