Exploring the link between chronic pain and depression

NOT only can experiencing chronic pain affect your mood, experiencing depression can also raise your chances of living with chronic pain.

When you think of chronic pain and depression, you probably think of these as two separate conditions, right? One is a physical condition that causes physical symptoms, while the other is a mental health disorder that causes mental health symptoms.

But experts now understand the feedback loop between chronic pain and depression — and that many people with chronic pain also experience depression and vice versa.

Ahead, we’ll explore the relationship between chronic pain and depression and discuss treatments that can address symptoms and improve your quality of life if you live with both conditions.

What is the relationship between chronic pain and depression?

Chronic pain and depression are more intertwined than you might think, and many people who have one of these conditions also experience symptoms of the other.

On one hand, chronic pain can make it difficult to engage in daily life or activities you enjoy, which can cause feelings of isolation, anxiety, and depression. On the other hand, depression can also cause physical symptoms, such as headaches, muscle and joint pain, and more.

One study from 2021 explored the close relationship between chronic pain, sleep quality, and depression in 233 people living with chronic pain. In this study, 36% of participants had a diagnosis of depression, and roughly 66% reported poor sleep quality.

According to the results, researchers found a significant relationship between chronic pain and worse sleep quality, which directly affected depressive symptoms in study participants.

Another larger study published the same year analyzed the link between chronic diseases characterized by pain and rates of depression. Results of the study found that participants who lived with chronic diseases were more likely to experience chronic pain and higher rates of depression. The severity of chronic pain because of chronic illness also appeared to play a significant role in depression risk.

Researchers believe that the relationship between chronic pain and depression likely exists due to underlying neural mechanisms — certain structures, chemicals, and pathways in the brain.

For example, changes in serotonin, dopamine, and other brain chemicals can have a significant impact on both chronic pain and depression. And inflammation in the central nervous system also appears to play a significant role in the development of both conditions as well.

What percentage of people with chronic pain are depressed?

According to the American Psychiatric Association (APA), people living with chronic pain are at a higher risk of developing mental health disorders like depression and anxiety. In fact, statistics suggest that roughly 35–45% of people who have chronic pain also experience depression.

In a recent study from 2024, which surveyed almost 32,000 people across the country, researchers found that:

A total of 4.9% of participants surveyed reported experiencing co-occurring chronic pain, anxiety, and depression.

A total of 23.9% of adults with chronic pain experienced persistent anxiety and depression, compared with only 4.9% of people without chronic pain.

A total of 55.6% of people with chronic anxiety and depression reported having chronic pain, versus only 17.1% of people without mental health symptoms.

Treating chronic pain and depression together

If you live with both chronic pain and depression, overlapping treatment approaches can help you better manage the symptoms of both of these conditions.

Medications

Research shows that antidepressants can be a powerful tool for not only addressing the symptoms of depression but also helping manage chronic pain.

Some of the most commonly prescribed antidepressants include: selective serotonin reuptake inhibitors (SSRIs) serotonin-norepinephrine reuptake inhibitors (SNRIs) tricyclic antidepressants (TCAs) monoamine oxidase inhibitors (MAOIs)

Pain medications can also help address

We know that there’s a significant relationship between chronic pain and depression — and these conditions tend to occur together. Chronic pain often leads to feelings of depression, and depression can be an underlying cause of chronic pain.

chronic pain, which can in turn benefit depressive symptoms. Common pain medications include over-thecounter options, like nonsteroidal antiinflammatory drugs (NSAIDs) and other non-narcotic prescription options.

Psychotherapy

Psychotherapy, or talk therapy, is an important and effective treatment option for those with depression and chronic pain. Cognitive behavioral therapy (CBT) is the most common type of therapy for these two conditions.

One of the main benefits of CBT is that it can teach you how to recognize and address the thoughts, feelings, or behaviors that might be affecting your symptoms so that you can create a plan to manage them better.

How can I improve my mood with chronic pain?

Outside of medication and therapy, lifestyle changes also play a role in managing your symptoms and improving your outlook with chronic pain.

At-home relaxation approaches like yoga and meditation can help reduce stress, ease chronic pain, and improve your mood. It’s also important to find other hobbies and activities that you can do — within your means — that bring you joy and fulfillment.

If you feel like you could benefit from extra support, there are support groups and group therapy for people living with chronic pain, depression, and other conditions. Such as:

Pain Connection: A U.S. Pain Foundation Program

Chronic Pain Anonymous

Takeaway

We know that there’s a significant relationship between chronic pain and depression — and these conditions tend to occur together. Chronic pain often leads to feelings of depression, and depression can be an underlying cause of chronic pain.

If you live with these conditions and have been finding it hard to manage your symptoms, consider reaching out to a doctor or therapist for support. With the right treatment, you can learn how to manage your symptoms better and improve your quality of life.