Frequently, patients who suffer with chronic pain also suffer with depression. Whether you suffer with chronic pain and depression or you know someone who does, it helps to understand depression itself.
There are three key components of depression:
1. The individual does not feel good about him or herself.
An injury which results in chronic pain is frequently debilitating, which often results in a significant decrease in social, recreational, and domestic activities. For many, returning to work is either limited or not an option. Many important aspects of a person’s life that have brought meaning and fulfillment are diminished.
In social situations, someone with chronic pain dreads the question, “how are you doing?” The individual loses sources of topics and information to share in these settings. Consequently, one’s self-esteem dwindles, and the individual can become more isolated.
2. The individual does not have much hope for the future.
Because the individual most likely has reduced recreational, social, and physical activity, as well as the reduced ability or no ability to work, life with chronic pain becomes increasingly bleak. Suffering with chronic pain causes people to have little hope of enjoying life in the present, let alone the future. Add to this picture a financially depressed situation, and the situation becomes that much more dire. Finally, the individual suffering with chronic pain has most likely engaged in rounds of medical treatment and has begun to lose hope that treatment will ever resolve their symptoms.
3. The individual loses the ability to enjoy the things which one brought pleasure.
Chronic pain limits the ability to participate in once enjoyable activities. The sense of pleasure or the ability to enjoy life becomes significantly diminished. Lack of self-worth and hope for the future caused by chronic pain together with diminished physical capabilities make enjoying life that much harder.
These three components–decreased sense of self, hope, and ability to enjoy oneself–feed into each other, creating a vicious cycle.
However, with proper treatment, the individual suffering with chronic pain can regain a sense of hope, learn to manage pain more effectively, and once more take pleasure in social and recreational activities.
Cognitive Behavioral Therapy (CBT) provided by a licensed psychologist or professional counselor is a recommended approach. CBT has shown to be one of the most effective therapies for treating depression. The therapist works with the patient to examine behaviors and thought processes which may contribute to ineffective coping and then develop thoughts and behaviors that improve one’s ability to cope with depression and chronic pain.
Frequently, an antidepressant is also recommended as part of the treatment program. The combination of medication and psychotherapy has helped many who suffer with chronic pain and depression regain a sense of control over their lives.
Adapted from William Melchoir, Ed.D.’s Chronic Pain Report written for Michael T. Farrell, Ph.D. & Associates