Fibromyalgia, a disorder of pain processing that results in chronic pain, fatigue, and a plethora of other potential symptoms, has many potential comorbid conditions. Conditions that commonly occur along with fibromyalgia include chronic insomnia, migraine headaches, anxiety and depression. This article will focus on depression in the fibromyalgia patient.
Depression is one of the most common concurrent conditions with fibromyalgia, affecting about 30% of fibromyalgia patients. Both depression and fibromyalgia are caused by problems with the central nervous system. Depression is linked to imbalances in neurotransmitters that convey signals in the brain and the rest of the nervous system. It is not surprising that fibromyalgia patients experience problems with depression and anxiety, because fibromyalgia is a difficult condition to cope with. Fibromyalgia causes chronic pain and fatigue that can get in the way of obligations and desires, and there is no cure. Fibromyalgia patients have to deal with high levels of stress, and stressful situations over the long term can cause problems with depression or anxiety. Not all fibromyalgia patients become depressed, but depression is common in fibromyalgia patients. Fibromyalgia may lead to depression via changes in brain function, but it can also lead to depression through how chronic pain impacts an individual’s life.
In order to qualify for a diagnosis of major depression, also called clinical depression, the symptoms of depression must last for weeks. It is possible to experience these symptoms for shorter periods of time, but this is indicative of stress and sadness, not full-blown depression. Symptoms of depression include: loss of motivation and pleasure in doing the things you used to enjoy, indecisiveness, feeling sad, crying frequently, guilt, feeling worthless, fatigue, changes in appetite that cause significant weight gain or loss and even thoughts of death or suicide. Clinical depression is the most common form of depression experienced by fibromyalgia patients; other types of depression include seasonal depression and bipolar depression. The length of time that clinical depression lasts is variable and depends on many factors. If you know you are depressed, seeking treatment can help.
The best treatment for depression is the use of antidepressant medications. This is especially true in the case of fibromyalgia patients with depression, because antidepressants are an effective treatment for fibromyalgia, regardless of whether symptoms of depression are present. In fibromyalgia patients, antidepressants are used to reduce levels of fatigue and muscle pain, but they can also have an impact on mood in those who are suffering from depression. The most common type of antidepressant prescribed for fibromyalgia patients is called a tricyclic antidepressant. Antidepressants called selective serotonin reuptake inhibitors (SSRIs) are also prescribed, and in some cases an SSRI and tricyclic antidepressant may both be prescribed for control of pain and fatigue in fibromyalgia. Another type of antidepressant, called a mixed reuptake inhibitor, is also sometimes used. If a fibromyalgia patient is experiencing muscle pain and fatigue without symptoms of depression, antidepressants are prescribed at a lower dose than is necessary to treat depression. If a fibromyalgia patient is experiencing symptoms of depression, the medication is prescribed at the normal level for treating depression.
While medications are immensely helpful in fibromyalgia patients who are suffering from depression, medication alone may not be enough to completely solve the problems of depression. Medication primes your brain to get better by fixing chemical imbalances, but your thoughts can also have an impact on your mood. Therapy and lifestyle changes can also have a positive impact on depression symptoms. Therapy for depression involves talking with a psychologist alone or in a group. Therapy is not always easy to go through, but hearing another perspective can give you insight regarding your life that you would not have been able to get on your own.
Lifestyle changes that can help with feelings of depression include improving sleep, better nutrition, exercise, reducing stress and maintaining social support systems. Fibromyalgia patients may already have a problem with sleeping, so getting enough sleep may be difficult. The better your pain is managed, the better you will sleep, so medications such as antidepressants can be the first step to improving sleep quality. Other tips for sleeping well include giving yourself enough time to sleep, making sure your sleeping area is quiet, dark and a comfortable temperature, and avoiding caffeine six hours before you go to sleep. About 30 minutes to an hour of exercise each day can boost your mood and also has cardiovascular benefits. Eating well can maximize the amount of energy you have. One of the most important things you can do is to insure that you do not become socially isolated. The more that you are around people, the more motivated you will become. Anything from meeting with friends and family to joining a support group or taking some kind of class can be a step towards helping you get back control of your life.