Depression and Back Pain
Posted on Tuesday, November 15th, 2011
By Sean Campbell ‘Back Physio’.
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
Major depression is thought to be four times greater in people with chronic back pain than in the general population (Sullivan, Reesor, Mikail & Fisher, 1992).
Depression is Common for Those with Chronic Back Pain
Depression is more commonly seen in patients with chronic back pain problems than in patients with pain that is of an acute, short-term nature. How does depression develop in these cases? This can be understood by looking at the host of symptoms often experienced by the person with chronic back pain or other spine-related pain.
- The pain often makes it difficult to sleep, leading to fatigue and irritability during the day.
- Then, during the day, because patients with back pain have difficulty with most movement they often move slowly and carefully, spending most of their time at home away from others. This leads to social isolation and a lack of enjoyable activities.
- Due to the inability to work, there may also be financial difficulties that begin to impact the entire family.
- Beyond the pain itself, there may be gastrointestinal distress caused by anti-inflammatory medication and a general feeling of mental dullness from the pain medications.
- The pain is distracting, leading to memory and concentration difficulties.
- Sexual activity is often the last thing on the person’s mind and this causes more stress in the patient’s relationships.
Understandably, these symptoms accompanying chronic back pain or neck pain may lead to feelings of despair, hopelessness and other symptoms of a major depression or clinical depression.
Treatment:
If you are feeling down or depressed, speak to your doctor or therapist about it. It is a common “side effect” of ongoing back pain and can be helped by regular exercise, returning to your normal activities, medication to help with mood and sleep and counselling with a a qualified professional to help get you back on the right track.
Grade A stuff. I’m unquesitonably in your debt.