Coping With Chronic Pain And Devastating Depression

dealing with depression and chronic pain

Those suffering conditions that produce prolonged bouts of chronic pain are more prone to developing depression. Constantly having to deal with pain on a day to day, hour to hour or even minute to minute basis can have a profound effect on a person’s psyche and mental state. Extreme frustration, anger, helplessness and hopelessness may develop in patients who have to undergo living with any disorder, illness or injury that has left them in a state of pain.

Pain may interfere with a person’s ability to perform regular routines and activities of daily living. As the pain progress in severity and intensity, the person may experience depression as they may no longer be able to function the way they want or expected to. Feelings of uselessness may creep up. Depression for chronic pain patients does not really occur overnight. It usually starts with characteristics such as crying and depressed moods until it eventually develops and manifests the symptoms of major depression which includes anhedonia or the inability to experience any pleasure, lack of appetite for food and inability to sleep at night or insomnia.

Chronic pain may also cause depression if the source of the pain, illness or disorder, has a risk of death associated with it. Most terminally ill patients say that they are living each day in fear, feeling as if they might die the next hour or so. Cancer, for example, is one illness which can cause long term pain. The risk of developing depression among cancer patients is very high as patients may feel that the time for their death is looming. In most cases, this fear of death leads to long term depression and apprehension.

Another condition known as phantom limb pain, the pain sensation from an amputated extremity, provides chronic pain which results to long term depression. It is experienced by a number of post operative patients, no matter what age, gender and race. What makes phantom limb pain worse is it is psychological in nature. It is usually managed by placebo drugs. However, physicians also prescribe pain medications as the “phantom “pain is considered as something real by the patient. Fibromyalgia sufferers also are at an elevated risk of developing clinical depression.

Can Depression Make Pain Worse?

Pain can definitely makes depression worse, however, some studies have also shown that depression can actually make pain worse. When a patient with chronic pain experiences depression the psychological symptoms can disrupt proper eating and sleeping routines and brain cells do not function properly as well. This can interfere with the brain’s ability to produce natural pain killing chemicals, making the pain sensation more severe and intensified.

The best way to prevent depression associated with chronic pain is through early and effective pain management methods. Pain medications are usually given round the clock to prevent any pain sensation to the client. Handling the physical pain symptoms can significantly reduce the propensity of depression from occurring. However, even if pain management methods are being performed, patients may still develop depression. Antidepressant medications and other therapeutic pain managements are usually indicated for patients who are already experiencing depression to prevent progression of the condition.

Before taking any type of antidepressant it is important to inform the prescribing physician of all other medications being taken to avoid any dangerous drug interactions. If prescribed any type of depression medication it is also important to take the dosages outlined by the doctor. Any side effects are problems should be reported immediately.

It is important for any patient that has suffered an injury (back, neck, bone etc.) illness, or health condition that has left them experiencing pain on a regular basis to be aware how it can also affect their mental state and puts them at a higher risk of developing depression or other mental health disorders. Pain can be debilitating, both physical and psychological, and often times improving one can help improve the other. Communication with your doctor is always key and it can be extremely beneficial to inform them of not just your physical pain but of the mental toll it may taking on you as well.

Signs & Symptoms Of Psychotic Depression

Psychotic Depression warning signs

Psychotic depression is characterized as a severe case of major depression coupled with some form of psychosis such as delusions, hallucinations, both or some other type of a break from reality. It is a very serious condition and those experiencing this type of depression should seek professional help immediately. Those suffering from psychotic depression make up an estimated 25% of all patients admitted to a hospital for mental illnesses.

Since this disorder is made up of two parts, the depression aspect and the psychosis aspect, it is important to know the symptoms for each and how they manifest themselves as well as the treatment options for those suffering from psychotic depression.

Symptoms of Psychotic Depression

Those with this disorder may experience any of the normal symptoms of depression, but most notable may be:

  • Hopelessness
  • Guilt
  • Agitation, short temper, quick to get angry
  • Withdrawal
  • Insomnia or excessive sleeping
  • Anxiety
  • Feelings of worthlessness
  • Mental impairment, not being able to think clearly or concentrate
  • Neglect of appearance, does not bathe regularly or change clothes
  • Constipation

This disorder is also marked by the appearance of psychosis in the patient. Delusions (a false sense of one’s self or of what is going on) and hallucinations (seeing things or hearing things that are just not there) are the two major manifestations of the psychosis aspect of the disorder.

A patient experiencing delusions with psychotic depression may be unusually distrusting of others believing that others can hear their thoughts. They may also think that they are dying from a terminal disease such as cancer. They can believe that they are guilty of a serious crime that they never committed. They can also have a false sense of themselves believing that they are someone famous or overly important.

If they experience hallucinations then they may hear voices that insult them making them feel worthless and belittling them or telling them to harm themselves or others. They may see the devil or other incarnations of evil.

Unlike other mental illnesses that include psychosis such as schizophrenia, where the patient truly believes that their delusions or hallucinations or in fact real, someone suffering from psychotic depression knows that what they are seeing or hearing or believing about themselves is not real or based in reality. This produces a sense of shame in the patient and makes it harder to diagnose them since the shame they feel keeps them from talking about it or admitting their psychosis to health care providers. This sense of shame and not being able to control their thoughts may also lead to or make worse their depression.

Treatment Options

Psychotic depression ideally should be treated in a hospital setting where proper monitoring of the patient can take place. The risk for hurting themselves or others is higher than normal for those suffering from this form of depression so being under medical supervision until being stabilized is preferred.

Different medications can be used to treat psychotic depression. Usually a combination of depression medications along with anti-psychotic medications are used to stabilize the patient. Normally, antidepressants will have to be taken for a longer period than the anti-psychotic drugs. Treatment with medications can be effective and, if successful, results can be seen within one year. Follow up and maintenance treatment is highly recommended for patients as well.

For severe cases, or for cases in which medication did not produce adequate results for the patient, electroconvulsive therapy might be recommended. ECT has a very long and successful track record in helping those suffering from a vast array of mental health illnesses.

What Causes Psychotic Depression?

The exact cause of psychotic depression in not currently known. Some research points to a possible link between high levels of cortisol in the body. Cortisol is a hormone the body produces during high levels of stress or when presented with trying circumstances. Also a family history of mental illness may increase a person’s chances of developing a mental disorder.

Psychotic depression is a serious matter. Severe major depression along with psychosis often leaves one suffering from this disorder unable to take care of themselves. It also carries a high risk of someone afflicted with this form of depression to hurt themselves or others. Anyone at risk of or thought to be suffering from psychotic depression should seek immediate help. It is recommended to treat patients of this disorder in a hospital setting so they can be properly monitored while being stabilized. Treatment can be highly effective, so it is important to keep in mind that there is always hope for those going through psychotic depression.