The Vicious Cycle of Chronic Pain and Depression


There once was a chicken. And also an egg. And nobody seemed to know which arrived first.

Today, the mystery has yet to be solved.

For many folks with chronic pain, including myself, it seems we are trapped inside our own chicken and egg enigma with real-life consequences. Those consequences are the devastating, debilitating and derailing forces of depression.

Roughly 50 percent of people with chronic pain also have depression, according to Robert D. Kerns, National Program Director for Pain Management for the Veterans Health Administration. Many symptoms include the feeling of loss, isolation from friends and family and fatigue.

To further complicate things, these same experiences can also be results of the chronic pain itself that have caused the depression.

Unrelenting pain can take away so many of the things and activities you used to enjoy or even rely on, making you feel you are no longer yourself. For example, my life used to revolve around yoga. I was in the studio at least four times a week getting in touch with myself as well as getting in shape. I could not remember feeling any better than I did at that period in my life.

Then I got the ground pulled right from under my feet when I was hit with chronic migraines, neck and shoulder pain seemingly out of nowhere over two and a half years ago. I haven’t done yoga since.

The practice of yoga staved off my depression that I had experienced off and on since high school, so losing it was, and still is, something I had to grieve. That grief can become long-term and turn into depression as time goes on, and  you no longer recognize the person you’ve become. So not only are you missing the things that once gave you life, you’re also missing yourself.

You also now have two conditions to treat  —  pain and depression  — that are separate in one way but completely intertwined in another.

This creates a snowball effect. Actually, no, it creates a blizzard.

Pretty soon, you don’t know where you are, who you are or what’s ahead. This feeling can make your physical pain feel so much worse. This pain then makes you even more depressed than you were before, and the cycle continues.

And when I look back, I can’t see a damn thing.

The person I used to be and the life I used to live is something completely foreign to me now. This experience and this pain is all I know. At 28 years old, I’ve involuntarily taken on the role of a shut-in aside from going to work, which in itself is a challenge. I no longer socialize with my friends because it’s exhausting and painful. I no longer exercise because it’s exhausting and painful. I no longer clean my apartment or go to the store or travel because it’s exhausting and painful. If I have to do those things, I pay the physical and mental price for days. And the cycle continues once more.

Then, of course, you wonder: Would I still have this depression if my chronic pain was treated?

At this point, it is hard to say. It has become so ingrained into my being that I can’t imagine anything else. I can’t imagine not crawling into bed right after work and staring at the ceiling for hours until I eventually fall into a horrible and restless sleep. I can’t imagine picking up my niece and not cringing in agony. I can’t imagine going for a jog and not feeling my collarbone begging to burst out of my chest.

I long to do these things more than I can even describe. And that longing is painful and heartbreaking.

And, once again, the snowball flies down the hillside.

I don’t know what lies ahead or if there is calm after this storm. I’ve been continuously let down by false hopes from doctors and I’ve spent countless minutes in the car crying after a diagnostic test turned up negative.

I obviously still need to believe there will be relief one day. But until then, I tumble in the cold.

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Thinkstock photo via chaoss

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