Simply using medication to treat depression and chronic pain doesn’t allow powerful, more meaningful treatments to show themselves, indicates a recent study published in the Journal of the American Medical Association. The research discovered that people using only antidepressants who were then given drug-free pain-management counseling were increasingly likely to see their depression subside more than those who underwent more well-known forms of depression counseling.
Considering long-term pain and depression often occur together, this is good news, says the lead author of the study.
“Depression commonly occurs in people with chronic pain,” says Kurt Kroenke, MD, of the Indiana University School of Medicine and Regenstrief Institute. In fact, in 30 to 50 percent of pain or depression cases– the two conditions work together. “Some people who have chronic pain develop depression because they’re always in pain and their mood drops,” Kroenke says.
There are physiological reasons for this, too. “Depression heightens your sensitivity to pain,” Dr. Kroenke admits. Not to mention, there are lots of neural pathways in the brain that are similar to pain and depression alike.
Adults who endured low-back, knee, or hip pain for more than three months and had at least moderate depression were separated into two segments. The first one had depressive symptoms and were advised to seek treatment– without the researchers having any say in what kind of treatment they found. The second group underwent intervention therapy in three different stages. The study subjects were given traditional antidepressants during the initial stage, and during the second stage they were taught pain self-management techniques like meditation, relaxation, exercise, and other psychological methods meant for coping with their pain. In the third stage, nurses evaluated their depressive symptoms and made adjustments to their antidepressant medication if necessary.
More patients in the intervention group saw legitimate improvements in their depression and pain symptoms. Specifically, a whopping 47.2 percent said they felt comprehensive improvements in pain, compared with 12.6 percent in the other group. Also, 17.9 percent of the intervention group patients saw significant improvements in their depression symptoms after just one year, compared to a paltry 4.7 percent of the usual care group– and 26 percent rated their improvement as a 50 percent decrease in depression symptoms and a 30 percent decrease in pain, compared to just 7.9 percent of the usual-care patients.
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