RSD Support From Ones Who Care

Chronic Pain and Depression: Managing Pain When You’re Depressed

...conclusion

Treating Chronic Pain and Depression: Cognitive Therapy for Chronic Pain continued...

One approach is cognitive therapy. In cognitive therapy, a person learns to notice the negative "automatic thoughts" that surround the experience of chronic pain. These thoughts are often distortions of reality. Cognitive therapy can teach a person how to change these thought patterns and improve the experience of pain.

"The whole idea is that your thoughts and emotions have a profound impact on how you cope" with chronic pain, says Thorn. "There's very good evidence that cognitive therapy can reduce the overall experience of pain."

Cognitive therapy is also a proven treatment for depression. According to Thorn, cognitive therapy "reduces symptoms of depression and anxiety" in chronic pain patients.

In one study Thorn conducted, at the end of a 10-week cognitive therapy program, "95% of patients felt their lives were improved, and 50% said they had less pain." She also says, "Many participants also reduced their need for medications."

Treating Chronic Pain and Depression: How to Get Started

The best way to approach managing chronic pain is to team up with a physician to create a treatment plan. When chronic pain and depression are combined, the need to work with a physician is even greater. Here's how to get started.

See your primary care physician and tell her you're interested in gaining control over your chronic pain. As you develop a plan, keep in mind that the ideal pain management plan will be multidisciplinary. That means it will address all the areas of your life affected by pain. If your physician is not trained in pain management herself, ask her to refer you to a pain specialist.

Empower yourself by tapping into available resources. Several reputable national organizations are devoted to helping people live full lives despite pain. See the list below for their websites.

Find a cognitive therapist near you with experience in the treatment of chronic pain. You can locate one by contacting the national pain organizations or cognitive therapists' professional groups listed below.

Living With Chronic Pain and Depression: Resources You Can Use

American Pain Foundation
http://www.painfoundation.org/

Arthritis Foundation
http://www.arthritis.org/

American Chronic Pain Association
http://www.theacpa.org/

Academy of Cognitive Therapy
http://www.academyofct.org

Association for Behavioral and Cognitive Therapies
http://www.abct.org/

Beck Institute for Cognitive Therapy and Research
http://www.beckinstitute.org/

Reviewed by Brunilda Nazario, MD on March 20, 2008

SOURCES:

American Pain Foundation, "Pain Facts and Figures."

Bair, M. Archives of Internal Medicine, 2003; vol. 163: pp. 2433-2445.

Williamson, G. Journal of Gerontology, 1992; vol. 47: pp. 367-372.

Caudill, M. Managing Pain Before It Manages You, The Guilford Press, 2002.

Schatzberg, A. Journal of Clinical Psychiatry, 2004; vol. 65 (supplement 12): pp. 3-4.

Wessely, S. Human Psychopharmacology: Clinical and Experimental, 2004; vol. 19: pp. S1-S2.

Haythornthwaite, J. Pain, 1991; vol. 46: pp. 177-184.

Mann, J. New England Journal of Medicine, 2005; vol. 353: pp. 1819-1834.

Morley, S. Pain, 1999; vol. 80: pp. 1-13.

Thorn, B. Cognitive Therapy for Chronic Pain, The Guilford Press, 2004.

Steven Feinberg, MD, adjunct associate clinical professor at Stanford University School of Medicine and medical adviser to the Bay Area Pain and Wellness Center -- Los Gatos, Calif.

Beverly E. Thorn, PhD, professor of psychology, University of Alabama -- Tuscaloosa, Ala.; author, Cognitive Therapy for Chronic Pain.

Reviewed by Brunilda Nazario, MD on March 20, 2008

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