If you live with chronic pain, you already know it doesn’t just affect your body. It can drain your energy, disrupt your sleep, limit your independence, and erode your mood. Over time, chronic pain can lead to depression. In turn, depression often makes chronic pain even worse. This complicated relationship can feel like a trap: the more pain you’re in, the more depressed you feel. And the more depressed you feel, the more everything hurts.
Understanding the mind-body connection can make a significant difference in regaining a sense of agency over your symptoms and life. So, what’s the relationship between depression and pain, and how can you cope?
The Connection Between Physical Pain and Depression
Pain is a full-body experience. It impacts every part of your life, from how you sleep, eat, and move to how you feel, think, and interact with others.
Chronic pain is the leading cause of long-term disability in the U.S., and the number of people who experience it has increased in recent years—about 52 million people and counting live with chronic pain.
For many people, chronic pain leads to emotional challenges, irritability, social isolation, and feelings of hopelessness. It can take away things you used to love doing. It shrinks your life down to a black-and-white list of what you can and can’t do. It can make everyday tasks feel impossible. Over time, these limits weigh on the mind.
These intertwining symptoms are one reason for the connection between depression and pain. Depression is one of the most common mental health conditions experienced by people with chronic pain.
Unfortunately, many people never get the mental health support they need. Pain often dominates medical conversations, which can lead to missed diagnoses or undertreated depression. However, treating both pain and depression is essential because they’re usually two sides of the same coin.
Chronic vs. Acute Pain
Recognizing the difference between chronic and acute pain can help you assess whether you have an injury or whether your pain is tied to your mental health.
Acute pain is short term. It’s your body’s response to injury or illness, and it resolves once you heal. Think of a sprained ankle, broken bones, a stubbed toe, or post-surgical pain.
Chronic pain, however, is pain that exists for more than three months and is considered long term. It may be caused by mental health issues, an ongoing health condition, autoimmune disorders, fibromyalgia, nerve damage, or injury that didn’t fully resolve.
Chronic Pain and Depression: Which Comes First?
It’s the classic chicken-or-the-egg question: Does pain cause depression, or does depression cause pain? The answer is both.
People who live with chronic pain are more likely to develop depression. And people with depression are more likely to experience pain. That’s because both conditions involve changes to your brain chemistry and nervous system, like disruptions in serotonin and norepinephrine levels (which regulate both mood and pain) and hyperactivation of the brain’s threat detection system.
In other words, these two conditions feed each other, and can easily become a self-reinforcing cycle. If you’re wondering which came first for you, here are some questions to consider:
- Have you always experienced chronic pain, or did it develop after a period of depression or trauma?
- Are you prone to anxiety, PTSD, or other mental health conditions that increase the likelihood of physical pain?
- Might you have unprocessed emotional experiences that could be contributing to physical symptoms?
You don’t have to know the exact cause. What matters is that both pain and depression deserve care, and getting support for one often helps relieve the other.
The Cycle of Depression and Chronic Pain
Here’s how the pain-depression loop can play out: You experience chronic pain → The pain limits your ability to do things → You feel frustrated, helpless, or isolated → Depression symptoms increase → You sleep less, eat less, or withdraw → Your pain feels worse → And the cycle continues.
This cycle can impact almost every area of your life, including:
- Mood and relationships: You may feel irritable, withdrawn, or unable to explain what you’re going through.
- Work, school, and daily life: Chronic pain can make it hard to focus, keep a schedule, or perform tasks consistently.
- Physical health: Depression can reduce your ability to care for yourself, exercise, or manage other medical conditions.
- Self-esteem: Feeling like a “burden” or “not yourself” often chips away at your confidence and sense of self-worth.
- Sleep: Pain and depression are both linked to disrupted sleep, which further worsens both.
- Substance use: Both physical pain and emotional challenges can lead people to use substances as a way to cope or find relief from their symptoms. Over time, this pattern of temporary relief can create a cycle of dependence and developing a substance use disorder.
