There aren’t many of us who haven’t experienced bleak, suffocating depressed feelings and thoughts. For some these experiences can stretch into what feels like unending periods of low mood, lethargy, lack of interest in normal activities, a heightened sensitivity to pain and disturbed sleep patterns. Some experience feelings of hopelessness and helplessness.

There is no single cause of depression as it varies with each individual; however, there are common triggers for developing depression: social factors such as redundancy, isolation or bereavement; psychological factors including anxiety and family background; and physical factors such as long-term health problems, genetic factors and pain. It’s very common for people experiencing chronic back pain to also report feeling depressed.

I have a philosophy of life-long learning and constantly look for opportunities to deepen my understanding and skills. So a few years ago I jumped at the chance of participating in some research into the links between attitude to health, back pain and depression in conjunction with London South Bank University (LSBU).

Before I continue, let me make one thing clear: the pain and suffering associated with back pain is not ‘in your head’ – it is a very real physical experience. However, I have long noticed that an individual’s approach to dealing with their back pain could influence how long they suffered with the complaint. It was also obvious to me that patients who seemed depressed simultaneously to having back pain appeared to suffer more physically than patients who weren’t depressed.

Dozens of academic papers have explored links between back pain and depression but they can’t agree whether having back pain increases your risk of developing depression or if being depressed makes you more prone to back pain. I think both scenarios probably exist!

My own observations and previous research suggest that there is a psychological element that can influence how much and for long a person suffers with back pain. A researcher at LSBU approached my clinic and over twenty of my patients were kind enough to complete a set of questionnaires before they started treatment and after an initial set of treatments. The results were very clear.

Patients who had the attitude of confronting their back pain (who felt in control of it) experienced less pain and less everyday disability associated with their back pain problem than patients who felt fearful of their pain. This was true even for patients who initially presented with chronic, very painful conditions.

Patients with the confrontational attitude also were reported to be less depressed after treatment. It would be an exaggeration to claim that treatment was the direct cause of this alleviation of depression: it’s more likely that it is a reduction in pain; a feeling of being back in control and returning to usual activities contributed to reducing depressed mood.

My own reading of these results is that a patient who feels that they can do something about their back pain, is one who will follow up treatment with their chiropractically trained professionals recommendations regarding diet, exercise, sleep and lifestyle changes. And of course the biggest indication of taking control of ones’ back pain is seeking out treatment in the first place.

If you feel you are depressed it’s important to talk to your GP who can discuss treatment options with you. If talking therapy appeals to you, the British Association for Counseling and Psychotherapy (www.bacp.co.uk) have a register of qualified therapists.

Crucially though there are many things that you can do to help yourself beat the blues – whether they are associated with your back pain or not:

Exercise: In the American Journal of Preventive Medicine, researchers report that 30-minute aerobic workouts of moderate intensity, performed three to five times per week, cut mild to moderate depression symptoms nearly in half. If you are experiencing back pain, consult your local chiropractically trained professional for advice on safe levels and types of exercise.

Keep a diary: Getting your thoughts out on paper or even just listing the racing thoughts in you mind helps you make sense of your feelings and feel calmer.

Try meditation: Mediation helps you to find a sense of calm and to ‘step back’ from your every day problems. The breathing exercises also involve maintaining good posture. Find a book, CD or class that works for you.

Care for yourself: Many depressed people lose the motivation to look after themselves properly. You will feel better if you are eat properly, pay attention to your physical appearance, and don’t abuse alcohol or drugs.

Get social: When feeling low it’s tempting to avoid social activities but research has shown that people who stay connected with others suffer from depression less. You may not feel like it but keep in touch with supportive people.