I read somewhere that the neurochemical pathways for pain and for depression are almost identical. What I saw on inpatient psychiatry were a lot of patients suffering both from chronic pain and from depression. The two seem to go together.
One day I was talking with a friend who was very upset because her son was suicidal. In the past, he had sometimes been depressed but never suicidal. Then she said that he was a construction worker and a few days previously had sustained a lower-back injury in a construction accident and was in severe pain. It has been my observation that the pain triggers for depression are lower back injuries and chronic pain. In other words, a terrible toothache or acute heartburn don’t seem to trigger depression.
The depression is not about the pain, which is how most doctors treat it. It is not the idea of pain that you are depressed about. The pain causes the depression in the same way that an abscessed tooth causes pain. They are inseparable cause-and-effect issues, therefore the way to heal the depression is to eliminate the pain. Aggressively treat the pain and the depression will heal itself.
These ruminations come to you today courtesy of an injury I suffered when I pulled a muscle in my hip on Monday morning. By Monday afternoon it seemed all better so I went to my exercise class. Tuesday morning, it hurt. By Wednesday morning I was in terrible pain and by Wednesday afternoon I was paralyzed by depression.
I have long maintained that depression is a social disease that should not be treated with medicine. This is one of the few exceptions in which I think depression arises from the body, not the mind, but again the medical treatment should not be primarily for the depression but for the pain. However, I would support limited, short-term use of antidepressants, which might be very helpful in alleviating the depression while working on the pain.
Antidepressant manufacturers and the FDA agree that antidepressants should only be used for six months. So why are physicians keeping patients on antidepressants for years at a time? And why aren’t they being disciplined and sued for prescribing antidepressants in violation of their intended usage?
You should work aggressively to identify and eliminate the source of your pain, with the expectation that your depression will then clear up.
As for me—I will stay off my feet, use a heating pad, take aspirin and expect to feel better in a couple days.