That's basically what I was trying to say, but I would emphasize that the pain is not a "psychiatric" problem but a problem with brain function. Fibromyalgia, for example, appears to be an abnormality in the normal muscle pain functions--nothing's being pinched, but something is acting as if it were.
I knew I wasn't going to get away with this example without some kind of response. So hopefully I'll just make one point and get back to the thread topic.
Do you have any minor discomforts that you just ignore? Of course. So there are two possibilities for psychogenic pain. One is an actual pain receptor pathway stimulant, whether originating in the nerve end or anywhere else along the path including the interpretive center in the brain. The other possibility is that one is paying more attention to the impulses along that pain receptor pathway which occur in everyone but which are usually ignored. It may seem like a nit pick of a distinction, and it may seem like it doesn't matter because the result is the same, real pain to the person experiencing it, but it does actually have very important implications in investigating and treating diseases like fibromyalgia.
Depression can be manifest in a multitude of ways not often recognized as depression. Not every person suffering depression mopes or feels sadness. Some people express depression with hostility and annoyance toward everything and some in perceived physical pain. Still others, not necessarily depressed (but it can be a co-diagnosis) report pain as a manipulative behavior where actual pain does not exist and perceived pain is not necessarily something triggering the pain pathway. We typically think of such behavior as drug seeking and some is, but not all.
Denial is part of the cascade of events so should be mentioned as well. Again addiction is a typical problem in which denial plays a big part, but there are other reasons one uses denial as a protective mechanism. And keep in mind that not all people using pain as a drug seeking behavior are outright faking the pain. It is an unconscious behavior in many cases.
Take a depressed person who's job is being affected and is affecting them in that they are having performance problems. They cannot get motivated to work. Their boss is giving them bad performance evaluations. But the depressed person doesn't recognize the depression is the underlying cause. The depressed person doesn't allow the performance evaluations to be considered because there is an ego protecting mechanism manifesting itself as denial. However, if one is experiencing pain, now that person can rationalize they have a "legitimate" reason to not go to work and to be performing poorly.
Pain with no cause outside of the brain isn't always drug seeking behavior, it isn't always depression, sometimes it's just how that person learned to cope with any number of things. Have you ever felt so overworked that getting sick sounded good because you could rest and do nothing?
Pain can be a symptom, a depressed person can be more sensitive to normal stimuli. Pain can be a protective mechanism, a person in denial for whatever reason has pain which legitimizes something else. And, pain can be manipulative behavior, drug seeking for example but there are other rewards such as attention or relief from responsibility. You can see that things get very complicated. Diagnoses are hard to make because the reasons for one's brain to use pain as a protective or coping mechanism are not always obvious.
Now, with all that said, and I do think with fibromyalgia the studies have been extensive enough, every once in a while a new disease is discovered that wasn't recognized that people do have that has nothing to do with psychological or behavioral factors yet was believed to be psychological. The key in the case of fibromyalgia is the almost complete failure of pain medications to treat the symptoms, and the fact that of all treatments, antidepressants are just about the only thing that has resulted in improvement in any patients.
OK, I'm too far off topic now but hopefully discussing the fact that depression is manifest in different ways was useful.