Can chronic depression lead to physical, not imaginary, symptoms? I have pain in my lower back spreading up to my spine, shoulder, neck and head and I am wondering whether these symptoms are related to my depression.

I went recently for many tests: cardio, Lyme disease, candida, thyroid, kidney, liver. They are negative but I still shake inside and have the pain described above.

Answered by: Brian Fallon

Absolutely. Chronic depression can manifest primarily as physical symptoms that are experienced as very real. These symptoms may result in muscle pain, severe neck and head pain, weight loss, fast heart beat, throat tightness, light-headedness, internal agitation, mental confusion. If a medical work-up has been largely negative, a mental health consultation is strongly indicated. Also worth noting is that the mechanisms of pain in the human body are tightly connected to the pathways that lead to mood disorders; so, treatment of pain may be most effective using a medicine typically considered to be an anti-depressant - as for example with "Cymbalta" or "Effexor".

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Brian Fallon, M.D., M.P.H., M.Ed.
Director, Lyme and Tick-Borne Diseases Research Center  

Brian A. Fallon, MD, MPH, is the director of the Center for Neuroinflammatory Disorders and Biobehavioral Medicine and director of the Lyme and Tick-Borne Diseases Research Center at Columbia University.

A graduate of Harvard College, he obtained his M.D. degree from the Columbia University College of Physicians and Surgeons, as well as a master's degree in public health epidemiology from Columbia University.

He did his medical internship at Columbia University Medical Center and research training and an NIH fellowship in biological psychiatry at Columbia Presbyterian Medical ...
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