Relaxation training. Various techniques can help people to relax and reduce the stress response, which tends to exacerbate pain as well as symptoms of anxiety and depression. For example, patients might attempt to participate in activities in order to improve function and distract themselves from focusing on the pain. Therapists use CBT to help patients learn coping skills so that they can manage, rather than be victimized by their pain. CBT is based on the premise that thoughts, feelings, and sensations are all related. Cognitive behavioral therapy (CBT) is not only an established treatment for anxiety and depression, it is also the best studied psychotherapy for treating pain. Various psychotherapies can be used on their own to treat pain in patients with depression or anxiety, or as adjuncts to drug treatment.Ĭognitive behavioral therapy. Pain is demoralizing as well as hurtful. Some antidepressants or anticonvulsants may alleviate pain while treating a psychiatric disorder but be aware of potential drug interactions.Relaxation training, hypnosis, and exercise may also help.Cognitive behavioral therapy (CBT) is not only an established treatment for anxiety and depression it is also the best studied psychotherapy for treating pain.A review identified a number of treatment options available when pain occurs in conjunction with anxiety or depression. Even when both types of problems are correctly diagnosed, they can be difficult to treat. Focus on pain can mask both the clinician's and patient's awareness that a psychiatric disorder is also present. Treatment is challenging when pain overlaps with anxiety or depression. They also are implicated in both anxiety and depression. In addition, two neurotransmitters - serotonin and norepinephrine - contribute to pain signaling in the brain and nervous system. These same regions also contribute to anxiety and depression. The somatosensory cortex (the part of the brain that interprets sensations such as touch) interacts with the amygdala, the hypothalamus, and the anterior cingulate gyrus (areas that regulate emotions and the stress response) to generate the mental and physical experience of pain. Shared anatomy contributes to some of this interplay. But as researchers have learned more about how the brain works, and how the nervous system interacts with other parts of the body, they have discovered that pain shares some biological mechanisms with anxiety and depression. Chronic pain is depressing, and likewise major depression may feel physically painful. Researchers once thought the reciprocal relationship between pain, anxiety, and depression resulted mainly from psychological rather than biological factors. Psychiatric disorders not only contribute to pain intensity but also to increased risk of disability. About 65% of patients seeking help for depression also report at least one type of pain symptom. For example, about two-thirds of patients with irritable bowel syndrome who are referred for follow-up care have symptoms of psychological distress, most often anxiety. The overlap of anxiety, depression, and pain is particularly evident in chronic and sometimes disabling pain syndromes such as fibromyalgia, irritable bowel syndrome, low back pain, headaches, and nerve pain. People suffering from depression, for example, tend to experience more severe and long-lasting pain than other people.
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Why these conditions often occur together and how to treat them when they do.Įveryone experiences pain at some point, but in people with depression or anxiety, pain can become particularly intense and hard to treat.
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