Suffering from chronic pain such as backache can be debilitating. It affects one's quality of life, and many patients complain about the toll it takes on their general well-being.
However, few people realise that chronic pain can be fatal. Research from the University of Pennsylvania shows there is a link between chronic pain and suicide and depression.
“There is a 2, 5 to 10 times increase in anxiety or major depression in patients with pain,” says Dr Anusha Lachman, child and adolescent psychiatrist from Stellenbosch University.
“Its unwelcome presence and debilitating impact can considerably increase the risk of suicide among people living with it.”
Several large-scale epidemiological surveys have now established that the presence of any condition involving pain doubles the risk of suicide in the general population.
Less focus on psychological symptoms
According to Lachman doctors tend to focus on treating the physical pain and are less likely to consider psychological treatments.
“Screening for depression is well established in primary care for patients with a long-term physical health condition. However, while there are a number of screening tools for pain, most tend to be specific to particular types of pain. Finding validated screening tools that simultaneously screen patients for both depression and pain is rare,” she told Health24.
Depression might also go undetected, because it shares symptoms with chronic pain. Sleep disturbance, weight and appetite changes and changes in libido or energy can occur in both conditions.
“The presence of chronic pain appears to increase the resistance of depression to treatment,” says Lachman. “It is known that there are sets of beliefs held by patients about pain regarding its severity, predictability and interference in daily life. Negative distortions of these conditions bear resemblance to the cognitive duo of depression: a negative sense of the future and the environment.”
Risk factors for suicide
Patients suffering from chronic pain should be aware of the risk factors for depression, and should follow up with a psychologist or psychiatrist if they are uncertain about what their symptoms may indicate. Risk factors include:
- A family history of suicide
- Previous suicide attempts
- A history of alcohol and substance abuse
- Impulsive or aggressive behaviours
- Losses such as work, family or social roles
- Resistance to seeking help for fear of stigma