Greetings:

I have treated with a psychiatrist since 1998 with good results for major depression and social anxiety with agoraphobia. I have treated with a pain management specialist for chronic pain (post surgical C5-6 followed by MVA) since 2006.

This is my question...how do I find a program or psychiatrist who specializes in chronic pain? My psychiatrist indicates opiates are not good for my depression and I should get off of them ASAP. Once I get off them, he can help stabilize my depression. My pain management specialist doesn't know what to do with me as my depression and anxiety continue to increase the longer I take the opiates. We try to stay on the cleanest, most up to date extended release medications (both for depression and pain), but there is a lack of communication between the two specialties and almost denial by my psychiatrist that I need pain management assistance.

Please note I have done everything I can to deal with the chronic pain including an inpatient pain management program, multiple modalities, breaking the bank for my household in doing so. One year we spent $50,000 after insurance seeking any modality that might be of assistance.

I spent 10 days in an inpatient psych hospital a year ago, followed by 6 days in my local hospital recovering from the side effects of the medication I was given to stabilize my symptoms of depression with suicidal ideation. It seemed like the function of the hospital was to stabilize me and let me go. There was no interest in discussing the side effects of the pain meds on my depression and social anxiety.

I found John Hopkins in Maryland has a Psychiatry and Behavioral Sciences Department with a specialty area of chronic pain. This is exactly the type of program I am seeking; however, I am in the greater Sacramento, California area.

Is anyone aware of any programs in Northern California that address both mental health and chronic pain concerns as a unit, rather than separate issues. I find pain and depression are profoundly related...both the symptoms as well as side effects from medications. How do I find a medical professional in Northern California who has expertise in both specialties with an interest in assisting individuals who are dealing with both issues and having a difficult time doing so.

Any input you may have would be helpful. Thank you for your time and consideration.

Dawn

First, can you tell us what is causing your pain? Why are you taking pain medications? And why on earth would you consider getting off them if you're in chronic pain?

The pain management clinics I've been to have include d psychologists. None of them have stated that opiates increase depression! In fact, I just looked up several of them online, and NONE of them listed depression as a side-effect. I take antidepressants because I'm clinically depressed and have been all my life, but I'm also a chronic painer and my pain meds do not increase my depression ~ and I've taken opiates for years!! I just don't understand this.

ut I do agree that pain and depression are related ~ pain CAUSES depression. But pain medications don't that I can see. It sounds to me like someone is handing you a line of bull, unless you PERSONALLY don't handle them well. But to ask you to get off your pain meds if you're in severe pain is asking quite alot in my book.

As I said, most pain clinics I've been in had both the pain clinic AND the psychologist who specialized in pain. So I really don't know what to tell you. I guess I assumed they were all that way. LOL. Silly me. I wish you the very best. I hope your pain is relieved. God bless. hugs, Lee

Wow, what a concept...a psychologist in a pain management clinic. Now that would be nice to find. I know UC Davis claims to have this set up, but when I went to see a doctor there I met with one who told me I had lost my rights to pain management because I am a recovering alcoholic..HA! (Sober since 1998) What is up with that? After three visits the US Davis doc gave me the phone number for a gentleman who works with recovering addicts. I phoned him as instructed, found out what he really does, we talked at length, and he suggested I change doctors because I sure didn't sound like I needed his assistance.

The pain comes from cummulative trauma to my neck, followed by a specific incident requiring surigical intervention at C5-6 (discectomy with fusion and insertion of titanium plate). I was improving wonderfully, then was rear ended in a MVA while at a stop light. A full sized pick up truck hit me while going in excess of 30 mph. My 1 yr old car was totaled and 3 other vehicles were damaged. Since then the symptoms of nerve damage and/or pinching have come back as before the surgery. I have radiating pain from bilateral shoulders to bilateral fingertips. It's not bad if I don't use my hands or arms for anything...but you can imagine how that might go. I am on SSDI due to this and major depression/social anxiety with agoraphobia. I have a service dog which helps keep me in contact with the world and not hide out in my house at all times. (I did stay home for 3 years after the MVA, leaving only if my husband accompanied me.)

I really appreciate the information that opiates do not cause depression. I am on Kadian XR, Dilaudid, Celebrex, Soma, Effexor XR and klonipin. I see my psychiatrist today and think I will ask more questions about additional treatment for the depression since it has been so bad for the last 4 years. You've given me enough information that I now feel a bit more empowered to push the psychiatrist a bit for information. I've been with him since 1998 and really don't want to replace him, but don't have much of a choice if he is not going to treat my increased symptoms.

Still...if there is anyone who lives in No Cal who knows of a pain management clinic that also treats depression, it would be helpful.

Thanks,
Dawn

Ok, I found one for you. It's Northern California Pain Care, and here's the link to its http:norcalpaincare.com It has both the pain management and the psychologist. I was an idiot and didn't look to see exactly where it was but you can do that when you visit the site. I hope this helps you. Best of luck. God bless. Hugs, Lee

Ok, I found one for you. It's Northern California Pain Care, and here's the link to its http:www.norcalpaincare.com It has both the pain management and the psychologist. I was an idiot and didn't look to see exactly where it was but you can do that when you visit the site. I hope this helps you. Best of luck. God bless. Hugs, Lee

PS: if the link doesn't work just type it in the search engine.