Depression - Mind and Body Connection

The mind body connection is a well established medical principle, however the magnitude and severity of that connection as it relates to depression and pain is often underestimated. According to Thomas N. Wise, MD.


"We are just beginning to realize the high number of patients coming to doctors with physical complaints that, at least in part, stem from depression.


Approximately 12% of the general population is depressed, and among those with physical illness that number increases dramatically to maybe more than 40%; an astronomical number of ill patients are depressed."


Depression and pain are of epidemic proportion in the United States. The American Psychiatric Foundation (APF) estimates that 19 million American adults are currently suffering from depression and 57% of Americans have lived with some degree of chronic pain.


The annual economic burden of depression alone in the United States tops $70 billion, according to the Depression and Bipolar Support Alliance.


Social, work, and family situations are also adversely affected by physical symptoms. In a survey conducted by Freedom From Fear, 40% of people report that physical symptoms disrupt their work; 43% report an upset in their social lives; and 47% realize the adverse effects these physical symptoms have on their home lives.


APF research has shown that 80% of people eventually diagnosed with depression first complain to their doctors about physical ailments. Depression often takes on specific and real physical symptoms before psychiatric manifestations are evident to patients and medical professionals.


It is widely accepted that depression is related to neurotransmitter activity, specifically that of serotonin and norepinephrine. According to Dr. Wise, "Depression brings about specific biological changes which can directly affect energy level and pain perception.

Serotonin tends to modulate our ability to perceive pain; those with abnormal serotonin may well have lower pain thresholds." This serotonin imbalance would serve to make some of the normal aches and pains of daily living more stressful and uncomfortable.


The reverse is also true; patients with physical illness are more likely to experience depression as their illness often imposes physical limitations and pain.


Research out of Duke University goes a step further and identifies depression as an independent risk factor for death in patients who have undergone coronary artery bypass surgery.


In a study of more than 800 patients, followed post-surgery for an average of 5.2 years, researchers found that those who suffered from depression at the time of surgery or after surgery were more than twice as likely to die.


Because these findings were adjusted for other risk factors including age, sex, and general health, depression alone emerged as a significant risk factor. Dr. Wise explains, "When individuals are treated with SSRI anti-depressants they have a reduced re-infarction rate. It is still to be determined if that has to do with alleviating the depression or the blood thinning properties of SSRIs."


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