Chronic pain is pain that can last for several months. It can interfere with a person’s quality of life, magnifying negative thoughts and resulting in symptoms of depression.

The American Psychiatric Association (APA) says that those living with chronic pain have a heightened risk of developing mental health issues such as depression. This could be because chronic pain can increase levels of stress and contribute to a lack of sleep, overall resulting in low moods.

A 2017 study estimates that up to 85% of people with chronic pain experience severe depression.

This article examines whether chronic pain can lead to depression, including how it often occurs in a cycle. It will also detail treatments for both chronic pain and depression.

chronic pain and depressionShare on Pinterest
Jonut Runcan/500px/Getty Images

The National Library of Medicine explains that most people with chronic pain develop anxiety and depression. Pain evokes a response, which can be physical and emotional. Chronic pain or pain that does not go away can induce:

  • stress
  • feelings of tenseness
  • anxiety
  • irritation
  • agitation

Over time, these feelings can result in symptoms of depression, all stemming from the stress and anxiety of dealing with chronic pain. It estimates that more than 67% of those who have received a diagnosis of chronic pain also have a psychiatric disorder.

Alternatively, a Mental Health America report states that mental health conditions may trigger physical pain sometimes. People with depression may have a higher chance of developing chronic pain, and depression itself can ultimately worsen the pain. Stress can result in inflammation and tense muscles, increasing pain and resulting in a cycle between the two conditions.


Research suggests there is an overlap between chronic pain and depression, looking at two chemicals known as serotonin and norepinephrine that can inhibit as well as trigger pain. Researchers refer to these as chemical messengers, as they transmit messages between neurons and muscles.

Authors of a 2017 study explain that a person may be more prone to developing depression when there is a reduced level of these neurotransmitters in the body.

According to a 2020 study, chronic widespread pain can have a negative impact on an individual’s quality of life. It can cause:

  • symptoms of depression, such as feeling low
  • feelings of helplessness
  • a sense of dissatisfaction with life

Individuals may also have difficulty concentrating, maintaining a regular sleep cycle, or performing everyday tasks.

A journal article from 2013 affirms that chronic pain and depression can be challenging to treat when they occur together. Most of the time, a person may need to see a psychiatrist and pain specialist to treat their symptoms.

Learn more about depression here.

Chronic pain is pain that a person experiences for 3–6 months, according to the National Center for Complementary and Integrative Health. Long-term conditions that may cause chronic pain include:

Symptoms of chronic pain may include:

  • stiffness
  • discomfort
  • soreness
  • muscle spasms
  • skin temperature changes

Learn more about chronic pain here.

Because depression and pain may induce one another, it can feel like a cycle. Pain can elicit negative emotions or symptoms of depression, and depression or negative emotions can result in unexplainable physical symptoms such as muscle tenseness.

Chronic pain may cause individuals to feel down and depressed, and they may not have the energy to engage in the activities they usually would.

Chronic pain and depression may be based on common neuroplasticity mechanism changes, which are a potentially important route for the onset and aggravation of chronic pain and depression.

Overlapping issues in the cycle include:

  • anxiety
  • alternating moods
  • anger
  • stress
  • fatigue
  • irritability
  • lack of self-esteem or ability to feel good about oneself
  • social isolation
  • problems with daily living, including maintaining relationships or going to work

Medications and therapy may help treat chronic pain and depression.


Antidepressants are medications that people take to treat symptoms of depression. The Food and Drug Administration (FDA) has also approved them for the treatment of other conditions, such as:

They also have an off-label use for those with pain, insomnia, and migraine. The off-label use of a drug refers to drugs that a doctor may prescribe for a different condition than what the FDA has approved.

That said, tricyclics and serotonin-norepinephrine reuptake inhibitors (SNRIs) are two types of antidepressants that may be effective to treat chronic pain.

Tricyclic antidepressants, such as amitriptyline, increase the amounts of serotonin and norepinephrine in the brain and block the effects of acetylcholine.

SNRIs, such as duloxetine, also increase the number of neurotransmitters in the brain. They may cause adverse effects, including headaches and high blood pressure.


The United Kingdom’s National Health Service (NHS) mentions cognitive behavioral therapy (CBT) as part of the treatment plan for those with chronic pain, depression, and other mental health conditions.

It is a type of talk therapy that focuses on current problems. It helps individuals think positively and identify the negative thoughts that are keeping them feeling trapped in the pain and depression cycle.

The NHS provides some self-care tips that may help manage pain:

  • engaging in regular exercises, such as walking and dancing, to relieve stiffness
  • maintaining a regular sleep pattern, as sleep deprivation can worsen symptoms
  • practicing relaxation techniques, such as meditation
  • joining a hobbies class to distract the mind, such as photography or sewing

As for depression, the National Institute of Mental Health (NIMH) recommends that people:

  • avoid drinking alcohol
  • avoid the use of nicotine
  • eat nutritious foods as instructed by a healthcare professional
  • walk for 30 minutes every day, if able
  • share their feelings with someone they trust

People may consider opting for alternative treatments to reduce long-term pain:

  • Acupuncture: This is a Traditional Chinese Medicine (TCM) technique in which an acupuncturist inserts thin needles into the individual’s skin to stimulate specific areas to treat pain.
  • Biofeedback: This is a type of mind-body therapy in which people change how their body works. For example, they may learn to control their breathing to reduce anxiety or sit in a different way to relieve muscle tension.
  • Spinal cord stimulation: This involves placing a spinal cord stimulator into the individual’s spinal cord. The procedure may suit those who have undergone back surgery but have seen no improvement.

Chronic pain can cause stiffness, soreness, and other painful symptoms which last for several months. This stress and anxiety that occurs when having to deal with chronic pain can result in symptoms of depression.

Medications, such as antidepressants, or therapy, can help address pain and depression. Home remedies, such as exercising or joining a support group, may also help.