Understanding Pain-Induced Depression with Lupus

Chronic pain is a daily challenge for many people living with lupus, but the mental health impacts of pain are often overlooked. 

Pain is one of the most common lupus symptoms and is considered chronic when it lasts for six months or longer. Chronic pain in lupus can be caused by inflammation or damage to nerves, joints, or tissues. In some cases, pain can be attributed to underlying disorders that often occur with lupus, like fibromyalgia or arthritis. It often takes a multidisciplinary team approach to find the right combination of treatments that reduce pain and improve daily functioning and quality of life.

People living with lupus who are managing chronic pain are more likely to struggle with their mental health (Jiang et al., 2024). Depression and anxiety are significantly more common among adults with chronic pain (Aaron et al., 2025) – in fact, people struggling with chronic pain are up to four times more likely to experience depression (Stubbs et al., 2017). However, people living with chronic pain are less likely to access much-needed mental health care (De et al., 2024).  

While there are strategies for managing pain that can help relieve physical symptoms, understanding the connection between chronic pain and depression can be empowering. Recent research findings suggest that the link between chronic pain and depression may have to do with systemic inflammation, a hallmark of lupus (Jiang et al., 2025). Leaving pain uncontrolled can put you at greater risk for depression (Zeng et al., 2025).  

Symptoms of depression when living with chronic pain include (Sawchuk, 2022):  

• Persistent feelings of sadness or hopelessness
• Loss of interest in activities you used to enjoy
• Feeling like a burden to others
• Difficulty concentrating or making decisions
• Withdrawing socially
• Irritability or anger
• Feeling numb emotionally
• Suicidal thoughts* 

*If you are experiencing suicidal thoughts, you’re not alone. Reach out anytime to the 988 Suicide & Crisis Lifeline. Call or text 988 24/7 to connect with a trained crisis counselor.  

Depression and anxiety can intensify chronic pain, and both chronic pain and mood disorders tend to worsen under stress. As such, according to a study on how depression contributes to pain conducted by Harvard Health, caring for your mental health and managing stress is important when living with lupus.

Here are 6 evidence-based approaches to manage pain-induced depression:  

• Mindfulness Meditation. Practicing mindfulness – conscious awareness of the present moment – trains our brain to separate ourselves from our experience of pain. This reduces the mental suffering and difficult emotions that intensify physical pain. Mindfulness can be practiced anywhere, making it a free and accessible intervention to reduce the mental load associated with chronic pain (Mindfulness Meditation Reduces Pain by Separating It from the Self, n.d.). Search for a therapist trained in mindfulness meditation near you using the online Psychology Today directory, or by calling your insurance provider for a list of in-network providers.  
• Acceptance and Commitment Therapy (ACT). ACT is an evidence-based therapy that focuses on acceptance of pain and commitment to living a meaningful life in spite of it. By focusing on living by your values, you can take away some of the power pain has over your life. Studies show that ACT can improve pain acceptance, reduce emotional distress, and enhance quality of life (Martinez-Calderon et al., 2023).  
• Interpersonal Therapy (IPT). IPT focuses on improving interpersonal relationships and social functioning to reduce depression and anxiety with chronic pain. Chronic pain can often lead to social isolation, so IPT helps people living with chronic pain improve communication and conflict-resolution skills to bolster relationships. Healthy social ties act as a buffer against the psychological impacts of chronic pain (Poleshuck et al., 2010; Liesbet Goubert & Bernardes, 2025).  
• Compassion-Focused Therapy (CFT). Improved self-compassion and mood, as well as reduced pain have been shown to result from CFT, an intervention that teaches you to practice self-compassion and gentle self-talk (Malpus et al., 2022). After engaging in CFT, many people report feeling different, doing things differently, and experiencing a change in attitude regarding pain (Penlington, 2018).
• Cognitive Behavior Therapy (CBT). CBT for chronic pain involves education on the links between stress and pain, stress reduction exercises, and cognitive strategies to recognize and challenge unhelpful thought patterns about pain. Through CBT, you can work on setting baseline pain tolerance levels and gradually returning to activities you enjoy (Lim et al., 2018; Ehde et al., 2014). Find a therapist that specializes in CBT through the online directory provided by the Association for Behavioral and Cognitive Therapies.  
• Antidepressant medication. Studies suggest that antidepressant medications might be effective in managing pain as well as mood. Antidepressants can offer an analgesic response in people with pain, affecting nerve pain signals. These medications may block pain signals traveling from the spinal cord to the brain, reducing perceived pain intensity, in addition to improving mood (Birkinshaw et al., 2021; Hall-Flavin, 2019). Antidepressants may interact with other medications and can have negative side effects for some people. Talk to your doctor to see if antidepressant medication may be a safe and effective treatment option for chronic pain-induced depression.  
• Stress reduction. Because stress can exacerbate both physical pain and depression, finding ways to manage stress can help mitigate the effects of pain-induced depression. Activities like progressive muscle relaxation, deep breathing, guided imagery, and gentle yoga have been shown to reduce stress and alleviate symptoms of pain-induced depression (NIH, 2020). 

Living with lupus can mean managing chronic pain and taking care of your mental health. If you’re struggling with pain-induced depression, know you are not alone. Share your concerns with your doctor, seek a therapist experienced in helping people with chronic pain, and don’t give up – with the right combination of treatments you can find relief and begin to feel like yourself again. 

Authored by:
Heather Rose Artushin, LISW-CP

This blog post and the lupus resources found on the National Resource Center on Lupus are, in part, supported by the Centers for Disease Control and Prevention under Cooperative Agreement Number NU58 DP006139. The contents are solely the responsibility of the developers. Points of view or opinions do not, therefore, necessarily represent official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.

This blog post is for educational and information purposes only. Consult with your doctor/health care team for medical advice.