RODALE NEWS, EMMAUS, PA—Relying solely on medication to treat the common combo of depression and chronic pain leaves some powerful treatments out of the picture, suggests a study published in the Journal of the American Medical Association. The study found that people on antidepressants who underwent drugfree pain-management counseling were more likely to see their depression lift than people who underwent traditional depression counseling.
That’s important because the two conditions often occur together. “Depression commonly occurs in people with chronic pain,” says Kurt Kroenke, MD, of the Indiana University School of Medicine and Regenstrief Institute, who was lead author of the study. In 30 to 50 percent of pain or depression cases, the two conditions coexist. “Some people who have chronic pain develop depression because they’re always in pain and their mood drops,” he says. But there are physiological reasons as well. “Depression heightens your sensitivity to pain,” explains Dr. Kroenke. Also, there are neural pathways in the brain that are common to both pain and depression.
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THE DETAILS: Adults who’d had low-back, knee, or hip pain for more than three months and had at least moderate depression were divided into two groups. The first group was told its members had depressive symptoms and were advised to seek treatment, without the researchers influencing what kind of treatment they received. The second underwent an intervention therapy divided into three stages. During the first stage the patients were given traditional antidepressants, and during the second they were taught pain self-management techniques, such as relaxation, exercise, and psychological tricks for coping with and distracting themselves from their pain. In the third stage, nurses assessed their depressive symptoms and adjusted their antidepressant medication as needed.