If you have chronic pain, you may also be depressed. For example, one study found that among a representative, community sample of men and women, 35% of the study's participants who reported chronic pain were also depressed. Risk of depression was not associated with any particular pain type or site. Pain and depression seem to have a “reciprocal relationship”: they tend to feed upon each other; more pain can trigger greater feelings of depression and increases in depression can make pain feel worse. If you think you may be depressed, you may wish to talk with your primary care physician, therapist, or other health care provider.
One action you can take now is to examine how you talk to yourself. What you are telling yourself everyday about your pain, about who you are now, or what the future may hold has an important impact on your emotional life. Negative beliefs, thoughts, and self-talk play an important role in predisposing people to depression and can play a role in prolonging or worsening depression. When pain and depression co-occur, negative self-talk has been found to be associated with more depression and greater pain interference. Depression makes chronic pain management even more challenging.
What is Negative Self-Talk?
The term negative self-talk refers to thoughts, ideas, beliefs, or even images that are overly negative and leave you feeling hopeless. This kind of self-talk takes a bad situation and makes it worse. Below are some examples:
- My life is ruined.
- All of my friends have forgotten about me.
- I'll never work again.
I'm completely disabled.
- No one understands what I'm going through.
- There's nothing I can do.
- I'm useless.
- Nobody cares.
You may have said some of these things to yourself. They may feel true, especially on a really bad day. However, extreme thoughts, ideas, and beliefs are rarely completely true. Generally, if we challenge an extreme thought, we find exceptions (“Hmm…well, my sister understands what I'm going through”), possibilities (“I think I could work part time”), and hope (“There are a few strategies that really do reduce my pain”).
I am not suggesting that you lie to yourself or become overly positive. Instead, pay attention to how you talk to yourself and watch for those times when you may be overly negative. When you hear your negative self-talk, challenge it. Why should you just accept it? If someone else said the same things to you, wouldn't you question their right to talk to you like that? When you notice a negative thought, ask yourself:
- What is the evidence that this is true?
- What is the evidence that this is not true, or partly true? Are there exceptions?
- Is there a less extreme way to think about this that will help me to be hopeful?
- Would someone who loves me talk to me this way? If not, why am I treating myself this way?
Living with pain is hard enough. Don't make it worse than it has to be. Pain and depression don't have to go together.
About the Author. Dr. Linda Ruehlman is a social/health psychologist and researcher, co-founder of Goalistics, and Director of the Chronic Pain Management Program, an interactive site that helps people with chronic pain to manage their pain and live richer, more effective lives.
DISCLAIMER: This blog is provided as an educational and informational resource only. It is not intended nor implied to be a substitute for professional psychological or medical advice.