Relevant studies have shown that more than 50% of patients with depression exhibit somatic symptoms of chronic pain. At the same time, chronic pain will increase the incidence and recurrence rate of depression, and depressed patients with painful symptoms will have a higher degree of depression severity. .
So, what is the relationship between chronic pain and depression? What factors can cause comorbidity of pain and depression? How to diagnose and prevent the comorbidity of pain and depression?
Back pain (photoAC)
Epidemiological investigations show that the incidence of chronic pain among the elderly in mainland China is as high as 41.1%, and the incidence varies depending on the region, age, gender and other factors.
Women are more likely than men to suffer from chronic pain. The incidence of chronic pain gradually increases with age. Some occupational pain can lead to the development of chronic pain. For example, jobs that require long periods of standing, poor sitting posture, or repetitive movements can increase the risk of chronic pain.
The causes of chronic pain include physiological factors, psychological factors and social factors. Physiological causes include tissue damage, disease, or sequelae of disease treatment. Psychological causes include anxiety, depression and other mental factors. Social factors include living environment, social support, etc. Therefore, the causes of chronic pain are multifactorial and must be considered comprehensively.
1. Physiological model:Pain causes the body to produce a stress response, which affects the emotional regulation function of the human brain, thus triggering depression.
2. Psychosocial model:Pain makes people feel exhausted, helpless and out of control, leading to low mood and depression.
3. Behavioral model:Pain affects an individual’s behavioral performance, such as reduction in social activities, loss of interest, etc., thus inducing depression.
4. Cognitive model:Pain can change an individual’s perception of themselves, the environment, and the future, produce negative thought patterns, and exacerbate depressive symptoms.
5. Quality of life mode:Long-term pain affects an individual’s quality of life, making them feel tired and frustrated, which can lead to depression.
Headache (photoAC)
There is a strong relationship between chronic pain and depression. The interactions between them are complex and two-way, often forming a vicious circle.
Common factors associated with comorbidity of chronic pain and depression mainly include:
1. Sleep problems:Reduced sleep quality can worsen both pain and depression;
2. Economic pressure:Financial difficulties can exacerbate depression and limit the effectiveness of pain treatment;
3. Degree of pain:Increased levels of pain may be associated with increased levels of depression;
4. Self-assessment of poor health:Patients’ negative evaluations of their health may be related to the emergence of depressive mood;
5. Poor self-care skills:Reduced ability to care for oneself can increase the patient’s burden of pain and depression.
These factors interact to influence the onset and progression of chronic pain and depression. Therefore, in the treatment and management of chronic pain and depression, it is necessary to consider these factors and develop an individualized treatment plan.
Research shows that the following diseases or conditions are more likely to cause comorbidity with pain and depression:
1. Somatic diseases,Such as stroke, coronary heart disease, hypertension, diabetes and tumors, etc., can all lead to comorbidities of pain and depression;
2. Neuropathic pain:It is often accompanied by lesions or injuries to the nervous system, such as neuroinflammation, compression of nerve roots, etc. This pain is often comorbid with depression;
3. Increased age,Older adults face various pressures, such as worsening physical health, changes in living conditions and reduced social support, which can easily lead to comorbidities such as pain and depression;
4. Genre:Research shows that women are at greater risk for depression when dealing with chronic pain, so women are more likely to suffer from comorbid pain and depression;
5. Occupation:Work that requires standing or bending for long periods of time can easily lead to chronic pain, thus increasing the risk of depression.
Reduced sleep quality can worsen both pain and depression (pxqui)
Symptoms of comorbid pain and depression fall into six broad categories:
1. Body Pain:Patients experience persistent chronic pain that can involve different parts of the body, such as head, neck, back, limbs, etc.;
2. Feeling of depression:It is often accompanied by persistent depression, manifested by low mood, loss of interest or happiness, self-deprecation, etc.;
3. Sleep problems:Patients may have sleep disorders, including difficulty falling asleep, poor sleep quality, excessive or insufficient sleep, etc.;
4. Decline in cognitive function:Patients may experience symptoms of declining cognitive function such as inattention, slow thinking, and memory loss;
5. Social dysfunction:Patients may have fewer interactions with others and lose interest in social activities, leading to a decline in social function;
6. Suicidal tendencies:In extreme cases, patients may have suicidal thoughts or behaviors and require prompt intervention and treatment.
