Pain and depression


If you have chronic pain, it isn't just your body that suffers. Pain also affects your emotional well-being, which can lead to depression.

The depression-pain cycle

It's natural to feel hopeless at times. But depression can make pain worse. And the worse pain gets, the more depressed you may become. That's why treating depression is just as important as treating the pain itself.

Symptoms of depression may include:

  • Feeling sad or hopeless
  • Losing interest in things you used to enjoy
  • Changes in sleep (sleeping too much or too little)
  • Fatigue
  • Big changes in your appetite

See more signs of depression, and use our depression assessment tool to get a better idea of whether you may have depression.

Why do I feel depressed?

Many people feel mentally and physically exhausted by pain.

woman with shoulder painYou may feel down because pain keeps you from living your life "normally."  Or you may be upset because you've gained weight due to inactivity or medication side effects. Some pain medications even list depression as a known risk.

Whatever the source of depression, your feelings are real.

Take action against depression

There are things you can do to help cope with the depression-pain cycle:

  • Recognize that your life with pain is different than it was before. Once you do this, you can begin to adapt, change how you approach activity, and develop better coping skills to move forward.
  • Retrain your brain to stop thinking of "can't" and instead focus on "can."
  • Exercise positive thinking. Like anything else, thinking positively takes practice.
  • Learn to relax with deep breathing, progressive muscle relaxation, meditation, and guided imagery 
  • Set realistic treatment goals. Small successes can boost your mood and your confidence.
  • Get educated about depression. The more you know, the better you'll be able to cope with your feelings.
  • Sign up for depression management classes near you.

Treatment for depression

For many, depression doesn't go away on its own without treatment — medication, counseling, or a combination of both.

Talk to your doctor about feelings of depression. The sooner you get treatment, the more likely you'll begin to feel better.

A behavioral health specialist may also suggest cognitive behavioral therapy, an approach which helps you change the way you think about pain and manage your feelings.

Build a support system

It can be hard to find others who understand your pain and believe you when you describe how you're feeling.

couple walking on beachMany people with chronic pain spend a lot of time alone because they feel they can't keep up with friends and family, or don't have the energy to go out. But being alone with your pain can sometimes lead to depression. Having people you can count on is an important part of coping with chronic pain.

Don't be afraid to ask for help, and be sure to let people know what you need to feel supported.

You can also find help and support in pain management message boards, blogs, and other community websites such as The American Chronic Pain AssociationKaiser Permanente is not responsible for the content or policies of external Internet sites, or mobile apps..

Caregivers: learn more about supporting someone who is depressed.

Reviewed by: Benjamin Balderson, MD, January 2019

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