Pain can be depression
Is the cause psychological?
Did you know that you can get physical pain from depression? Unfortunately, many patients and doctors do not know this. In women, (vague) physical complaints are often seen as menopausal complaints, while they are not. What exactly is the pain? And how do you know if the cause is psychological?
Depression can be accompanied by many physical complaints. Stomach and intestinal complaints, sometimes also nausea. Palpitations, chest pain, tightness, dizziness and tingling in the fingers. Insomnia.
physical misery
Pain is also common. This can be headache, migraine, pain in the face, in the mouth, pain when swallowing. Pain in neck, arms or shoulders; pain in the back, in the abdomen, chest; pain when urinating.
Recognizing depression behind physical complaints is often difficult, says Aly van Geleuken, psychologist and head of the Depression Center of the Mental Health Fund. On her information and advice line she hears many stories about physical misery that is difficult to explain, especially from older women who also suffer from menopausal symptoms.
“The doctor is often inclined to attribute all kinds of complaints to the menopause. Many symptoms of depression resemble menopausal complaints: tired, listless, irritable, sleeping badly, pain, changed appetite. But doctors often forget to ask about the mood, too. we hear from many people who consult us. Their doctor then says: it is the menopause, you have to go through it. Another is going to prescribe hormone preparations. Or sedatives, which can even worsen depression. The patients themselves often only tell about the physical side of their complaints. Nor do they wonder whether the cause lies elsewhere.”
Doctors who hear many or ‘vague’ pain complaints from their patients should therefore also ask about depressive symptoms. GPs are already more alert to this these days. But especially pain specialists such as neurologists and internists should pay attention to this. And don’t forget to think about psychiatric conditions when their patient complains of pain.
Patients and doctors alike rarely realize how ill you can be with a psychiatric illness. Van Geleuken deeply regrets this. “We know everything about cardiovascular diseases: the causes, the symptoms, how we can live healthier lives to prevent them. But we don’t have that knowledge about psychological problems. We are still too often trying to attribute physical complaints to physical illnesses .”
How do you know whether your physical complaints are related to your psyche?
- Step one, of course, is to think about that possibility: to be convinced that body and mind work closely together.
- Step two can be filling in a depression scale or a self-test, for example on the internet. A number of simple questions are asked and it is quickly clear whether you may be experiencing depression.
- Step three is: see your doctor. Especially if the complaint(s) last a few weeks.
Unfortunately, current depression self-tests mainly ask about psychological complaints. This also applies to that of the Depression Center. Aly van Geleuken realizes that. She therefore argues in favor of including questions about physical complaints in the questionnaires.
How come?
Depression probably also changes the experience of pain stimuli: a kind of lowering of the pain threshold occurs. Due to the disruption of the serotonin and noradrenaline systems in the brain. Normally a person has a certain resistance to pain, but that threshold seems to be lowered in depression, so that more pain signals come in. People then pay more attention to it, which further exacerbates the pain sensation.
What can you do?
Medical treatment may sometimes be necessary. When depression is treated, with or without medication, the physical complaints generally disappear. In addition, pain is often related to muscle tension. The patient can do something about this himself: with relaxation exercises. Light exercise and exercise are also good against depression and against pain; improving fitness and stamina can work wonders.