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For More Information on Depression Citations Reprints visit the national library of medicine’s 1. Kessler rc, chiu Wt, Demler o, merikangas Kr, This publication is in the public domain and may be reproduced Depression and medlineplus http://medlineplus.gov Walters ee. prevalence, severity, and comorbidity of or copied without permission from NIMH. We encourage you to en español http://medlineplus.gov/spanish 12-month Dsm-iv disorders in the national comorbidity reproduce it and use it in your efforts to improve . for information on clinical trials survey replication. Arch Gen . 2005 Jun; Citation of the National Institute of Mental Health as a source Chronic http://www.nimh.nih.gov/health/trials/index.shtml 62(6):617–27. is appreciated. However, using government materials inappro- priately can raise legal or ethical concerns, so we ask you to use national library of medicine clinical trials database 2. An Update of NIH Pain Research and Related Program these guidelines: http://www.clinicaltrials.gov Initiatives: Statement for the Record Before the n NIMH does not endorse or recommend any commercial prod- information from nimH is available in multiple formats. You Subcommittee on Health, Committee on Energy and ucts, processes, or services, and our publications may not be can browse online, download documents in pDf, and order Commerce, United States House of Representatives, used for advertising or endorsement purposes. materials through the mail. check the nimH website at (December 8, 2005) (testimony of the national institutes http://www.nimh.nih.gov for the latest information on of Health, united states Department of Health and n NIMH does not provide specific medical advice or treatment this topic and to order publications. if you do not have services). http://www.hhs.gov/asl/testify/t051208a.html. recommendations or referrals; our materials may not be used internet access please contact the nimH information accessed september 21, 2010. in a manner that has the appearance of such information. resource center at the numbers listed below. n NIMH requests that non-Federal organizations not alter our 3. national institute of neurological Disorders and stroke. National Institute of Mental Health publications in ways that will jeopardize the integrity and ninDs information page. http://www.ninds. “brand” when using the publication. science Writing, press & Dissemination Branch nih.gov/disorders/chronic_pain/chronic_pain.htm. updated n 6001 executive Boulevard July 24, 2010. accessed september 21, 2010. Addition of non-Federal Government logos and website links room 8184, msc 9663 may not have the appearance of NIMH endorsement of any Bethesda, mD 20892-9663 4. Hartman Jm, Berger a, Baker K, Bolle J, Handel D, specific commercial products or services or medical treat- phone: 301-443-4513 or mannes a, pereira D, st Germain D, ronsaville D, ments or services. 1-866-615-nimH (6464) toll-free sonbolian n, torvik s, calis Ka, phillips tm, cizza G. If you have questions regarding these guidelines and use of NIMH ttY: 301-443-8431 or Quality of life and pain in premenopausal women with publications, please contact the NIMH Information Resource 1-866-415-8051 toll-free major depressive disorder: the poWer study. Health and Center at 1-866-615-6464 or e-mail at [email protected]. faX: 301-443-4279 Quality of Life Outcomes. 2006; 4:2. e-mail: [email protected] Website: http://www.nimh.nih.gov 5. national institute of neurological Disorders and stroke. pain: through research. http://www.ninds. nih.gov/disorders/chronic_pain/detail_chronic_pain. htm#140523084. updated July 24, 2010. accessed september 21, 2010.

