The Interplay between Pain, Anxiety and Depression

Pain is a subjective experience with two inseparable components: sensory and emotional. The personal property of pain experience makes it difficult to manage and treat due to the influence of genetics, age, gender, spiritual beliefs, social-economic status, and cultural factors. Similarly, medical care methods partly control pain experience and regulate pain progression. Contrary to chronic pain, which is continuous and recurrent, acute pain is primarily due to trauma, acute medical conditions, or treatment. Whatever the case, both can cause mood disorders. The interplay between mood disorders and pain upholds a progressively significant bidirectional link, as mood disorders and pain are risk factors for each other. Depression and anxiety heighten pain perception or decrease pain tolerance. Acute or chronic pain can also increase the chances of mood dysregulation. Although depression and anxiety have a close relationship with acute pain, the interplay between depression and acute pain is more comprehensively studied. Most depressed patients present pain as their sole complaint in primary care practices, which unfortunately is overlooked by physicians. Howbeit, reports on experimentally induced pain perception in depressed patients are mixed, presenting both an amplified and reduced pain threshold and tolerance. Although there are less published data about pain and anxiety, the association is regular because increased anxiety equally increases pain perception while decreasing tolerance. The aim of this review was to elucidate more on the mechanisms delineating the interconnectivity of pain and mood disorders.