Diagnosis of comorbid pain and depression requires comprehensive consideration of the patient’s symptoms, medical history, physical examination, and exclusion of other conditions that may cause similar symptoms.
A typical diagnostic process includes:
1. Detailed medical history request:The doctor will ask the patient about the pain situation, the duration, the location of the pain, the characteristics of the pain, and whether it is accompanied by depressive symptoms such as low mood;
2. Physical exam:The doctor will carry out a complete physical examination to exclude possible organic diseases and evaluate the function of the nervous system, psychological state, etc. of the patient.
3. Psychological evaluation:Clinicians can use standardized psychological assessment tools, such as the Beck Depression Inventory (BDI), Depression Anxiety Stress Scales (DASS), etc., to assess the patient’s level of depression;
4. Other inspections:Depending on your specific situation, blood tests, imaging tests (such as x-rays, MRI, etc.) may be needed to rule out other possible causes.
How to prevent chronic pain from triggering depression (photoAC)
The key to preventing chronic pain from triggering depression is to manage pain effectively by adopting positive psychological and behavioral strategies to cope with it.
1. Regular exercise:Correct physical exercise can reduce the sensation of pain and promote physical and mental health;
2. Maintain a positive attitude:Try to maintain an optimistic attitude, actively deal with pain, and find joy and meaning in life;
3. Learn coping skills:Learn effective coping skills, such as deep breathing and progressive muscle relaxation, to reduce sensations of pain;
4. Seek Social Support:Communicate with family, friends or professional psychological counselors to share your feelings and concerns and gain understanding and support;
5. Seek medical care regularly:Seek medical care regularly, accept diagnoses and treatment from medical professionals, and actively collaborate on the treatment plan;
6. Maintain a healthy lifestyle:Maintain a healthy lifestyle, including good sleep habits, a balanced diet, quitting smoking and limiting alcohol consumption;
7. Get psychological treatment:Receive psychological treatment, such as cognitive behavioral therapy (CBT), stress management, etc., learn effective strategies for coping with pain and reducing depression;
8. Medicines:Under the guidance of a doctor, timely use medications, such as antidepressants, analgesics, etc., to reduce the symptoms of pain and depression;
9. Find hobbies and interests:Develop and maintain your interests and hobbies, participate in social activities and enrich your life;
10. Periodic review:Review symptoms of pain and depression regularly and adjust treatment plans promptly to prevent worsening of the condition.
Treatment of depression accompanied by pain requires comprehensive consideration of both pain and depression factors and a comprehensive treatment strategy.
1.Drug treatment:Commonly used medications include antidepressants and analgesics. Antidepressants can help improve mood and mental state, such as selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants, etc.; analgesics can relieve pain, such as nonsteroidal anti-inflammatory drugs (NSAIDs), opioid analgesics, etc.;
2. Psychotherapy:Psychological treatments include cognitive behavioral therapy (CBT), stress management, etc., which can help patients change negative thought patterns and emotional reactions and learn to cope effectively with pain and depression;
Attend social events (pixabay)
3. Physical Therapy:Physical therapy includes physical therapy, rehabilitation training, etc., which can relieve pain and muscle tension and promote recovery through physical therapy, hot compresses, massage, etc.;
4. Lifestyle adjustments:Maintaining a healthy lifestyle, including regular work and rest, healthy diet, moderate exercise, etc., can help improve physical endurance and psychological quality and reduce symptoms of pain and depression;
5. Social Support:Seeking support and understanding from family, friends and professional psychological counselors, participating in social activities and strengthening your social support network can help alleviate emotional stress and loneliness and improve mental health.
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