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Our bodies are incredible structures; we have evolved in such a way that every function of our physical self works to keep us safe and healthy. Pain, for example, serves an extremely important role in our lives. Pain warns us to stop any activity that is causing injury by making us conscious of the problem.

Some pain, however, lasts for weeks, month, or even years. This chronic pain (as it is known) sends patients to my office in search of a solution not only for their physical trauma, but for their emotional issues as well.

When I meet with new patients who are dealing with a chronic pain condition, it is often pretty evident that they are also suffering from some very major emotional effects, including depression. This psychological disorder can make life with chronic pain even more difficult.

How Does Pain Lead to Depression?

Pain is a function of the nervous system, which initiates a stress response when the body is endangered in any way. This reaction is a healthy defense mechanism and involves the release of hormones that affect every organ and system of the body.

In the short term, this process can be very helpful; for patients under the stress of chronic pain, though, these hormones can begin to undermine overall health. One of these unhealthy, long term effects is depression. Excess cortisol in the blood can interfere with mood enhancing neurotransmitters (including serotonin). Clinical depression is caused when there are disturbances in the levels of neurotransmitters.

There is something of a catch-22 here as well: disorders involving serotonin can also lead to increased sensitivity to pain, thereby perpetuating a terrible cycle of pain and depression. In fact, the cycle does not always begin with pain; sometimes it is the depression itself that can lead to pain.

In the past, when doctors could not find a physical cause for a person’s pain, the complaint was often dismissed as psychosomatic. Today, we understand that the pain experienced by depressed patients is authentic. Some individuals have stronger brain and nerve pathways that transmit mental status to all areas of the body.

Two neurotransmitters—serotonin and norepinephrine—are responsible for regulating thinking and mood as well as digestion and sleeping. These neurotransmitters also travel down the spinal cord, serving the rest of the body (hence the depression-pain connection).

In order for our bodies to perform routine tasks, there are a number of sensations—digestion, for example—that must be suppressed or ignored in order for us to pay attention to the world outside our bodies. We are not meant to bear witness to every mission carried out by our physical selves.

The suppression of sensation is usually accomplished by nerve fibers dependant on serotonin and norepinephrine. When there is disorder in these nerve fibers, they begin to fail. As a result, everyday sensory input is interpreted as discomfort or even as painful physical symptoms when nothing is actually wrong.

Beyond Pain and Depression

I am a chiropractor and enthusiastic proponent of healthy living; my empathy for patients suffering from pain and depression has been a guiding force in building my practice here in Monmouth County. I believe that it is unnecessary for any person to live anything less than a full, active, and healthy life. Check out our next blog entry, where we will detail the path that leads beyond depression and chronic pain.