In India, many people with depression first visit a doctor for body aches, weakness or headaches rather than sadness.
Pain and depression share brain pathways, and each can make the other worse.
Key concepts
- Physical symptoms are common in depression
- Normal test reports do not mean the pain is imaginary
- Treating depression often reduces pain
Symptoms and signs
- Headache, neck or back pain without a clear cause
- Heaviness, burning or weakness in the body
- Fatigue that rest does not fix
- Low mood, poor sleep and loss of interest alongside the pain
Causes
- Shared brain chemicals regulate mood and pain
- Poor sleep increases pain sensitivity
- Chronic pain conditions can lead to depression
Risk factors
- Long-standing arthritis, migraine or back problems
- Stressful life events
- Overuse of painkillers
Evidence-based management
- Medical check-up to rule out physical causes
- Some antidepressants also help chronic pain
- Graded exercise and physiotherapy
- CBT for pain coping and sleep
When to seek professional help
- Pain with low mood for more than two weeks
- Repeated tests and doctor visits without relief
- Using painkillers daily
Frequently asked questions
Does it mean my pain is 'all in my head'?
No. The pain is real; the brain processes pain and mood together, so treating mood can ease pain.
Should I keep taking painkillers?
Long-term daily painkillers can cause side-effects and rebound headaches. Discuss a safer plan with your doctor.
Medical references
Guidelines and official sources used for this article.
- Depressive disorder (depression) — fact sheet. World Health Organization.
- mhGAP Intervention Guide for mental, neurological and substance use disorders in non-specialized health settings, version 2.0. World Health Organization, 2016.
- ICD-11 for Mortality and Morbidity Statistics. World Health Organization.
- Author
- Dr. Kuldeep Budania, MBBS, MD Psychiatry
- Medical reviewer
- Dr. Kuldeep Budania, MD Psychiatry
- Last reviewed
This article is for general information and is not a substitute for personal medical advice.
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