Depression is a low mood, including a tendency to cry, have dark thoughts, feelings of guilt and even of despair. People with depression often experience difficulty sleeping and tend to restrict their activities. They find it hard to concentrate and make decisions and sometimes report changes in appetite and weight. When people have pain, it is often the case that they get distressed and worried, and they may feel isolated, hopeless and helpless. While these feelings and thoughts are not necessarily an indication of a diagnosis of depression (a mental disorder), they have been shown to form obstacles to better coping and recovery. When patients with pain experience these types of emotions for a long time, or when they feel overwhelmed by their emotions, it is useful to seek clinical help.