It is possible to interrupt and even stop the cycle of depression and chronic pain. The first step to beginning this positive cycle of activity is to get an accurate diagnosis for depression.

See Reducing the Risk of Pain and Depression

Depression is sometimes under-diagnosed

One of the biggest obstacles to treating major depression associated with chronic pain is getting the depression diagnosed.

A person with chronic pain may not receive a diagnosis of depression because:

  • The person does not recognize his or her symptoms of depression.
  • The person downplays depressive symptoms to his or her doctor and focuses only on the pain.
  • The doctor does not screen for depression.

See Treating Depression and Chronic Pain

The Depression Questionnaire

People who suspect they are experiencing depression can take the Depression Questionnaire. This self-administered test can help gauge the severity of depression.


The patient should circle the number that best indicates how much of this type of feeling has been experienced over the past one to two weeks—not at all (0), somewhat (1), moderate (2) or a lot (3). All questions must be answered. If it is difficult to answer any of the questions, a best guess will suffice.

Symptoms Not at all Somewhat Moderate A lot
Do you feel sad, low, blue, or unhappy? 0 1 2 3
Do you feel hopeless or discouraged about the future? 0 1 2 3
Do you feel useless or believe yourself to be a failure? 0 1 2 3
Do you feel inadequate or inferior to others? 0 1 2 3
Do you feel guilty or blame yourself for everything? 0 1 2 3
Do you find it difficult to make decisions? 0 1 2 3
Do you feel frustrated and irritable? 0 1 2 3
Have you lost interest in other people or your usual activities? 0 1 2 3
Do you feel unmotivated and find it difficult to do things? 0 1 2 3
Do you think you’re looking old, unattractive or ugly? 0 1 2 3
Have you lost your appetite or had a change in weight not due to dieting? 0 1 2 3
Do you have trouble falling asleep, or do you wake up during the night, earlier than you would like? 0 1 2 3
Do you feel tired much of the time? 0 1 2 3
Have you had crying spells or felt like crying but couldn’t? 0 1 2 3
Have you lost your interest in sex? 0 1 2 3

Add up your total score for the 17 symptoms and record it for scoring. The total score will be somewhere between 0 (answering “Not at all” to each item) and 51 (answering “A lot” for each item). Use the following key to interpret your score:

Total Score Degree of Depression
0-4 Minimal or no depression
6-11 Borderline depression
12-21 Mild depression
22-31 Moderate depression
32-51 Severe depression

People with a score of 22 or higher may consider contacting their doctor or other medical professional for a formal diagnostic screening for depression.

*If you have had thoughts about killing yourself or scored in the severe range of depression, you should consult a qualified mental health professional.