By: Jean Johnson for Back1Chronic back pain and depression are like a tortured married couple that doesn’t want to go on. The problem is that often neither member of the unhappy union knows how to get out of the relationship. Major depression is four times as likely in people who have chronic back pain than it is in the general population.
Further, although the interface of back pain and depression is one of the most common health issues health professionals encounter, few studies have been undertaken to examine the situation.
Forty-six-year old Clifford Daniel of Washington state died from complications associated with chronic back pain and depression in 2001. The last two years of Daniel’s life were spent in exhausting anguish. Even as he watched his body deteriorate, his attempts to get the medical community to take his complaints seriously were futile. In particular, when one physician told Daniel he would just have to “cowboy up,” the humiliated the 6’4” patient dropped into a deep and lasting depression.
Even though physicians in Daniel’s case did not diagnose depression, the medical community commonly associates the psychological disorder with chronic back pain. Researchers believe the relationship develops when back pain that does not go away disrupts normal mood, sleep, eating, sexual and concentration patterns. Also, difficulty with movement also leads to more time spent at home and hence, social isolation as well as potential weight gain. Beyond the actual pain, there may be gastrointestinal distress from anti-inflammatory medications. And financial difficulties from time lost from work can culminate in substantial sources of concern. These secondary effects can figure strongly in depression which in turn tends to magnify the perception of pain. What sufferers are left with is a seemingly overwhelming cycle that gives no respite.
Wanda Donovan has had chronic back pain since 2001 that after surgery in 2003 has lessened in severity. She has not been diagnosed with depression even though she had experienced lack of sleep, mobility problems that left her reclusive and unable to keep up with her housework, and general irritability. What the Lakota Sioux woman finally did, however, was seek non-mainstream assistance. “I use Indian,” Donovan said. “I go to a the medicine man and he told me what to do and how to meditate and everything. It did help reduce the depression because he listened to me and was compassionate. Of course he didn’t just wave his hand and say you’re well. It’s a two-way street, so there’s things you have to do too.”
Jon Kabut-Zinn, Ph.D. of the University of Massachusetts has pioneered a meditative, mindfulness-based stress reduction program for years to exceptionally positive results and wrote the 1990 book: “Full catastrophe living: how to cope with stress, pain and illness using mindfulness meditation.” Similarly, the Duke University Medical Center is exploring ways to lessen back pain and depression with loving kindness meditation based on Buddhist philosophy and technique.
Taken together these non-mainstream approaches could find a larger audience and enable patients who suffer from chronic back pain and depression to take a more active, hopeful role in the management of their symptoms.
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