The precise cause of depression is not known. In most cases multiple causes may be present. The severity and duration of depression is influenced by genetics, self image, your state of health and the environment. Everyone is susceptible to depression in the wake of major stress such as that which occurs with the loss of a loved one, after the end of an important relationship, with a major job change, after a move or with longstanding financial problems.

Job stress can pay an important role in the development of chronic pain and depression. Some of the job factors which might contribute include the following.

• Lack of control over job responsibilities
• Too much time away from home
• Unreasonable demands for work performance
• Repetitive activity or lifting which leads to daily discomfort or pain
• Frequent conflicts with supervisors or co-workers
• Lack of job security
• Night-shift work
• Frequent job shift changes
• Excessive overtime
• Perception of being underpaid for experience or performance

Depression can also adversely affect your overall health thus having additional negative impact on a spine problem. For example, it can cause an elevation of various stress hormones, which can damage the organs including the heart. Depression increases the likelihood of a person engaging in self-destructive behavior such as careless activities, over-indulging and driving recklessly.

Individuals with back pain and depression need to incorporate different self-help strategies to help manage their conditions. Some simple strategies are listed below.

Set realistic goals and prioritize tasks

• Spend more time with supportive family and friends
• Participate in a regular back care related exercise progam with individuals who have overcome or learned to mange their back pain.
• Avoid isolation and engage in activities you enjoy that do not increase back symptoms. 

If you suspect you have depression, schedule a physical examination with your family doctor or primary health care professional. There are numerous medical conditions which cause signs and symptoms similar to primary depression. Examples of these conditions include sleep deprivation, viral infection, and a low testosterone level can produce symptoms similar to male depression. If your attending doctor rules out an underlying medical condition further assessment may include a depression screening. The treatment of moderate to severe depression may require the use of medication and psychotherapy. Mild depression often resolves with proper nutritional supplementation and lifestyle modification.