Anxiety and Depression

Anxiety and Depression

Allen Hume, Ph.D. and Maureen C. Pierce, Ph.D.

Chronic pain and other health care issues may result in negative emotional states, including anxiety and depression. When we experience pain, our brain "sounds the alarm" by sending messages to release neurotransmitters, hormones and other chemicals to protect us. Once the threat is diminished, our body and brain goes back to a state of balance, or homeostasis. When the pain does not stop, however, our body continues to send out messages to protect us, which over time drains us, both physically and emotionally. We are then at greater risk of developing anxiety and depressive symptoms, that when left unaddressed can become their own problem. For example, many folks in pain may experience greater worry, less control over these worried thoughts, increased restlessness and tension, and greater irritability due to the pain response. Or there may be greater sadness, loss of interest in previously enjoyed activities, feeling guilty or worthless for no good reason, or perhaps even hopeless about the situation. These responses are understandable and occur in many with chronic pain and other health care issues.

Addressing these feelings is a priority and can be done in many ways, acknowledging the feelings and thoughts, seeking counseling, discussing with your medical provider, and/or taking a medication that is targeted to the symptoms you experience. Interestingly, there is evidence that the part of the brain where physical pain is experienced is also the part of the brain where negative emotional states are experienced. So in a sense, our pain response is both physical and emotional at the same time. Take a look at the websites listed in “resources”, consider accessing your family and social support system, and talk with your health care provider if you are experiencing these feelings.

Steps to Get There

  1. Take part again in activities you used to enjoy as much as you can — you may have to make a list of activities and select the ones you can still do in spite of pain.
  2. Learn some new stress management skills, including relaxation, deep breathing, guided imagery, and meditation, all of which have been shown to help depression, anxiety, and pain.
  3. Use your social support network. With chronic pain, you may have to make new contacts with others, either individually or in a group setting. There are many resources available in your community, online, and professionally.
  4. Learn how to use cognitive behavioral therapy (CBT) to address your negative thoughts, which will help you feel better.
  5. Listen to your favorite music, watch a movie you particularly enjoy or read a good book.
  6. Stay focused on being as active as possible — when we are passive in our approach to life we are more likely to dwell on negative feelings, experiences, and pain.
  7. Discuss your feelings with a trusted medical provider. Follow all recommendations, both for pain and emotional symptoms. Pain and stress interact; therefore, we must address both at the same time.
  8. You may want to enter individual counseling with someone who understands chronic pain. Group therapy can also be very helpful.

Resources

Anxiety

• American Psychological Association, www.apa.org/helpcenter/stress.aspx
• Anxiety Disorders Association of America, www.adaa.org
• National Institute of Mental Health, www.nimh.nih.gov
• Mental Health America, www.mentalhealthamerica.net

Depression

• Depression Screening, www.depressionscreening.org
• National Alliance on Mental Illness, www.nami.org  
• National Institute of Mental Health, www.nimh.nih.gov
• American Psychological Association, www.apa.org