Pain and Depression
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Pain and DepressionAnalysis of my mother’s
chronic pain
By T.Y13 July 2014
Final Project for “Understanding the Brain: The neurobiology of Everyday life”
Introduction Last May when I was hit by dehydration one
couldn’t help thinking about what was going on in my brain even amused by it during the events of nausea and headache.
From these events, I realized that learning about brain is learning about my own self and peoples around me.
My 78 years old mother was recently released from upper back pain with the help of antidepressants.
This lead to the current research into pain to understand my mother’s experience.
Mechanism of Pain Mechanism of Pain Modulation The Relationship of Pain and Depression Analysis of my Mother’s Pain Summary Acknowledgements Reference
Contents
Mechanism of Pain (Transduction)
Pain Producing Substance
Pain receptor(Nociceptor)
noxious stimulus
Ion channel open
MechanicalChemicalThermal From damaged
cell K+
H+
ATPFrom blood Bradykinin Serotonin Histamin
Others Prostaglandin Cytokine SubsatnsP
Primary neuron excited
Mechanism of Pain (Transmission & Perception)
Thalamus
Neocortex(somatosensory cortex)
Limbic system
ouch
emotion
Brainstem
Hypothalamus
Spinal Cord
Nociceptor
Dorsal Root Ganglia
Pain Producing Substance
Mechanism of Pain (Axson Reflex)
Thalamus
Neocortex(somatosensory cortex)
Limbic system
ouch
emotion
Brainstem
Hypothalamus
SubstancePCGRP
VasodialationTo collect white blood
cell
Spinal Cord
Nociceptor
Dorsal Root Ganglia
Pain Producing Substance
Thalamus
Neocortex(somatosensory cortex)
Limbic system emotion
Brainstem
Hypothalamus
Spinal Cord
Nociceptor
Dorsal Root Ganglia
sympathetic nerves
NA
vasoconstriction
ouch
Pain Producing Substance
Mechanism of Pain (Sympathetic nerves Facilitation)
Mechanism of Pain Modulation
Thalamus
Neocortex(somatosensory cortex)
Limbic system emotion
Brainstem
Hypothalamus
Spinal Cord
Nociceptor
Dorsal Root Ganglia
Pain Producing Substance
β-endlphine
GABA
Midbrain(PAG)
PONS(nucleus raphes magnus)
Serotonin
PONS(locus ceruleus)
Noradrenaline
descending pain control pathways
Relationship between Pain and Depression
Pain causes more pain.Pain causes stress.Stress causes more pain.
Stress Stress Stress
Depression
The experience of the chronic pain cause neuroplasticity .-- strengthening nerve connections or adding new nociceptor
More pain, more stress
The continuous stress weakens the descending pain modulation system.
Sympathetic nerves facilitation
Pain
Stress
vicious cycle of pain
The back pain was not from her back but from her brain
Analysis of my Mother’s pain
<Detail>
<Symptoms> She could not look down because that caused strong pain.
My mother’s back pain started in November 2013.
The pain accelerated and by the new year of 2014, she could hardly cook for looking down caused terrible agony on her back.
In March 2014, her jaw started to ache. She went to a psychotherapist and started
to take antidepressant medicine in April 2014.
The back pain was not from her back but from her brain
Analysis of my Mother’s pain
<Result of the treatment> First 5 weeks, Mother felt very sleepy much of the
time, but realized the back pain was softer.
Late in June 2014, she said “ Today I cleaned up the toilet of the house. Can you imagine how happy I am ? Because it was the first time in about 6 month!!”
The back pain was not from her back but from her brain
Analysis of my Mother’s Pain
<What was wrong with her ?> My mother’s severe back ache was a result from the
vicious cycle of pain.
<What was her original stress> Colonic diverticulitis: caused continuous pain for
last 2 years. High blood pressure : for last 6,7 years.
Increasing deafness: caused communication difficulties for last 2,3years. Diverticulosis happens when pouches form in the wall of the colon. If these pouches get inflamed or infected, it is called diverticulitis. Diverticulitis can be very painful( by WebMD)
The back pain was not from her back but from her brain
Analysis of my Mother’s Pain
<What made it worse ? Secondly stress> Relation with her doctor : Her doctor does not
understand her pain from the diverticulitis.
Diminishing hobby : the pain prevented her from sitting in front of the computer to edit and share her photos.
Pain itself: “What else could be more stressful than the pain prevent you from looking down for 6 months!!” – by My mother
Analysis of my Mother’s PainThe back pain was not from her back but from her brain
How the medicine work to her painSNRI: Serotonin & Norepinephrine Reuptake Inhibitors
Prevent Noradrenaline to be uptaken
More Noradrenalin to be used for
modulate the pain
More serotonin to be used for
modulate the pain
Prevent Serotonin to be
uptaken
It helps the descending pain control system
It is very hard to convince oneself the physical problems are caused by your own brain when you having severe pain.
A person with chronic pain even if he/she is not showing explicit symptoms of depression, but implicit symptoms of depression could be progressing in the body.
Dealing with old people’s pain is very important because dementia is believed to have some relationship with depression.
Summary
Many thanks for the wonderful lectures by Professor Peggy Mason, your passion for understanding the brain really made me amused . And thank you for all of the staff of the University of Chicago and Coursera.
Thanks to my mother who had been suffered severe pain, but always showed her happy face to me when I visited her.
Thanks to my husband for setting up the studying desk and encourage me to research new things. Now I will do bit more housework.
Thank for Weblio which is free english-japanese dictionary site. Without it I could never finished the course. (Weblio: http://ejje.weblio.jp/)
Acknowledgements
Reference
Web Site Pain Relief: http://www.shiga-med.ac.jp/~koyama/analgesia/ (Japanese)Karada no shikumi: http://blog.physicalsupportnagoya.com/ (Japanese)MNT: What is serotonin : http://www.medicalnewstoday.com/articles/232248.php
WebMD : http://www.webmd.com/TheBrain From Top To Bottom: http://thebrain.mcgill.ca/Wikipedia and Many other websites
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