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Living with chronic back or neck pain can lead to depression, feelings of stress, anxiety, sadness, and other mental health-related symptoms. Your spine specialist or pain medicine doctor may refer you to a psychologist and/or a psychiatrist. Referring you to a mental health professional doesn’t mean your doctor thinks your pain in all in your head! Rather, he/she is taking a positive step in treating you as a whole person—by treating both the physical and emotional pain.

Back and Neck Chronic Pain is Complex

As someone living with chronic pain caused spondylosis, degenerative disc disease, spinal cord injury or some other spine problem, you understand pain is a complex problem, and treatment requires the expertise of a spine specialist. Perhaps your pain management program includes a combination of treatments—a medication for neuropathic pain, a muscle relaxant, a periodic epidural spinal injection, and/or physical therapy. Well, treatment of stress, anxiety, and depression (there are different types) requires the same level of expertise but from someone who specializes in managing mental health problems.

Depression and Chronic Pain

Did you know that depression and chronic pain often go together? Depression is a serious condition, and nothing to be ashamed of. It has been reported that as many as 50% of people with chronic pain are depressed.1 So, if you are depressed, you are far from being alone.

The signs and symptoms of depression can manifest themselves differently in each person, but tiredness, sleep disruption, changes in eating habits, listlessness, and feelings of hopelessness are all quite common. Notably, depression can contribute directly to chronic back and neck pain, as ongoing aches and pains are a very common symptom of depression.

Treating Depression and Chronic Pain

Two classes of antidepressants frequently used to treat depression in those who experience chronic pain are selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). Commonly prescribed SSRIs include and fluoxetine (Prozac) and sertraline (Zoloft), whereas commonly prescribed SNRIs include duloxetine (Cymbalta) and venlafaxine (Effexor). These drugs have been shown to be safe and effective for managing depression in the context of chronic pain, but like all medications, they come with some risk of side effects. As always, be sure to discuss these medications in detail with your doctor before beginning any treatment regimen that includes them, and inform your doctor of all the medications (including over-the-counter medications), herbal remedies, and supplements you are currently taking so as to avoid any negative drug interactions.

Besides, or in addition to medications, other types of treatment may include:

  • Talk therapy, more formally called cognitive behavioral therapy (CBT). The focus of CBT is to help the person manage their situation—and may include engaging the patient to change certain thought patterns to a more positive outlook, learning how to problem solve, and conquering fears.

  • Practice relaxation techniques such as meditation and/or breathing exercises.

  • Consider joining a support group.

  • Regular exercise can help curb feelings of stress, anxiety and depression. Exercise causes the body to release endorphins, which can make you feel better and may help reduce pain perception too.

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