Psychosocial factors and medication

Is overcoming depression and anxiety a requirement to get rid of chronic pain? Or can chronic pain be overcome solely through doing rehab? How important are psychological and social factors compared to biological in the treatment and elimination of chronic pain?

I’ve been debating whether to try an SSRI, but I don’t want to deal with the sexual side effects, which can be permanent in some cases. My rehab is taking a lot longer than I’d like, even though I’ve worked with multiple physical therapists. I’m coming up on a year now of rehabbing tendinopathies, and the fact that I still have them is extremely discouraging.

I’m wondering if my nervous system is in a state of hypervigilance and the weight training isn’t really doing much to affect it all. I was reading about rheumatoid arthritis and central sensitization; RA patients often have central sensitization: https://www.google.com/amp/s/www.practicalpainmanagement.com/amp/20846.

My disease is well controlled though, as good as it can be given the medication available today. My biomarkers show I am in remission, but in terms of symptoms I still have active disease.