Almost everyone has heard of or known of a patient with depression who says they are in pain. It must sometimes seem weird. After all, how could a psychological condition be causing physical pain? Well, that pain is not something imaginary. It’s real.

Anyone who has ever lived a life not pampered by obscene wealth will likely relate to the feeling of stress. More accurately, they will likely relate to the experience of ‘tense muscles’. Everyone knows that pain relatively well. That is the exact pain that people with depression experience.

Muscle tension is part of the fight or flight response. When you are afraid, you feel stress, which activates a whole slew of bodily reactions, from adrenaline to tenseness. But fear is not the only thing that triggers stress. Life in general in our fast-paced modernised society is generally stressful. Work. Social responsibilities. A bad day. All those things and more generate stress

Everyone has been stressed at some point. When stressed, people often says their “Joints are stiff.” That’s the body being unable to differentiate the difference between ‘fight or flight’ stress and daily stress. More often than not, people cope with these daily stress by relaxing in their own ways. Hobbies, social outings, massages, the works. But that gets expensive very quickly if daily ‘de-stresses’ are needed. Drinking, partying, drugs, sex, all requires money. For people on the poorer end of the scale, this becomes contradictorily healthier, as they tend to drop into works of fiction like books and games which are less expensive. Either way, the cost required to maintain a low stress life stacks up with depression, which is why mental illnesses that causes it often severely affect a person’s standard of living financially.

One form of stress inducer is uniquely damaging to the mentally ill, and that is sadness. Sadness creates stress, but for those suffering through depression, that stress never leaves them. Depression happens basically when your brain forgets how to turn off the chemical creation that stimulates sadness. It is quite literally the brain malfunctioning.

When that happens, your body goes into this constant state of sadness, which induces stress. And as stated before, the body is unable to identify stress for survival and those of sadness, and treats them the same. In the end, depressed people are stuck in a constant state of fight or flight, having a literal battle within themselves on a daily basis.

Imagine that stiff neck and creaking shoulder never going away. Imagine if that discomfort stays with you for weeks, months, maybe even years at a time. That is the physical pain that people with depression feel. That pain stays for so long that it becomes a normal thing. You feel it as naturally as you breathe.

When those depressed says their body hurts and they feel like they are in pain, they mean it. Their muscles are tensed, constantly awaiting for something bad to happen that never will. In turn, the constant strain informs the brain that the body is under physical threat, creating more stress. It becomes an endless cycle.

That is the reason why people with depression self medicate with alcohol and drugs as a desperate attempt to rid their body of both the sadness and pain. The person falls back on things that once gave them joy, numbness, or apathy. Depression causes the pain, but in turn, the pain perpetuates the sadness. When a person’s body is stiff from stress, they lose the will to do activities that could otherwise help them. Exercising. Going out. Just staying awake becomes difficult. In the end, sleep becomes an escape, which many depressed individuals do rely on. And because sleep becomes the escape, doing daily activities becomes even harder.