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Elisa Goldstein, Ph.D.Elisha Goldstein, Ph.D.
A blog about mindfulness, stress-reduction, psychotherapy and mental health.

Is Chronic Pain and Depression destroying your life?

Elisha Goldstein, Ph.D. Updated: Aug 21st 2008

cracked dry skin on a woman's backSally is a 32 year old woman with chronic pain from an old back injury from work. One day at work she was under deadline to get a report done and all of a sudden pain began shooting down her leg. "oh not now, I have so much to do, I’m never going to get this done", Sally says. The pain begins to get worse as she sits in her chair trying to feverishly ignore it and type away. As the day creeps on, the pain is just too debilitating, she is unable to concentrate and can’t complete her job. This scenario continues off and on for Sally because her condition is chronic. Soon, her coworkers become upset with her because she’s holding back the team and her boss brings her in for meetings talking to her about her lack of productivity. Sally begins to become plagued with thoughts like "I’m never going to get better, no one can help me, and I can’t help myself". Depression is upon her.

Chronic pain is inherently, chronically stressful. It interferes with our day to day functioning and our relationships. It’s difficult to concentrate, function, and live the lives we want to. Many of the things we were used to doing that were pleasurable or fun are taken away. We have difficulty playing with kids, going to dinner, moving around a party, or even making love. Even worse, it affects our relationships. Those of us who don’t walk around with chronic pain fail to recognize or acknowledge in people who have the condition. What results? Those with chronic pain may not receive the social support they need, not experiencing empathy or love. This can wear anyone down to the point where the risk for depression gets higher and higher.

If there are two things we can be assured of in this life, it’s stress and pain. With chronic pain we know by the adjective "chronic" that it’s not going away. So in working with it, trying to get rid of it is going to be a continually disappointing effort. If we can’t get rid of it, what can we do?

We need to change our relationship to pain in order to gain relief!

  • Practicing approaching the pain with attention and checking your judgments at the door is different than wishing it away or that it wasn’t a part of your life. In other words, practice mindfulness with your pain. Mindfulness is a simple and practical way to intentionally pay attention to your pain, while putting aside your lenses of judgment. Clinical studies show a significant reduction in suffering associated with chronic pain after working the Mindfulness-based Stress Reduction (MBSR) program for 8 weeks. There are many ways to do this and many resources available for practice. For more information on locating an MBSR program near you, you can use the Mindfulness-based Stress Reduction program locator provided by UMASS.

  • Make sure to try and restore social relationships. When depression and chronic pain are upon you, many social relationships can begin to wither away. It’s vital to try and revitalize these relationships before they are lost permanently. It’s tough to ask for help when you’re depressed and in pain. If you can ask close friends or family to visit the doctor with you to learn about chronic pain they can understand it better. This way the family or friends will understand better and be more able to support you in the treatment of your depression and chronic pain. Also, if the pain is too great, give yourself permission to explore with the doctor what pain medications and antidepressant drugs might be suitable to get you through this rough patch.

I’d love to hear your comments, stories, or questions concerning your chronic pain and how you have coped with that pain. Please feel free to share your experiences below.

Elisha Goldstein, Ph.D.

Elisha Goldstein, Ph.D. is a clinical psychologist in private practice in West Los Angeles and is author of the upcoming book The Now Effect, co-author of A Mindfulness-Based Stress Reduction Workbook, Foreword by Jon Kabat-Zinn, author of the Mindful Solutions audio series, and the Mindfulness at Work™ program currently being adopted in multiple multinational corporations.

Check out Dr. Goldstein's acclaimed CD's on Mindful Solutions for Stress, Anxiety, and Depression, Mindful Solutions for Addiction and RelapsePrevention, and Mindful Solutions for Success and Stress Reduction at Work. -- "They are so relevant, I have marked them as one of my favorites on a handout I give to all new clients" ~ Psychiatrist.

If you're wanting to integrate more mindfulness into your daily life, sign up for his Mindful Living Twitter Feed. Dr. Goldstein is also available for private psychotherapy.

Reader Comments
Discuss this issue below or in our forums.

Chronic pain+narcotics - canadian Douggie - May 23rd 2014

I also have severe chronic pain, mostly from playing a high level of hockey and a few mva's. My comment is for anyone who is in AA yet requires narcotics because nothing else works for you chronic pain. I went through a period of years when I drank daily not knowing I was using the drug "alcohol" as a pain reliver, drinking beer specifically is in the culture of hockey and "the boy's"! My doctor knew I drank too much yet I never had an issue of stopping drinking, I never binge drank, didn't use hard liquor but did drink daily beers. When Iooked into the whole AA thing and went to a few meetings I realized I wasnt an alcoholic but I had a different disease all together, chronic pain and years later was diagnosed by many more than one doctor with severe back/neck disc and spine damage as well as fibromyalgia, which wasn't even a disease when my pain started 20+ years ago. The msg I guess I'm trying to get out there is sometimes AA is so quick to label you a drunk because of there sometimes misguided views that some attempt to diagnose. If alcoholism is a disease let a doctor to the diagnosis. Its possible,  like myself you just happed to be taking the wrong drug. I now take opiates for many years, don't drink...mostly cuz it makes me barf and skip meds once in awhile so I may enjoy some wings, game on tv and a few cold ones! That's it til the next time a buddy invites me out. AA can be a great option for most, but they can be very pushy and radical, they are not a group to diagnose ANYTHING including alcoholism. 

Ditto - Maddy - Jul 17th 2013

Reading your story was like it was written from me. I looked into brain mapping but can't afford it. I am now looking at EST. I am having a terrible time finding a doctor since I moved to Louisiana in February. I have seen 3 doctors so far and they either can't or won't help me. I am becoming suicidal again. I'm so lots...

4 a lifetime - Kandy - Sep 6th 2010

 I grew up emotionaly abused and repressed by someone who dispised me. I therefore was conditioned to be ashamed of all things that were normal functions.

 At 40 I spent most of my life a victim to the same type of person. I was avidly reading psychology manuals from age 10 and still am trying to find what was wrong with me.

 I was assaulted by an abusive man in 2003 and some injuries were so bad that they missed others. I now live with chronic pain daily but it is my nature to not show it. This is what I do naturaly and instinctivly so I have to catch myself and try to relax whenever I am not alone.

It leaves me either constantly on gaurd for my slip up and I am stuck in uber-alert mode probably since I was 4. I have never been out of it. I know this intensifies my pain but I find it quite hard to control and noone understands this. It's a catch 22 that continues to make everything worse. I have tried many antidepressants as well as inhibitors and therapy ect... but I have never been in a diffrent situation untill the last few years and now I get no relief.Meds make me feel wierd and sleepy. I get sick on all pain pills so I cannot take anything.

Apologies for the saga, I guess I'm saying I just deal with it and people walking past me never know it.

Alcoholism, chronic severe spine pain, depression - Will - Mar 1st 2010

Im a recovering alcoholic. My spine has been damaged since my youth, Im 46. I have Bi-polar disorder. Triple diagnosis. My sponsor and most of AA's dont support pain management with opiods. This class of medicine is the only relieve I get so I can have a functional life and dont become dependant. Ive tried everything else. The stress from chronic pain will kill me. Alcohol will kill me. I dont want to lie to anyone. My doctor understands my situation, she's seen the MRI's. She has also seen me struggle with alcohol, pain, and depression. Since when does the AA program enter into the pain management field. The Big Book talks of the "manic" types. That's all it says. How can I be honest? In meetings you are limited to discussion of Alcohol, nothing else.

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