The Mind-Body Couple

Breaking the Depression - Chronic Pain Cycle

• Tanner Murtagh and Anne Hampson • Episode 115

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Depression and chronic pain create a vicious cycle that can feel impossible to break. If you're caught in this loop, you're not alone – and there's hope for healing both simultaneously.

Many people experience depression as a natural response to living with chronic pain, but few understand how these conditions feed each other through nervous system dysregulation. When your system stays in a heightened state of danger for too long, it can trigger both physical symptoms and a freeze/shutdown response we recognize as depression.

Throughout this episode, we share our personal experiences with this cycle and outline four key strategies to break free. We explore how purposeful action – starting with tiny steps like brief journaling or getting sunlight – can gradually mobilize your nervous system out of shutdown. We discuss true embodiment practices that create safety with all sensations rather than forcing toxic positivity. We highlight the importance of modifying activities instead of complete avoidance, and we provide guidance on creating a depression flare plan for your most difficult days.

The sensitization cycle connecting pain and depression is real and brutal, but understanding this connection is the first step toward healing. Whether you experience exhaustion, low motivation, social withdrawal, or all of these symptoms alongside your chronic pain and illness, your body isn't broken – your nervous system is simply trying to protect you the best way it knows how.

As someone who has personally healed from debilitating chronic pain and depression using these approaches, I can tell you that recovery is possible. Each small step you take creates momentum toward healing both conditions simultaneously. Join us as we explore this crucial mind-body connection and provide practical tools to help you reclaim your life.

Ready to start healing? Check out our free emotion practice video, explore our comprehensive online course, or book a consultation with one of our therapists through the links below. 

Free emotion practice: https://youtu.be/CC6wTTaWJaY


Tanner Murtagh and Anne Hampson are therapists who treat neuroplastic pain and mind-body symptoms. They are also married! In his 20s, Tanner overcame chronic pain and a fibromyalgia diagnosis by learning his symptoms were occurring due to learned brain pathways and nervous system dysregulation. Post-healing, Tanner and Anne have dedicated their lives to developing effective treatment and education for neuroplastic pain and symptoms. Listen and learn how to assess your own chronic pain and symptoms, gain tools to retrain the brain and nervous system, and make gradual changes in your life and health!


The Mind-Body Couple podcast is owned by Pain Psychotherapy Canada Inc. This podcast is produced by Alex Klassen, who is one of the wonderful therapists at our agency in Calgary, Alberta. https://www.painpsychotherapy.ca/


Tanner, Anne, and Alex also run the MBody Community, which is an in-depth online course that provides step-by-step guidance for assessing, treating, and resolving mind-body pain and symptoms. https://www.mbodycommunity.com


Also check out Tanner's YouTube channel for more free education and practices: https://www.youtube.com/channel/UC-Fl6WaFHnh4ponuexaMbFQ


And follow us for daily education posts on Instagram: @painpsychotherapy


Discl...

Speaker 1:

Welcome to the MindBodyCouple podcast.

Speaker 2:

I'm Tanner Murtaugh and I'm Anne Hampson. This podcast is dedicated to helping you unlearn chronic pain and symptoms. If you need support with your healing, you can book in for a consultation with one of our therapists at painpsychotherapyca or purchase our online course at embodycommunitycom to access in-depth education, somatic practices, recovery tools and an interactive community focused on healing. Links in the description of each episode.

Speaker 1:

Hi everybody, welcome back to the podcast.

Speaker 2:

Hi everyone. Today we are talking about healing depression when living with chronic pain and illness.

Speaker 1:

Yeah, and we know this sounds like a heavy topic one because it is, but we think it's necessary to talk about.

Speaker 2:

Yes, because often people are stuck in this loop. They're stuck in this loop of chronic pain and symptoms making them feel depressed, which makes sense, and then depression making their symptoms worse.

Speaker 1:

Yeah, and at this point, right now, I really want to validate that loop because it completely makes sense, when we're living with pain and symptoms, to feel depressed.

Speaker 2:

Yes, and understanding that these things feed each other.

Speaker 1:

Yeah.

Speaker 2:

It's really key because even in my healing I had physical treatments and then I had mental health treatments, but the two worlds were never meshed.

Speaker 1:

Yeah, that's right. Like they weren't really meshed for you, were they?

Speaker 2:

No, and it's so key because understanding the connection and understanding that by treating depression and understanding this mind-body connection we can heal both together, that this is possible, and in our one-on-one therapy, in our agency, in our digital course, we've helped so many people overcome chronic depression and chronic symptoms together.

