There is an established link between chronic back pain and depression which is thought to be both situational and biochemical. One symptom that may be experienced by depressive individuals but is not as well-known as other symptoms is called anhedonia.
Anhedonia is the inability to experience pleasure, particularly from activities you used to enjoy. A mother who doesn’t enjoy playing with her baby, for example, may be suffering from anhedonia. This is a particularly devastating condition; not only does it render life joyless, but those afflicted may feel they have “gone crazy” or that they are bad people who don’t love those close to them anymore. Understanding the mechanisms of anhedonia will help individuals with chronic pain to cope with it.
Chronic Pain And Your Brain
Anhedonia has a clear biochemical cause. To understand this condition, you need to first understand a key component of the brain’s reward processing mechanism, the neurotransmitter dopamine.
Dopamine performs many functions in the body. Most relevant to our topic is its job of initiating the reward/pleasure response in the brain, which helps motivate us to seek further reward and pleasure by pursuing activities that induce this positive response.
Dopamine is also part of the body’s response to stress. It is responsible for the release of adrenalin that occurs during physical or psychological stress that readies us for action. Chronic pain is both physically and mentally stressful, which means your stress response is constantly being triggered. Over time, the constant release of dopamine can deplete your brain’s supply. A lack of dopamine translates into a lack of pleasure.
Anhedonia is not a sign of insanity or apathy. It is the result of your body’s continual effort to respond to the stress of chronic pain. See http://www.netdoctor.co.uk/special_reports/depression/anhedonia.htm for more on biochemistry and anhedonia.
When you go to a doctor or psychiatrist with anhedonia or other depression symptoms, you’ll likely be offered an anti-depressant right away. Most anti-depressants used today don’t increase dopamine in the brain, however. An older class of medications called MAO inhibitors disrupt the breakdown and recycling of dopamine. This, however, is believed to lead to long-term depletion of the neurotransmitter.
One way to increase dopamine in the central nervous system is to supplement its precursors. Tyrosine is an amino acid that leads to the development of levodopa, which is converted into dopamine. Supplementing l-tyrosine may help people with anhedonia. Levodopa can also be taken as a pharmaceutical combined with another compound called carbidopa that delivers it to the central nervous system. Finally, levidopa can be found in the herb mucuna pruriens.
Lifestyle and dietary changes can help boost your dopamine levels naturally. Being physically active may be beneficial, as exercise stimulates endorphin release and dopamine production. Eating more protein is recommended for people with anhedonia because tyrosine is found in protein-rich foods like eggs, cheese, almonds, fish and poultry. Finally, maintaining healthy levels of D and B vitamins, which affect the proper function of dopamine, is recommended.
Of course, one of the best ways to combat anhedonia is to manage the stress that caused it. Keeping up with your pain management plan is difficult once motivation is lost, but it is necessary to continue on with it. Fear of activity associated with back pain and other conditions often leads to worse pain, since the body’s structures need movement to stay replenished by fresh blood flow and to maintain conditioning. If you aren’t responding to your current pain management efforts, seek out new ones. There are many alternative options beyond mainstream medicine. See http://nccam.nih.gov/health/whatiscam for more information on complementary and alternative medicine.
Understanding the cause of anhedonia and the link it has to your chronic pain is the first step toward treating it. There are many natural treatment options for both back pain and its psychological and emotional ramifications.