meds, or a referral for a mind-body intervention, such as physical therapy or biofeedback, if you have low back pain or migraines. After reviewing 18 random- ized, controlled clinical trials, researchers from Ger- many concluded that antidepressant medications are associated with considerable improvements in pain, as well as depression, fatigue, sleep disturbances and quality of life among people with fibromyalgia. It can take up to four weeks for antidepressants to work so you may not notice a difference in how you feel right away. And if the first one doesn’t agree with you, stay open-minded about trying another. “People tend to have individual responses so it’s some- what of a trial-and-error process to find the right one,” says O’Mahony. “Lower doses may be better for those who are sensitive or older.” Generally, people tend to stay on antidepressants long-term to control chron- ic pain. If a drug stops working for depression, it may be time to increase the dosage or switch to a new one.
Adjust your attitude. Have you ever considered that your thoughts could be making your pain worse? It’s possible. In fact,
what’s in your head tends to get translated by your body more than you might think; psychologist Rex Schmidt says that negative thinking exacerbates aches, worsens your mood and behavior and leaves you vulnerable to depression or to sinking deeper into it if you already do have the blues. These habits include catastrophizing, or frequently ruminating on worst-possible scenarios, making your condition seem more threatening than it is; overgeneralizing, viewing a negative event as part of an endless pattern of misfortune; personalizing, thinking you played a role in bringing it on; and engaging in black-and- white thinking, the tendency to look at things in extreme, all-or-nothing terms. Learning to correct these ways of thinking is the hallmark of cognitive- behavioral therapy (CBT)—a home run for treatment, since CBT has been found to help both depression and chronic pain. “If you change the way you think about your situation, you can reduce your perception of pain as well as depression,” Schmidt says. Start by consciously reminding yourself that one
especially painful day won’t incapacitate you for life; that it isn’t necessarily the beginning of a downward
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By changing your thoughts you can help your pain and depression.