Speaker 1:

Yeah, and so I think that first step then, tanner, is what you're saying is we need to understand how they are linked and how they connect to each other, and it's not one or the other.

Speaker 2:

Yes, and today we're going to break down talking to real strategies that can help you and really remind you that, even on these hardest days that you're facing with depressive symptoms, that you're not alone and you're not without options, that there is hope in healing this. And that's really what we want to outline today to get you started.

Speaker 1:

Yeah, for sure it is.

Speaker 2:

And, like you were just saying, Anne, it's first understanding the symptom depression loop that it's real and it's brutal it's helpful we talk about in our approach. It's helpful to understand that depression is a nervous system state. Depression occurs when we move towards this freeze or shutdown response in our nervous system and for a lot of people, like we've said, if you've had chronic symptoms for a long time, it makes sense that you're shutting down to survive. Now, really quickly, what this can look like, it does vary person to person. There is nuance to this. It looks a little bit different with each individual. But when we talk about this freeze or shutdown response, the physical experience can be this exhaustion, this low energy that people feel. We often get like heavy sensations, low muscle tone, numbness. For a lot of people I know that we work with, they almost have poor immune function, so they're often getting sick. And of course, this physical experience can include chronic pain, chronic symptoms and often chronic fatigue.

Speaker 1:

Well and that's interesting that you make those in the list of physical symptoms that could be connected to depression, because I think a lot of listeners out here might relate to those but not identify that they're depressed. So again reflecting oh am I depressed? Is there something going on there? Brings to that awareness of it too.

Speaker 2:

You're right, because the first step is, like you need that awareness. Yeah, now the mental experience. This is lacking motivation or interest, dissociation. At a more extreme end, feeling like low mood, depression, feeling like low mood depression, numbness, loneliness, hopelessness and helplessness. And, lastly, the behavioral experience that you want to look out for can be this lack of movement, lack of purposeful action, social disconnection and withdrawal. Like you see, the people almost withdraw into distraction. They just start to avoid their world and, at a really extreme end, this can almost look like lack of responsiveness for a lot of people. And so, like Anne was saying, just having that awareness, am I meeting some of these criteria for this depressive state or the freeze or shutdown response? Because, if you are, we need to start to work at that, we need to start to shift that.

Speaker 1:

And it doesn't mean, like, the typical mind-body healing approach isn't useful and doesn't work. It just means also having this lens of like okay, I am in this free shutdown or I am depressed as well, and I need to take care of that and nurture myself there too.

Speaker 2:

Yeah, and chronic pain. It's so vital that people understand and this is like one of the key messages we are sharing on our podcast Chronic pain and symptoms is not just a physical experience, it's an emotional experience, and we talk about depression. This is a sign your nervous system is dysregulated, meaning this sense of danger, this heightened sense of danger, is causing you to feel depressed and this is going to, over time, sensitize your system and produce pain and physical symptoms.

Speaker 1:

So that brings us to the sensitization cycle.

Speaker 2:

Yes, they feed back. There's a feedback between pain, physical symptoms and dysregulation, negative thoughts and beliefs, negative behaviors. Depression fits right in there.

Speaker 1:

Yeah, and, if you like, kind of what we're saying about the sensitization cycle. We talk a lot about that in our course.

Speaker 2:

Yes, we really do, and it's so key to understand when we talk about this sensitization cycle, to understand that your pain and symptoms are not just in your head, it is in your nervous system. Neuroplastic pain and symptoms are very real. What it means is that your body is not damaged or diseased in any way, and what's occurring is this heightened sense of danger is triggering your symptoms over time, and when people are feeling depressed, that's a sign that your nervous system has just been in this heightened state of danger for too long, and that's a great place to validate the fact that, okay, I do maybe identify or relate with feeling depressed and I have pain and symptoms.

Speaker 1:

But that really good reminder, tanner, that just because I feel depressed and I know it's connected to my symptoms doesn't again mean my symptoms are all in my head.

Speaker 2:

And I want people to know. I think it is so key that you are not weak for feeling depressed or for having chronic symptoms. You're human. This is a natural human response when that level of danger has been too high. Personally, when I had widespread, debilitating chronic pain which I use this approach to fully heal, there were points at the end of my journey where I was deeply depressed in this shutdown response and you know and witnessed me in that where I was near unresponsive by the end. I was dissociative, I was not leaving our apartments, I was just completely isolated and lost in trying to heal my pain, not seeing there was a connection between the two of depression and chronic pain, and so I really want to empathize with people that I know how hard it is to work through that, but I also want to give this message of hope that working through that is possible.

