Sadness and depression
When the feeling of being down or sad persists and is accompanied by persistent negative thoughts and feelings, it can lead to depression. Depression can trigger many different emotions, thoughts, bodily sensations, and behavioral responses (actions), but it is characterized by the presence of very specific symptoms that must have been present for at least two weeks and have affected normal functioning.
The core symptoms of depression are 1) sadness, 2) decreased desire/interest and 3) decreased energy or increased fatigue. Accompanying symptoms may include decreased confidence or self-esteem, self-blame or guilt, difficulty thinking and concentrating, sleep disturbances, motor agitation or motor inhibition, thoughts of death or suicide, and appetite and weight gain.
Depression is a common side effect of severe stress when stress eventually leads to exhaustion.
Depression and chronic pain
Feeling sad is a natural part of living with chronic pain and endometriosis, but for many, it can eventually develop into a depression that requires treatment. Suffering from depression alongside chronic pain can make pain worse, as depression is associated with a lower pain threshold and tolerance, as well as a higher pain intensity. Depression and pain can interact with each other in that chronic pain increases the risk of developing depression, and depression can perpetuate and exacerbate pain.
Depression is often triggered by a period of high stress. This is also true for people other than chronic pain patients. The condition can occur when moderate to severe stress has been going on for a long time and has slipped into exhaustion. For pain sufferers, the constant physical stress that comes with chronic pain may explain why so many develop depression, but the experience of losing control of the pain can also play a role in the development of depression. Only very few chronic pain conditions are solely caused by a pre-existing depression.
Whether or not patients with chronic pain are actually depressed can be difficult to determine. Experience shows that depression in people with chronic pain looks a little different than in others. For chronic pain sufferers, the symptoms of low energy and sleep disturbances are particularly prevalent, which may be explained by the fact that chronic pain often leads to poorer sleep quality, which increases fatigue and reduces energy levels. The question is whether chronic pain sufferers experience global depression or whether it is actually the pain that causes the depression so that the "depression" would disappear if the pain disappeared.
The depressive state of a pain sufferer often fades as the pain decreases, sleep is restored, relief is achieved, and the person becomes better able to cope with psychological and social challenges. The depressive state becomes more of a background variable that slowly dissolves as you manage or reduce what is in the foreground, such as pain, uncertainty, or worries about your ability to work, your relationship, or the future.
