Mental health is increasingly part of our everyday conversations, but one topic that often slips through the cracks is the strong connection between physical pain and depression. Whether it’s persistent back pain or unexplained headaches, symptoms that begin in the body can take a serious toll on the mind — and vice versa. In fact, many people suffering from depression don’t initially seek mental health support at all. Instead, they visit their primary care provider for pain-related complaints.
As summer activities pick up and the world grows more aware of the mind-body connection, it’s more important than ever to understand how chronic pain and depression intertwine. Here we’ll explore the complex relationship between pain and depression and what you can do to feel better.
How Pain and Depression Feed Off Each Other
Pain and depression often form a self-perpetuating cycle. A person living with long-term pain may become isolated, stop doing activities they enjoy, or struggle to sleep well — all of which can make them more vulnerable to depression. Conversely, someone suffering from depression may be more sensitive to pain or have lower pain tolerance due to changes in brain chemistry.
According to a study published by the National Library of Medicine, chronic pain-induced depression is a widespread but under-recognized condition. When pain is left untreated or undertreated, it doesn’t just wear down the body — it also impacts brain chemicals related to mood regulation. This may explain why individuals with depression often report more severe pain than those without.
Understanding this cycle is the first step in breaking it. You are not imagining your pain, and it’s not “just in your head.” Both conditions are real and both deserve attention.
How Depression Can Present Through Physical Pain
One of the more surprising aspects of depression is that it doesn’t always “look” like sadness or low mood. For many people, physical symptoms are the first (and sometimes only) signs.
Some of the most common pain-related symptoms tied to depression include:
● Headaches or migraines
● Back or neck pain
● Muscle aches or tension
● Joint pain without injury
● Stomach cramps or digestive issues
● Fatigue or low energy not explained by exertion
These symptoms can appear even in the absence of obvious stressors. In some cases, patients undergo a range of medical tests, only to be told “everything looks normal.” This can feel frustrating and confusing. But there’s good news: recognizing these physical symptoms as potential signs of depression allows for more comprehensive treatment and better outcomes.
Five Ways to Manage Co-Occurring Pain and Depression
The most effective treatments for chronic pain and depression often involve a combination of approaches. Here are five evidence-based strategies that may help:
1. Antidepressants – When prescribed by a trusted care team, certain antidepressant medications can positively impact both mood and pain perception.
2. Cognitive Behavioral Therapy (CBT) – A type of talk therapy that helps you manage negative thought patterns and build coping skills.
3. Exercise and Physical Therapy – Gentle, regular movement can reduce inflammation and boost mood through endorphin release.
4. Mindfulness and Stress Reduction – Practices like meditation, breathing exercises, and journaling can help lower physical and emotional stress.
5. Support Groups and Connection – Whether in-person or virtual, sharing experiences with others can reduce feelings of isolation.
A team-based approach — including primary care, mental health professionals, and pain specialists — is often the best way forward.
You Don’t Have to Choose Which Condition to Treat First
One of the most damaging myths about pain and depression is that you must “fix” one before addressing the other. Tackling both physical and emotional symptoms is key to lowering the prevalence of chronic pain-induced depression and preventing long-term suffering.
At The Center for Treatment of Anxiety and Mood Disorders, we believe healing happens when we treat the whole person. If you or someone you love is struggling with chronic pain and showing signs of depression, don’t wait, help is available. Contact us today to learn more.