Speaker 1:

What allowed you to start working through that, Tanner, to get to that point?

Speaker 2:

You know, I think the starting place is everything we've covered so far in understanding the connection Because, like I said, I was getting physical treatments and I kind of had this belief of like, okay, if I can get my pain to go away, I won't be depressed anymore.

Speaker 1:

Okay, so you almost thought the opposite.

Speaker 2:

It was like I had it backwards. So I was doing all these physical treatments before I came to a brain and nervous system approach. Yeah, which I think is common oh yeah, and I just and I hear that all the time I just need my pain to go away and I won't be depressed. But actually I had to start working on my nervous system regulation, working through uplifting my nervous system out of the shutdown state, and then my pain started to reduce.

Speaker 1:

Yeah, yeah, and I think that's a great motivator and reminder. This is more a reason to maybe keep kind of developing that awareness that I might identify with depression and that is an area to focus on to get better.

Speaker 2:

Absolutely, and now we're going to shift to talking about healing strategies.

Speaker 1:

Yeah, yeah, the first one we really want to outline, which I think is one of the most important, is called purposeful action. Mm-hmm which I think is one of the most important, is called purposeful action. So the key with this is starting small, because I know when we feel depressed we don't want to do any action.

Speaker 2:

Yeah.

Speaker 1:

And so. But taking action is big. Often we wait for motivation, so we'll be like okay, well, when I feel motivated, I'll do something, but when we feel low and depressed, motivation doesn't come. So we need to do action first.

Speaker 2:

Yeah, it's so key because I think a lot of people they focus so much in their mind on their thoughts and, don't get us wrong, some of our approach is working on thoughts and beliefs, but when your nervous system is shut down, it is collapsed and so we need to uplift it. We need to help start doing these actions that are going to lift us out of this response.

Speaker 1:

And actions always come first, even if it's not, even if we're not feeling depressed or just feeling stuck or we're feeling kind of in freeze for other reasons.

Speaker 2:

action is first feeling kind of in freeze for other reasons. Action is first. Yeah, and I like what you said at the beginning here you need to go small when we are depressed and shut down, as I was when I was in pain. If you told me, go apply for 20 jobs, that would have been incredibly overwhelming. I actually have an event, a memory, where I was off work. You remember this and you were helping me because I was trying so hard to write this cover letter and resume to apply for a job to start working and I couldn't do it. I needed so much support from you because my mind just wasn't working and you basically wrote the cover letter at that point. But it's just an example that you can't overshoot this. You need to be gentle and careful and compassionate to your nervous system and start these small little steps in the right direction and and I like the compassion piece, tanner, because you're right we have to honor that.

Speaker 1:

We did these steps. I think, um, it can be really difficult because we can start feeling well, I should be doing this, or I should be doing that, or these steps. I think it can be really difficult because we can start feeling well, I should be doing this, or I should be doing that, or these steps should be. It should be easier for them to become bigger, but when we're feeling low or depressed, they aren't easy and that's just the reality of it. So, starting small and then applauding those small steps, some examples, and so we have examples of almost widening the world a bit. That could be showering or getting dressed at a set time, 10 minutes of sunlight outside, journaling for five minutes, working on a creative project, for example, like music, art or dance or something you enjoy, slow movement, yoga or qigong, a five-minute walk, a call to a friend. So all these actions lead to motivation, not the other way around.

Speaker 2:

Yeah, it's so key to understand Because I remember when I was depressed, I just was waiting for this inspiring moment that would lift me out. But these small, purposeful actions that I started to implement, they were mobilizing my nervous system, they were starting to give me some of that energy back that I needed, and the more little steps that I did, the more it uplifted me.

Speaker 1:

Yeah, and so that's a big key. It becomes hopefully easier as time goes on to do more.

Speaker 2:

And as we talk about consistency, not intensity, with all of this, now let's move to number two embodiment practices. These are practices that are essential for healing depression and chronic pain symptoms. It's a big part of our approach that we utilize. Now. There is this pressure in our culture Definitely you see this on social media, you see this in news. There's this pressure to stay positive or to just push through and ignore, especially when we have chronic pain, chronic illness. You hear this a lot. Right, like, just think positive, um, but it almost becomes too toxic. What, what occurs to people is now they're resisting their dysregulation, they're resisting their difficult emotions and this is going to cause you to feel way more dysregulated over time and worse in your chronic pain, chronic illness. One of the biggest misconceptions I see with embodiments because it's such a trendy term that's used a lot, people use it wrong. They think I'm going to embody calmness, I'm going to embody ease, but embodiment includes all sensations in your body.

