Surprisingly the same neurotransmitters like noradrenaline, serotonin, and dopamine which are involved in the chronic pain response are also some of the same molecules involved with depression and anxiety; so many of these conditions go hand-in-hand together. Treatment usually will involve treating the same biochemicals in order to alleviate any of these conditions. The key is identification of the cascade of chronic pain symptoms resulting from chronic depression or anxiety and vice versa.
Similar to what came first, the chicken or the egg, there is also a cause and effect relationship, with what came first; the pain or the depression/anxiety. In the end, the focus of treatment will be very similar and will concentrate on making dietary, exercise, sleep, and fluid intake changes along with adding an herbal/botanical and supplemental treatments.
Most people with generalized anxiety disorder will also experience pain in the form of arthritis or fibromyalgia. In people with chronic mood disorders, like anxiety and depression, back pain is more common when compared to people without chronic mood disorders.
Anxiety along with chronic pain can be difficult to treat as those who suffered both may have a lower tolerance for pain. People with anxiety may also be more sensitive to the side effects of medication – or be more fearful of side effects from medication. They also may be more fearful of pain as compared to someone without anxiety.
During the past few decades, the association of chronic pain with depression has been of great interest and research. For example, a general population study found that chronic musculoskeletal pain patients have higher rates of depression than individuals without reported pain. Almost one third of patients in a pain clinic population had major depression symptoms according to the Diagnostic and Statistical Manual (DSM IV) following structured interviews.
The presence of pain can make recognition of depression more difficult, even though increased severity of pain worsens depressive symptoms. Despite their differences in symptoms and classification, anxiety, depression, and pain all seem to exist concurrently to a surprisingly frequent extent.