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Chronic pain and depression are common co-occurring disorders that present an elevated risk for suicide. Chronic pain affects more than 100 million adults in the United States and has been a significant contributor to the 21st-century opioid epidemic, according to the National Institute on Drug Abuse. In 2012, treatment for chronic pain cost the United States upwards of $635 billion, according to the U.S. Association for the Study of Pain.
But new research shows that mindfulness practices can reduce both chronic pain and depression, making the practice a viable complement to clinical treatment and a possible alternative to prescription opioids for pain management. The research, recently published in the Journal of the American Osteopathic Association, evaluated the effects of an eight-week Mindfulness-Based Stress Reduction (MSBR) course on 28 adults in rural Oregon who experienced chronic pain and depression for one year or more.
MSBR is a mind-body program anchored in the Buddhist tradition. It combines mindfulness meditation and yoga to help treat a number of conditions including stress, anxiety, depression, and chronic pain. Founded by Jon Kabat-Zinn in 1979, MBSR is now offered at more than 250 hospitals across the U.S. and at hundreds of clinics around the world, according to Psychology Today.
Mindfulness-Based Stress Reduction and Chronic Pain
“Many people have lost hope because, in most cases, chronic pain will never fully resolve,” said Cynthia Marske, DO, an osteopathic physician and lead author of the new study, in an October press release. “However, mindful yoga and meditation can help improve the structure and function of the body, which supports the process of healing.” Marske explained that while curing is about eliminating disease, healing is more of a process of becoming whole. “With chronic pain, healing involves learning to live with a level of pain that is manageable. For this, yoga and meditation can be very beneficial,” she said.
Study participants, ages 34 to 77, took 2.5-hours of Hatha yoga and meditation classes a week with a trained MBSR instructor. They also practiced on their own for 30 minutes a day, six days a week. Researchers surveyed subjects before and after the course with a patient health questionnaire, the Pain Catastrophizing Scale (PCS), and a shorter version of the Modified Oswestry Disability Index (MO) to rate their levels of pain, depression, and disability.
The research findings indicate that MBSR can lead to a significant decrease in pain, depression, and perceptions of disability, with 89 percent of study respondents acknowledging an improvement in their mood and functional capacity.
Chronic Pain and Suicide
While the new research isn’t the first to study the effects of MBSR on chronic pain, its focus was to ascertain whether the program could effectively reduce common co-occurring symptoms of depression. This comorbidity has led to an alarming rise in suicide rates, particularly among veterans (1.5 times higher than the general population) who experience depression and post-traumatic stress disorder (PTSD) in conjunction with chronic pain, according to the U.S. Department of Veterans Affairs.
A 2014 study notes that around half of patients who seek treatment for chronic pain experience major depressive disorder (MDD), and a 2012 study shows a direct link between chronic pain, depression, and suicidal ideation, with opioid overdose being a leading risk factor. A 2017 review examined prior research on yoga and meditation in the U.S. military, noting that “rates of chronic pain in the military are alarmingly high, ranging from 25 to 82 percent among active duty and veteran populations.” The report cited a number of yoga intervention studies that saw a decrease in symptoms of depression among retired and active duty service members who practiced movement and meditation.
The National Institute of Mental Health states that suicide is a leading cause of death in the U.S., and the Centers for Disease Control and Prevention (CDC) flags mental health disorders like depression as well as physical pain as major risk factors for suicide. A recent CDC report published in August detailed the impact the ongoing COVID-19 pandemic has had on mental health and suicidal ideation in America. By late June, 40 percent of adults were struggling with substance abuse and mental health issues, with 31 percent experiencing anxiety or depression. Compared to similar data from 2018, the CDC found that more than twice as many respondents had considered suicide within the past month at the time of the survey (10.7 percent in 2020 versus 4.3 percent in 2018).
While yoga and meditation have been scientifically proven to reduce symptoms of depression and help treat chronic pain, the practices should not be used as a substitute for medical treatment without the advice of a doctor or licensed mental health professional. If you or someone you know is struggling with depression and contemplating suicide, call the Suicide Prevention Lifeline at 1-800-273-8255. In response to the mental health crisis exacerbated by COVID-19, the National Suicide Designation Act was recently signed into law in October, and by 2022, the new number will simply be 9-8-8.