Speaker 1:

And now one thing I want to say is I'm all for positive thinking, positive messaging, safety messaging that are positive, embodying calmness. So I'm all for that. I talk about that with people, but also feel safe allowing discomfort too.

Speaker 2:

Well, that's what it is, because if you can do somatic work consistently with the sensations of depression, it's going to teach us over time that we no longer need to fear those sensations and we can learn to cultivate safety and release them.

Speaker 2:

I remember getting this point early on, when I was healing and I was starting to come out of my depression as I started to do some of this work, and what occurred before my depression fully lifted is I no longer felt in great danger when I was feeling it. I touched into it, I had explored it, I had given myself exposure to intentionally approaching it and creating safety at the same time so often that when it came up, it wasn't like my whole world was crashing down. I was able to tolerate being with it. Now, a gift that we want to give all of you is we have a free emotion practice that I will put the link in the description of this podcast episode. This is on our YouTube channel. It'll get you started for free. Also, in our course have over 60 somatic practices and brain retraining exercises to support people. So if you need the extra support, the link for our course is down below as well.

Speaker 1:

And our hope for, either like engagement with the course or their free emotion practice, is to help guide people to feel like they can explore emotions and create safety with it and sit with them a little bit and so moving towards them, like Tanner was talking about of that desensitization around it. So number three modify, don't avoid. And so depression tells us to avoid life, and while rest can be important, avoidance and isolation can make depression louder and that's something we want to remember because everything in us will want to avoid and that makes sense when we feel depressed. So again, we want to validate that and this kind of modify and don't avoid might feel the opposite of what the body and mind wants.

Speaker 2:

Yes, it's the opposite of what the urge inside is going to be, because you have to understand where you're going into. A freeze or shutdown response. Your system, it is shutting down to survive. Our nervous system doesn't do things by mistake. It's trying to protect you, and it's trying to protect you by making your world small. But now we're pushing up against that. So, instead of avoiding, can we just do a little bit more or modify what something bigger might be, so at least we're slowly widening our world out.

Speaker 1:

So some questions that might be helpful to ask. How can I modify instead of canceling, or instead of a walk, can I sit outside for five minutes Instead of not working today, could I do half the day?

Speaker 2:

This is it, because when we get dysregulated myself included our thinking gets so extreme and a common thought pattern that happens to people is this all or nothing.

Speaker 1:

Yeah, and Tanner, you really relate to that. I think you still struggle with that I still.

Speaker 2:

It's gotten way better over time. But I'm all or nothing. Either I'm all in, I'm going full cylinders ahead, or I'm all or nothing. Either I'm all in, I'm going full cylinders ahead, or I'm just not going to do it.

Speaker 1:

Yeah, which is it you know which can be helpful, and sometimes, when we're all in, maybe a little bit, but we can't sustain that Um and can feel really hard, cause when we feel low again, then we're like, okay, nope, not at all, and we just avoid.

Speaker 2:

And so it's so key of can you just modify and do half of what you were going to do?

Speaker 1:

Yeah.

Speaker 2:

So you're not doing nothing. It's still these small behaviors that are mobilizing your system, helping you pull out of a freezer shutdown response. Now the last point we want to hit on, number four build a depression flare plan. Just as you might imagine, I'll say that one again, alex, just as most of you listening might have a flare-up plan for your chronic pain, chronic illness, having a depression flare plan is key, and so you want to understand when your depression is getting extreme. What are some things that I can utilize? Now, the real key here, when I'm talking about this with people, is you want to map this out first. It's like back to that example where I was trying to write that cover letter and complete shutdown. The reason I needed Anne to do that so much is my brain was shut down Like I couldn't think, and so the last thing you want to be doing is trying to come up with your depression flare plan while you're already in the flare, because it's going to be really hard to do.

Speaker 1:

Yeah, and that really does relate to when we're in our you know our pain flare, like you said, of like, okay, I've thought of this beforehand, this is kind of what I'm doing to create safety. So, very much similar.

Speaker 2:

I would write out some points and we'll give you some examples here of what it can include. But again, this is very unique to each person because everyone's nervous system is unique, so you could have people to call or connect with a playlist that comforts you. I have multiple playlists. When I was healing I did, but I do now. I have playlists where you know I can kind of calm and soothe myself. I have also like uplifting, motivating playlists. They're quite effective, like music can be quite healing in this way. A list of your favorite meals or snacks.

