Home Health & Hospice

Recognizing the connection between pain and depression

Homecare Insider, October 28, 2013

Pain and mood disturbances seem to go hand-in-hand in older adults. According to the CDC, about 80% of older adults have at least one chronic health condition, and 50% have two or more. Depression is more common in people who also have other illnesses or whose function becomes limited.

Although some estimates of major depression in older people living in the community range from less than 1% to about 5%, this percentage rises to 13.5% in those who require home healthcare.

Homecare patients who experience pain may also suffer from:

  • Feelings of anxiety
  • Depression
  • Apathy
  • Sleep disturbance

Fear of the meaning of pain (e.g., worsening of condition, end of life), apprehension, and anxiety can augment the pain response and make coping more difficult. Depression, if present, must be treated aggressively, or pain management is not likely to be successful.

When treating a patient for ongoing or chronic pain, be aware of the following key signs and symptoms of depression:

  • Feelings of hopelessness and/or pessimism
  • Feelings of guilt, worthlessness and/or helplessness
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable
  • Fatigue and decreased energy
  • Difficulty concentrating, remembering details and making decisions
  • Insomnia, early–morning wakefulness, or excessive sleeping
  • Overeating or appetite loss
  • Thoughts of suicide
  • Persistent aches or pains, headaches, cramps, or digestive problems that do not get better, even with treatment