A post circulating on social media explains that chronic pain and depression are "deeply interconnected" in the brain, citing "Ma et al., 2025". We checked. The paper exists and the post summarises it fairly. But the more useful study published this year is a different one: a large review showing how often chronic pain comes with mental health conditions, including ADHD and autism.
The Brain Side: Pain and Mood Share Wiring
The review cited in the post was published in Frontiers in Molecular Neuroscience in October 2025 by anaesthesiologists in China. It gathers existing research on the chemical messengers involved when pain and depression occur together:
- Glutamate and GABA. Too much excitation (glutamate) and too little braking (GABA) can make the nervous system over-sensitive, so pain signals feel stronger. This is called central sensitisation.
- The body's own opioids. This system dampens both pain and emotional distress. When it works less well, both get worse.
- Stress and social molecules. Substance P, the stress hormone CRF and oxytocin all act on pain and mood at the same time.
The brain regions involved, such as the prefrontal cortex, the anterior cingulate cortex and the amygdala, handle both pain and emotion. This is a narrative review: it summarises earlier work, much of it in animals, and brings no new data. It explains why the two problems feed each other. It does not tell you what to do about it.
The Numbers: A Review of Nearly a Million People
In August 2025, a team led by Brendon Stubbs at King's College London published the first "umbrella review" on the topic in European Psychiatry: a review of reviews and studies covering 957,168 people with a mental health condition and 16.6 million controls. For comparison, about 20 to 25 percent of the general population lives with chronic pain.
- Depression: 54 to 65 percent of people with major depression also had chronic pain. The link runs both ways: pain raises the risk of depression and depression raises the risk of pain, by about 1.3 to 1.9 times.
- PTSD: the highest figures, 88 to 96 percent, came from refugees living with PTSD. Another group reached 66 percent.
- ADHD: between 29 and 67 percent, but based on only two studies and 263 people with ADHD.
- ADHD and autism together: 77 percent in one small study of 77 people, with no comparison group. Lower back pain was the most common.
- Bipolar disorder: about 24 percent, close to the general population.
The figures for depression and PTSD rest on large amounts of data. The figures for ADHD and autism are real signals but come from very few people. They are a reason for more research, not a firm percentage.
What Helps? The Honest Answer
This is where the review is most sobering. For treatment, the evidence was sparse. Cognitive behavioural therapy had only a small effect on pain, too uncertain to be conclusive across the studies included. Acupuncture added to medication reduced pain in some studies, and brain stimulation helped pain in people with dementia. None of this adds up to a clear recipe. The authors' main message is practical: clinicians should ask about pain routinely in mental health care, and ask about mood routinely in pain clinics, then combine approaches.
What This Means for You
If you live with both pain and low mood, you are not imagining the connection, and treating only one side often leaves the other stuck. It is worth telling each professional about both. If you have ADHD, are autistic, or suspect you might be, and you also live with persistent pain, mention it: it is common and often overlooked. Our earlier article on ADHD and chronic pain looks at one large study in more detail.
Two free checks can help you start that conversation: the PHQ-9 depression screener, and, if your pain comes with very flexible joints, our hypermobility screening. Neither is a diagnosis. Both give you something concrete to bring to an appointment.
Sources: Ma M, Zhang Y, Tao K, Lu Z. "Neurochemical crossroads: exploring the neurotransmitter network in chronic pain and depression comorbidity." Frontiers in Molecular Neuroscience 2025;18:1675814. Stubbs B, Ma R, Solmi M, et al. "Chronic pain in mental disorders: an umbrella review of the prevalence, risk factors, and treatments across 957,168 people with mental disorders and 16,606,910 controls." European Psychiatry 2025;68(1):e113.