Depression is a psychological disorder. Interrelationships between depression and physical health are evident, and may manifest as commonly unrecognizable signs and symptoms. This inquiry may support clinicians in optimizing treatment for patients who undergo surgical procedures likely to induce pain, who also present with underlying depression. If clinical depression is implicated as a variable which negatively influences a patient's perception of pain, or which serves as a barrier to pain relief, poor clinical outcomes may result. Understanding the barriers to postoperative pain management, with an emphasis on depression as a variable co-morbidity, may challenge conventional therapeutic modalities currently in use.