6. staud r. Biology and therapy of : pain in fibromyalgia syndrome. Arthritis Research & Therapy. 2006; 8(3):208. u.s. Department of HealtH anD Human services 7. national institute of arthritis and musculoskeletal and national institutes of Health skin . fibromyalgia. http://www.niams.nih.gov/ national institute of mental Health Health_info/fibromyalgia/default.asp. published april 2009. niH publication no. 11–7744 accessed september 21, 2010. epression not only affects What is depression? How are depression and chronic pain at present, the most common treatments for depression include: major depressive disorder, or depression, is a serious mental linked? your brain and behavior— D illness. Depression interferes with your daily life and routine and scientists don’t yet know how depression and chronic pain are n cognitive behavioral therapy (cBt), a type of psycho­ therapy, or talk therapy, that helps people change it affects your entire body. reduces your quality of life. about 6.7 percent of u.s. adults ages linked, but the illnesses are known to occur together. chronic 18 and older have depression.1 pain can worsen depression symptoms and is a for negative thinking styles and behaviors that may con­ Depression has been linked with in people who are depressed.2 tribute to their depression of Depression Bodily aches and are a common symptom of depres­ n selective serotonin reuptake inhibitor (ssri), a type of other health problems, including n ongoing sad, anxious, or empty sion. studies show that people with more severe depression medication that includes citalopram feel more intense pain. according to recent research, people (celexa), sertraline (Zoloft), and fluoxetine (prozac) chronic pain. Dealing with more n hopeless with depression have higher than normal levels of proteins n serotonin and norepinephrine reuptake inhibitor n feeling guilty, worthless, or helpless 4 than one health problem at a called cytokines. cytokines send messages to cells that (snri), a type of antidepressant medication similar to n feeling irritable or restless how the immune system responds to infection and , ssri that includes venlafaxine (effexor) and duloxetine time can be difficult, so proper n loss of in activities or hobbies once enjoyable, including the strength and length of the response. in this way, (cymbalta). cytokines can trigger pain by promoting ,5 which including sex While currently available depression treatments are gener­ is the body’s response to infection or injury. inflammation helps treatment is important. n feeling tired all the time ally well tolerated and safe, talk with your health care protect the body by destroying, removing, or isolating the provider about side effects, possible drug interactions, n Difficulty concentrating, remembering details, or making infected or injured area. in addition to pain, signs of inflam­ and other treatment options. for the latest information on decisions mation include swelling, redness, heat, and sometimes loss of medications, visit the u.s. food and Drug administration n function. Difficulty falling asleep or staying asleep, a condition website at http://www.fda.gov. not everyone responds called , or sleeping all the time many studies are finding that inflammation may be a link to treatment the same way. medications can take several n overeating or loss of appetite between depression and illnesses that often occur with depres­ weeks to work, may need to be combined with ongoing sion. further research may help doctors and scientists better n thoughts of death and suicide or suicide attempts talk therapy, or may need to be changed or adjusted to understand this connection and find better ways to diagnose minimize side effects and achieve the best results. n ongoing aches and pains, , cramps, or digestive and treat depression and other illnesses. problems that do not ease with treatment. people living with chronic pain may be able to manage one disorder that has been shown to occur with depression their symptoms through lifestyle changes. for example, for more information, see the nimH booklet on Depression at 6 is fibromyalgia. fibromyalgia causes chronic, widespread regular may help reduce some symptoms http://www.nimh.nih.gov/health/publications/depression/ muscle pain, tiredness, and multiple tender points—places of chronic pain. exercise may also boost your and index.shtml. 7 on the body that hurt in response to light pressure. people help treat your depression. talk therapy may also be help­ with fibromyalgia are more likely to have depression and other ful in treating your chronic pain. mental illnesses than the general population. studies have What is chronic pain? more information about depression treatments can be shown that depression and fibromyalgia share risk factors6 and chronic pain is pain that lasts for weeks, months, or even years. found on the nimH website at http://www.nimh.nih. treatments.7 it often does not ease with regular pain medication.2 chronic gov/health/publications/depression/how-is-depression­ pain can have a distinct cause, such as a temporary injury or detected-and-treated.shtml. if you think you are depressed How is depression treated in people who infection or a long-term disease. But some chronic pain has no or know someone who is, don’t lose hope. seek help for obvious cause.3 like depression, chronic pain can cause problems have chronic pain? depression. with sleep and daily activities, reducing your quality of life.2 Depression is diagnosed and treated by a health care provider. for more information on chronic pain see the national institute treating depression can help you manage your chronic pain on neurological Disorders and stroke website at http://www. and improve your overall health. recovery from depression ninds.nih.gov/disorders/chronic_pain/chronic_pain.htm. takes time but treatments are effective.