Columbia University Medical Center
Ranked #1 in Psychiatry
U.S. News & World Report
Ranked #1 in Research Funding
National Institutes of Health
NewYork-Presbyterian Hospital The University Hospital of Columbia and Cornell

Ask the Experts


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".