Depression and Fibromyalgia
Sunday, October 1, 2006
By: Lynne Matallana
Reprinted from FMOnline
When dealing with a chronic pain illness, it is no wonder that a person with fibromyalgia may develop secondary psychological complaints, such as depression, fear, anger, and/ or anxiety. Fibromyalgia is not a psychological illness; however, all physiological illnesses also affect you emotionally. It’s important to remember that we are a complete entity: body, mind, and spirit.
Because our physical experiences are intertwined with our emotional experiences (and vice versa), it is not difficult to understand that it is beneficial to seek treatment for both your physical and emotional self. Certain things that can be part of the fibromyalgia experience can cause you to become frustrated and even depressed. For example, experiencing a prolonged pre-diagnosis period, poor or limited support from the medical community, lack of understanding by family members and friends, severe chronic pain and fatigue that can last for weeks and even months at a time, changes that disrupt your lifestyle, and the inability to do the things that you used to do can all affect your emotional health. Even the most optimistic person can become emotionally challenged when it comes to the symptoms and life-altering challenges that can result from fibromyalgia.
Depression is not an emotional weakness or something that you can just will away, but rather a complicated medical condition that is caused by chemical imbalances in the brain.
Because fibromyalgia has multiple symptoms, many of which are the same as depression, it’s easy to miss the signs of depression. Sometimes the symptoms come on slowly over time, and you might not be aware that you are experiencing them.
If you have lost interest in activities that used to bring you enjoyment, or if you avoid participating in the normal activities of life because you feel empty, lonely, or fatigued, it is time to discuss your symptoms with a health-care professional. It might be uncomfortable admitting that you are depressed, but by denying it, you are denying yourself treatment. Because co-existing illnesses have a relationship to one another, by treating your depression, you should also see improvement in your fibromyalgia.
Although admitting that you are unhappy or even depressed might be a new and difficult experience for you, it is important to remember that these feelings are not a sign of weakness. Asking for emotional support and/ or seeking out psychological treatment(s) can be an important part of your overall health improvement.
Psychological and physiological symptoms can be treated with pharmacological agents or through behavioral interventions. Robert Bennett, MD, feels that psychological counseling, particularly the use of techniques such as cognitive restructuring and biofeedback, may benefit some individuals who are having difficulties coping with the realities of living with their physical pain and associated psychological symptoms.
Developing these symptoms isn’t something you should feel guilty or embarrassed about. Learning to adjust to new challenges and circumstances can cause anyone to need emotional support. If you made the decision to start a new career, it would not be unusual to seek out counseling or get assistance from an expert in the field. In dealing with lifestyle changes and emotional issues, it also makes sense to seek out counseling or assistance!
Along with the various types of medical treatments that treat the physical aspects of fibromyalgia, there are other treatment options that can treat the mental, emotional, and spiritual aspects of your health.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT) has been well studied as an additive approach to the traditional medical treatment of chronic pain and fibromyalgia. As David Williams, Ph.D., University of Michigan, points out, if two individuals have fibromyalgia, their reaction to pain will differ. Your own individual coping skills, learned behaviors, and emotional reactions will influence not only how you will react to pain, but how you will experience it.
One way to learn how to manage the symptoms of worsening pain is through CBT. By learning to recognize maladaptive thoughts and practice specific techniques for pain management, you might produce improvements in your overall pain. The major philosophical assumption of CBT is that by changing your thinking and your belief system, you in turn change your behavior. This in no way means that you have to “think yourself well.” If, however, you accept the fact that there is a strong connection between what you think and how you feel both emotionally and physically, you will benefit in learning how to develop skills to help change your thinking and to develop an aptitude to solve problems.
Biofeedback is a treatment technique in which people are trained to improve their own health by using signals from their body. A person is hooked up to one of numerous types of biofeedback machines. The machine can detect sensitive internal bodily functions and report (through lights, bells, graphs, pictures, and so on) important information that will help both the patient and therapist gauge and direct the progress of treatment. For patients, the biofeedback machine acts as a sixth sense that allows them to visually recognize the activities going on inside their bodies. It can also act as a reward system for patients, letting them know (through lights, bells, and pictures) when they are mentally changing the responses happening in their bodies. For example, the machine can pick up electrical signals in muscles and then report this activity back to patients in the form of a bright flashing light, or a line on a screen that moves upward with tension and downward with muscle relaxation. The light flashes faster or the line moves upward if the machine picks up signals that reflect tension in muscles. With this information, patients can recognize what is happening in their bodies and make an active mental attempt to change those responses.
The biofeedback process has shown that people have more control over their involuntary bodily functions (heart rate, digestion, pain) than once thought. But nature limits the extent of such control. The biofeedback technique puts a lot of demands on patients requiring them to practice biofeedback techniques every day. The lessons learned, however, may help patients feel more in control over migraine and tension headaches, muscle tension and pain, high and low blood pressure, digestive problems, and blood circulation.>Individual Therapy
Individual therapy consists of one-on-one counseling. It is comprised of individual time with the primary therapist, medical provider, or specialty therapists. Such a working relationship may last for only a few sessions or may continue for much longer, depending on your needs. Although talking to a counselor for the first time can feel awkward of embarrassing, individual therapy can be effective in helping you deal with a variety of issues and help improve your quality of life.
Supportive Group Therapy
Group therapy is the process in which individuals with similar issues or health-condition challenges meet in a group setting, with a designated leader (facilitator, therapist, or health-care professional) to benefit from the exchange or experiences and thoughts that lead to the discussion of positive ways to solve problems. The dynamics and direction of the group must be kept in line with the goals of the session by the group’s leader.
People with fibromyalgia may benefit from both structured group-therapy sessions and more informal support-group meetings. In a medically directed forum, participants usually are the ones who decide the topics to be discussed and the direction of the discussion (with the guidance of the health-care professional). In a support-group meeting, an expert usually shares information that is then discussed, questioned, and absorbed.
Excerpted from The Complete Idiot’s Guide to Fibromyalgia