People with chronic pain often find that exercise and other physical activities are more difficult and, consequently, steadily decrease them. Decreasing activities, however, not only brings increasing disability through loss of strength and mobility, it also adds to boredom, isolation, and despair. Relationships, including those with doctors, can become strained by a health problem that doesn't get better. Not surprisingly, a high percentage of persons with chronic pain become depressed. Even though this depression is usually brought on directly by pain, it nevertheless is a legitimate depression and a legitimate problem.
Depression adds to the intensity, suffering, and disability experienced with a chronic pain problem.
This is because the consequences of chronic pain and the symptoms of depression look very similar. In fact, groups of chronic pain patients who are asked to generate a list of pain consequences and a list of symptoms of depression are always surprised to find that the lists are virtually identical. It becomes impossible for patients to disentangle what part of their suffering, pessimism, lack of energy, and sleep disturbances is due to pain, and what part is due to depression. The good news is that depression can be successfully treated, even when the physical cause of a pain cannot be helped. Indeed, treatment of depression is often one of the most powerful ways to increase the quality of life for someone with chronic pain.