Anxiety, Mental Health

How Pain Affects the Brain in Depression

How Pain Affects the Brain in Depression

Did you know that according to the World Health Organization, those living with chronic pain are 85% more likely to have comorbid anxiety or depression?


Understanding the relationship between how pain affects the brain in people who are depressed is crucial for integrated treatment approaches. 


Pain can not only diminish a person’s quality of life but can also profoundly impact brain function, contributing to depressive states. 


This article explores the connection between chronic pain and depression, examining the neurochemical and hormonal changes involved, the impact on physical health, and the significance of understanding how pain alters brain function.


Chronic Pain and Depression: A Bidirectional Relationship

Pain and depression share a bidirectional relationship where each condition can aggravate the other. This bidirectional relationship is not a coincidence but rather rooted in complex neurobiological mechanisms


For example, pain and mood regulation share the same neural pathways and neurotransmitters. Any disruption to these neurotransmitters can result in heightened pain sensitivity and mood disturbances. 


This is why people who experience chronic pain are a lot more likely to develop depression and struggle with regulating mood and emotions. 


Researchers have also found that depression has the potential to affect the physical structure of the brain with these changes ranging from inflammation to brain shrinkage.


Here is how pain affects the brain in depression on a neurological level.


Neurochemical Dynamics & Hormonal Changes that Affect the Brain in Pain and Depression

Chronic pain leads to alterations in brain chemistry that affect the level and activity of several neurotransmitters and hormones such as serotonin, norepinephrine levels, cortisol levels, endorphins, and pro-inflammatory cytokines.


Serotonin and Norepinephrine Levels

During chronic pain serotonin and norepinephrine levels in the brain decrease. As these neurotransmitters are essential for regulating mood, their depletion results in depression.


Hypothalamic-Pituitary-Adrenal (HPA) Axis

Chronic pain impacts the hypothalamic-pituitary-adrenal (HPA) axis, resulting in elevated cortisol levels, the body’s primary stress hormone. Prolonged high cortisol levels can lead to various negative effects on the brain, including reduced hippocampal volume, which is associated with depression and cognitive decline.



Chronic pain conditions can also result in a decreased production of endorphins, our body’s natural painkillers. Lower levels of endorphins not only increase pain perception but also contribute to feelings of hopelessness and despair.


Pro-Inflammatory Cytokines

Both chronic pain and depression cause increased levels of pro-inflammatory cytokines. These inflammatory markers affect brain function and reduce neuroplasticity, further linking pain and depression.


How Pain & Depression Impact Physical & Mental Health?

The relationship between chronic pain and depression extends beyond the brain. Those living with both conditions can experience a range of physical and psychological health problems including:


Poor Sleep 

Pain can make it difficult to fall asleep or stay asleep, while depression often disrupts sleep patterns. Poor sleep, in turn, worsens both pain and depressive symptoms, creating a vicious cycle that is hard to break.


Heightened Levels of Fatigue 

The constant strain of dealing with pain and the emotional toll of depression can drain energy levels, making daily tasks difficult to manage. This fatigue can further reduce physical activity which can cause physical health to deteriorate and result in increased pain sensitivity.


Poor Cardiovascular Health 

Increased stress levels can elevate blood pressure and heart rate, contributing to a higher risk of heart disease.


Poor Immune Function

Chronic pain and depression weaken the immune system, making you more susceptible to infections and illnesses. The stress and inflammation associated with these conditions can also impair immune function, leading to higher chances of health complications.


Behavioral Impacts

Chronic pain can result in low self-esteem as an individual is unable to work or participate in social activities and hobbies to the best of their abilities. Reduced physical activity can give rise to a sedentary lifestyle which can result in increased stress levels, anxiety, and other depressive symptoms.


The Importance of Exploring Pain and Brain Function

Understanding how pain affects brain function and contributes to depressive states is crucial for administering the right treatment approaches, medication, and prevention strategies to help improve quality of life.


By identifying specific neurochemical or hormonal changes in individuals, treatments can be tailored to individual genetic profiles, helping enhance efficacy.


Combining pain management with mental health support can also address both conditions simultaneously, improving overall outcomes.


Early intervention in pain management can also prevent the onset of depression, reducing the burden of these co-occurring conditions and helping improve the quality of life for those affected.


Treatment Approaches for Pain & Depression

The relationship between chronic pain and depression is bidirectional but also complex and multifaceted. 


Understanding how pain affects the brain and contributes to depressive states is crucial for developing integrated and effective treatment approaches including pain management techniques that use medication, physical therapy, and alternative treatments, as well as, psychological therapies such as cognitive behavioral therapy to help combat depression.


By addressing both the physical and emotional components of these conditions, healthcare providers can offer more comprehensive and personalized care improving the quality of life for those living with chronic pain and depression.


At Spectrum Therapeutic Solutions we offer individual, couple, family, and group therapy and counseling sessions to help individuals overcome anxiety, depression, PTSD, bipolar disorder, and more! To learn more call us at (902) 932-2395



Q) How do chronic pain and depression influence each other’s treatment?

Chronic pain and depression have a bidirectional relationship and are often treated together using a combination of medication, therapy, and alternative treatment methods. Not treating one condition can exacerbate the other, so both conditions must be treated simultaneously for effective results.

Q) Can lifestyle changes impact pain perception and depressive symptoms?

Yes, lifestyle changes can have a direct impact on pain perception and depressive symptoms. Refraining from participating in activities and hobbies due to pain can lead to increased stress, anxiety, and depression. Smoking, drinking, and an unhealthy diet can also exacerbate both conditions.

Q) What role does neuroplasticity play in chronic pain and depression?

Neuroplasticity allows the brain to change or adapt to intrinsic or extrinsic stimuli such as pain and depression. As such, it plays a vital role in the brain’s adaptation to pain and stress. Any disruption in neuroplasticity can result in higher pain sensitivity and psychiatric disorders such as depression, PTSD, anxiety, etc. 

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Spectrum Therapeutic Solutions was Founded in 1989 as an occupational health service it grew to include therapeutic counselling in 2005.


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