Severe injuries, pain and depression
An April, 2007, study by the University of Michigan Health System documented some of the connections between pain and depression. The study noted that people suffering from severe pain are at high risk to suffer severe depression, as well. We have observed this same phenomenon over several decades of injury practice and we have documented it with many of our clients' treating physicians. The U of M study goes a step further to quantify the problem.
The researchers at U of M noted that depression is often caused by chronic pain, alone. In addition, inability to participate in physical activity, inability to maintain fitness levels and general deconditioning all contribute to cause depression or to make it clinically more severe. Jarring life transitions resulting from injury and financial concerns also can contribute. None of this is rocket science or jarring, but it is good to see the problem documented and confirmed in a reliable way.
The existence of depression is a complicating factor in healing and coping, as well. The U of M study documented that people reporting moderate to severe depression were 11 times more likely to report that they are experiencing difficulty sleeping. They are also likely to experience injury to social relations and loss of social support, difficulty with alcohol or drug use, difficulty with maintaining even a part-time job, and difficulty with fitness, weight control and hygiene.
If you or a loved one has experienced a severe injury, please be alert to the symptoms of anxiety and depression. If you observe them, discuss them with the care givers to assure that the medical problems experienced by the patient are not compounded by clinical depression. Over the years, we have observed a number of our clients who were very severely injured--particularly men--but who refused prescription drugs for depression in the following months. Eighteen months to two years later, many of them were willing to acknowledge that their overall recovery and well-being was delayed as a result, and that their pain control and emotional health did not gain momentum until they began taking anti-depressants and re-establishing healthy sleep patterns.