Speaker 1:

That's usually what I tell people to go to.

Speaker 2:

Because that's what you go to. That's why you're telling.

Speaker 1:

That's what I tell people to do too Well, because it's really helpful, it's comforting and it makes me feel good. Obviously that's not the same for everyone.

Speaker 2:

But you know what. That's yours, in small doses. Of course you want to be careful here, but it is true. I uh, I always know if anne's feeling a little lower because, uh, I'll go into the freezer and all of a sudden there's some ice cream sandwiches in there.

Speaker 1:

Yeah, I like those. It's ready to go? Yeah, the kids eat them and then you're upset with the kids, yeah, yeah, so eat your ice cream sandwiches anyways.

Speaker 2:

We're getting way off track. But a list of your favorite meals or snacks, whether that's ice cream sandwiches or not, a list of friends or family you can call for support Watching your favorite lighthearted show. This is one of my favorites. This was a huge part of my healing, is I? When I was feeling low, I felt there's this phenomenon where you're almost you're trying to match your mood with like what you're watching. So what would happen is I'd be watching these like dark shows already feeling awful, and so what I started to do is put on these like light comedies, lighthearted shows, modern Family.

Speaker 1:

Yeah, Well, you know what, Tanner? I think that's a great idea because like, and that's a great idea because like, and that's a bit of the fake it till you make it idea and not and not saying that's the positive like thinking we were just talking about. So not like that in terms of like forcing yourself to just be positive. But that is kind of trying to bring yourself into a bit more joyful sensation by watching a light-hearted show, and so you're trying to kind of shift states that way.

Speaker 2:

Absolutely. And then we got safety signals, which is a big part of our approach. This could be present moment sensing, really, truly, for three to five minutes. Focus on sight, sound, taste, touch, smell, whatever feels supportive for you Like, really dive into that. Some of that simple mindfulness stuff. The reason there was that huge trend in the early 2000s around mindfulness was it works. It really does work.

Speaker 2:

And so you know, I think a lot of people know of mindfulness but when push comes to shove we don't do it.

Speaker 2:

And so some of that simple present moment sense, it can be so supportive. It could be breath work, certain breathing patterns. If you are doing breath work you don't need to get super fancy Long exhale in and out through the nose, exhale twice as long as the inhale. If you can do that consistently, that's going to help calm your system and put you in a better state that maybe you could go and do some purposeful action and put you in a better state that maybe you could go and do some purposeful action. And it could also be somatic massage, like massaging your ears, massaging the backs and side of your neck, making small circles on your chest. All these things can be very supportive and naturally bring a sense of compassion that we truly need when we feel depressed. The other thing that you can do like we said, part of how we can create safety is through these cognitive messages, so that goes back to that kind of a bit of where we can bring in a bit of that positivity where it is helpful.

Speaker 2:

Yeah, and you don't need to lie to yourself here. You're going for safe self-talk to try and create a sense of safety within, and really we're going for more balanced ways of thinking. So we'll give you some examples here. My nervous system is trying to protect me by shutting down. I don't need to fear these sensations.

Speaker 1:

Or these sensations don't need to indicate any disease or physical problem my body is physically healthy I can teach my body to move and lift out of the freeze response I can respond to sensations with deep care and compassion for myself I don't need to like the sensations, I just need to remember why they're safe yes, so all of these things that we just covered can be part of your depression flare plan. Yeah.

Speaker 2:

And again, prepare this when you are well and you're feeling good or somewhat of a higher mood, and use it when you're feeling low.

Speaker 1:

Yeah, and we know that when we're feeling low we might be feeling pain, or when we're feeling pain, we might be feeling low.

Speaker 2:

So it could be targeting the pain and kind of the sensations and low mood of depression at the same time personally, I've experienced this and witnessed me go through this, and I know this is incredibly hard, but you're taking the first step of even listening to this episode. You're here to overcome this, and so it's knowing that healing is possible by using these strategies that we've outlined in this episode, although we outline them in a very simplistic way. We know this can be complex and it can take time, so just consistently start to make small steps towards working through your depression. So thank you everyone for listening.

Speaker 1:

Thanks for listening.

Speaker 2:

And we'll talk to you all soon.

Speaker 1:

Talk to you next week. Thanks for listening. For more free content, check out the links for our YouTube channel, instagram and Facebook accounts in the episode description.

Speaker 2:

We wish you all healing.