What is the mind-body connection between nerve pain and depression?

Have you ever been waiting for a job interview and suddenly your stomach started to hurt, your palms turned clammy, and you felt lightheaded? 

Or we can look at a more serious instance. Let’s say a person has recently been diagnosed with diabetes. Would you expect that person to feel more anxiety and/or depression? 

The answer is likely yes. That’s because our minds and our bodies are undeniably connected. Recognizing this connection is important to addressing a medical condition–and it’s helpful to note that there are some medications that do both. 

Like what? 

One of the clearest examples is an antidepressant that helps address chronic pain. Let’s look at duloxetine (Cymbalta), which is taken by roughly 16 million Americans. You may know it as an antidepressant or you may know it as a medication to manage chronic pain. Both are accurate. 

The FDA first approved Cymbalta–the brand, as developed by Eli Lily–to treat major depressive disorder in 2004. Antidepressants had been used to treat pain for years, but in 2008 it was approved for a chronic, widespread pain disorder, fibromyalgia. In 2010, the FDA approved Cymbalta for treating musculoskeletal pain. Today the medication is approved by the FDA to treat:

  • Major depressive disorder
  • Diabetic peripheral neuropathy
  • Generalized anxiety disorder
  • Fibromyalgia
  • Chronic musculoskeletal pain

How can the same drug treat two very different conditions? 

The bottom line is that although the conditions are different, they may be connected. 

For instance, in duloxetine (Cymbalta) both pain and mood are regulated by the same neurochemicals: serotonin (a chemical nerve cells produce and a neurotransmitter) and norepinephrine (a naturally occurring chemical in the body that acts as both a stress hormone and neurotransmitter). 

These chemicals are thought to help nerve cells communicate with one another. Low levels of each may cause depression and affect how a person feels pain. When we discuss pain here, we’re referring to neuropathic pain. Both diabetes and fibromyalgia, for instance, can cause nerve pain. 

I’m in neuropathic pain and experiencing depression or anxiety. Should I seek medication that addresses both?

Not necessarily. Duloxetine (Cymbalta) could be a good option for you, but it’s best to discuss both with your doctor and your pharmacist. At Honeybee Health, we don’t always recommend medication–especially when it comes to pain. For pain patients, there are a lot of choices such as acupuncture, cannabis, group therapy, meditation, yoga, and more. 


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Dr. Jessica Nouhavandi

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