Depression is a condition is a mental health disorder that affects the mind and body. Depression is more than just “having the blues” or feeling sad for a couple of days. It can cause feelings of deep despair and malaise over a long period of time.  It can prevent a person from leading a normal, active and healthy life. Depression is often a chronic condition. Symptoms can recur throughout a person’s life.

Why it Occurs

The exact cause of depression is not known. It is believed to be linked to an imbalance of chemicals in the brain. Hormone fluctuations and genetic predisposition may play a role.  Environmental factors such as stress, loss of a loved one, or long-term physical or emotional abuse may also contribute to depression. Depression can be caused from chronic pain and fatigue as well as dysfunction in ability to achieve self care and daily activity.


Symptoms of depression can include uncontrollable feelings of sadness or hopelessness, irritability, difficulty sleeping, and an inability to concentrate. Symptoms may also include aches and pains, weight fluctuations and lethargy. A person who has depression may lose interest in activities or hobbies that were previously enjoyable. The person may lose interest in sex, and may have suicidal thoughts. Pain can worsen in the situation of chronic pain and depression.


Depression is diagnosed with a series of physical exams, lab tests, and psychological evaluations. The physical exams and lab tests can help identify physical problems. These tests can also screen for alcohol or drug abuse.  The psychological evaluations can help a  physician understand the severity and frequency of symptoms, and the mental health history of the patient and the patient’s family.


Depression is treated with medications to regulate hormones and brain chemistry. It is also treated with psychotherapy. Patients who don’t respond to these methods may benefit from electroconvulsive therapy (ECT). A person with severe depression may need to be hospitalized. Repeated or ongoing treatment may be needed. Depression needs to be treated as well as chronic pain as both may be contributing factors to the worsening of the other. Periodic screening for depression in the setting of chronic pain can help the patient achieve functionality faster in most cases.