Some people also experience:
- Fatigue
- Anxiety and agitation
- Decreased libido
- Financial strain
- Weight fluctuations
Coping Strategies for Pain and Depression
Even though chronic pain and depression are overwhelming, there are ways to cope. Here are some evidence-based strategies that can help you feel more in control.
Gentle Physical Activity
Movement, especially out in nature, helps regulate the nervous system, reduce stress hormones, and improve mood. It doesn’t have to be anything big or bold. Just moving your body in ways that feel doable and non-punishing can help, like:
- Walking
- Gentle stretching or yoga
- Dancing to a song you love
- Swimming or water therapy
Start where you are. If what you can manage is a walk around the block, that’s great, and it counts.
Stay Engaged
When you’re in the trenches of chronic pain and depression, engaging with the world can feel really difficult. These things can make your whole world feel shrunk down to the size of a pinprick, and you end up just trying to survive every day. It isn’t your fault. Getting professional support and trying new coping skills can give you the boost you need to keep connecting with people and engaging in activities that matter to you.
Even small steps toward engagement can help your brain relearn that it’s safe to reconnect. Try:
- Calling a friend
- Spending time outside
- Pursuing a hobby in tiny, manageable pieces
- Attending a support group
Antidepressants
Because pain and depression share neurological pathways, certain antidepressants can help treat both. These medications can:
- Increase your tolerance to pain
- Improve sleep and appetite
- Reduce symptoms of anxiety and depression
Talk to a psychiatrist about whether this might be a fit for you, especially if you’ve already tried multiple medications without success. For treatment-resistant depression, TMS (Transcranial Magnetic Stimulation) may be an option.
Consider the Whole Picture
When it comes to complex mental health issues and pain, treatment is most effective when it takes a whole-person approach. Seek treatment that considers every aspect of who you are, including your medical history, mental health needs, family system, trauma history, cultural background, and lifestyle.
How PrairieCare Can Help
Living with pain and depression is exhausting and isolating. But healing is possible. Whether you’re newly struggling or have been carrying this for years, we’re here to meet you with compassion, skill, and comprehensive care that actually works.
At PrairieCare, we recognize the profound connection between your body and mind. When you’re experiencing mental health or pain struggles, it can be tough to navigate them alone. If you’re looking for support, we’re here for you. We provide mental healthcare for anyone who needs it, whether it’s you, your child, or a young adult.
PrairieCare offers a full continuum of mental health services across Minnesota, including Intensive Outpatient Programs (IOP), Partial Hospitalization Programs (PHP), residential treatment for teens, and an inpatient hospital for anyone 35 and younger.
Get started by calling our team at 952-826-8475 or learning more about our admissions process here. You can also request a no-cost mental health screening by clicking the button below and filling out the form on the right. Our team will contact you within one business day to begin the process.
FAQs
Can depression cause body pain?
- Yes. Depression can cause physical pain, including migraines, muscle aches, back pain, nerve pain, stiffness, and digestive issues. This is often due to changes in your brain chemistry and nervous system.
What is the relationship between pain and depression?
- The relationship between pain and depression is bidirectional. Chronic pain can lead to depression, and depression can increase your sensitivity to pain. The two conditions often reinforce each other.
Can mental illness cause chronic pain?
- Yes. Mental health conditions like depression, anxiety, and PTSD can increase inflammation and stress responses in the body, leading to chronic pain over time.
What medication is used for chronic pain and depression?
- Certain antidepressants, such as SSRIs and other antidepressants, are often prescribed for both conditions. Transcranial magnetic stimulation is another option for treatment-resistant depression.
How to cope mentally with chronic pain?
- Getting professional support is key. In addition to therapy and medication, strategies like gentle movement, mindfulness, peer support, and structured treatment programs like IOP or PHP can help reduce the emotional burden of chronic pain.