Fibromyalgia is a neurological disorder that affects approximately 12 million people in the U.S. This chronic disorder causes aches and pains in the body that are severe enough to impact normal activity and disrupt sleep. If those symptoms weren’t enough, however, fibromyalgia also often causes mental health issues for many patients. It can lead to cases of depression, anxiety, or other psychological disorders. Here’s what you need to know.
What is fibromyalgia?
A person with fibromyalgia may feel pain in the muscles, tissues, joints, and tendons in different areas of the body. Although most of the population has a spot or two on their body that may be more sensitive than others, people with fibromyalgia often experience excruciating tenderness in very specific locations that are spread across their body. Tenderness is generally mirrored on both sides of the body and is located at nine specific points.
As if this intense pain in the body is not enough, the chronic pain of fibromyalgia is often linked to mental health illnesses such as depression and anxiety. Consider this:
- 62% of fibromyalgia patients will experience depression in their lifetime
- 56% will experience anxiety
Mental health issues and fibromyalgia obviously connect. Finding out why fibromyalgia and depression and other mental illnesses are so common is important for appropriate treatments for the condition.
Other common fibromyalgia symptoms
Symptoms of fibromyalgia also include the following:
- Pain and tenderness in the body
- Extreme fatigue
- Cognitive dysfunction (also known as “fibro fog”)
- Digestive issues
These symptoms tend to be chronic, with their severity increasing and decreasing from day to day, and sometimes hour to hour. You can learn more by watching the following video about fibromyalgia.
Why are fibromyalgia and depression so common?
Dealing with the chronic, daily symptoms can be stressful, but the stress hormone cortisol can actually drop precipitously for those with fibromyalgia. A corresponding drop in production of the “feel-good” hormone serotonin creates the perfect storm of skewed hormones and chronic pain to increase the chance of depression and anxiety.
Jacob Teitelbaum, M.D., medical director of The Fibromyalgia & Fatigue Centers has this to say about what’s going on in the body:
“Biochemically, depression is very different in [people with] fibromyalgia than otherwise. In fibromyalgia, it is often associated with an underactive adrenal function [a low cortisol level], whereas depression [in a non-fibromyalgia population] is associated with a high cortisol level.”
And just as lack sleep can exacerbate the pain of fibromyalgia, so, too, can it deepen depression or heighten anxiety. This may manifest itself as shortness of breath in anxiety and a fluttery feeling in the chest, or malaise and lack of interest in depression. For some, lack of sleep and fibromyalgia come together in a diagnosis of chronic fatigue syndrome, (CFS) further complicating treatment of both conditions. Depression shares common underlying causes with CFS, but the two are separate conditions requiring separate treatments.
Some of the connection between mental health issues and fibromyalgia may lie in the fact that many people surrounding the fibromyalgia patient just don’t think it’s that bad. Thorsten Giesecke, MD, is a member of the University of Michigan research team that is using state-of-the-art technology to study fibromyalgia. He notes:
“People still doubt fibromyalgia is a disease. Previously, we found that fibromyalgia patients really do have increased central pain processing. Now we can show this is not affected by depression. Something is wrong here, and it is not at all connected with depression.”
But the fact remains that people with fibromyalgia are three times as likely to be diagnosed with depression. This diagnosis doesn’t necessarily increase the pain of fibromyalgia, but it may increase a patient’s perception of their own health. A study by the American College of Rheumatology found that even as depressed patients assessed their physical healthy poorly, their performance on pain-related assessments and tasks was not significantly different than non-depressed people.
This supports the idea that existence of mental health issues such as anxiety and depression make coping with the pain of fibromyalgia even more difficult. Both mental health conditions and fibromyalgia are “invisible” illnesses that make dealing with the social stigma part of both a challenge. Add additional health issues to the long-term issues surrounding both mental health and fibromyalgia, and you have the potential for increasing severity of both.
How you can treat fibromyalgia and mental illness
There are important interventions that can help treat both mental health issues and fibromyalgia.
Address sleep issues
Fatigue can make both mental health and fibromyalgia challenging. If you are having difficulty sleeping, take a long look at your “sleep hygiene.” Your bedroom should be a place for intimacy and sleep only: no work allowed. Remove TVs, computers, and anything else that puts off digital light. The room should be dark and cool, and heavy blankets may help sleep.
Maintain a sleep routine that includes going to bed at the same time each night. You can include a cup of soothing tea such as chamomile or a spray of lavender essential oil on your pillow.
It is understandable that those with fibromyalgia may be hesitant to exercise, but research continues to demonstrate that regular, moderate exercise keeps joints and muscles fluid and moving. This can help in the long-term with strength and soreness. Try low-impact exercise such as walking, biking, swimming, or yoga, and commit to starting today, even if it is just a little bit. The benefits of exercise include helping you get a good night’s sleep.
A diet that is high in whole grain, fruits, and vegetables and low in sugar, saturated fat, and red meat can help control inflammatory responses in the body. The link between sugar and mood regulation is also well-established, with sugar sending the body on a roller coaster of highs and lows, affecting mood in the process.
Drink plenty of water between meals, and eat nutrient-dense foods like seeds and nut butters, legumes, and whole grain pastas. Fresh fruit like tart cherries and watermelon are a great snack (try either in sorbet) and also have some natural pain-fighting compounds. Add antioxidant berries and you are giving yourself a mood boost at the same time.
A recent study by the Johns Hopkins School of Medicine found that meditation could be a huge treatment option for anxiety and depression. Researchers reviewed 47 clinical trials involving 3,515 participants and found that 30 minutes of “mindfulness meditation” daily eased symptoms of anxiety and depression.
“Mindfulness meditation” is the Buddhist practice of focusing on the moment that is occurring and nothing else. Participants who practiced daily showed as much relief from symptoms of depression and anxiety as those taking antidepressants, even when controlled for the placebo effect (in this case, participants feeling better just because they felt they were being treated for their condition).
Participants who meditated in this way generally focused on accepting thoughts and feelings and being non-judgmental of themselves and where they were with regard to their lives. Average time spent daily on this was between 30 and 40 minutes, and participants who participated in an eight-week training program that used mindfulness meditation saw improvement in their anxiety, depression, and pain symptoms.
“A lot of people have this idea that meditation means sitting down and doing nothing,” Madhav Goyal, lead researcher on the study, said. “But that’s not true. Meditation is an active training of the mind to increase awareness, and different meditation programs approach this in different ways.”
Benefits of meditation seemed to increase the longer meditation was practiced. Goyal cautioned that some of the literature reviewed seemed to have some problems, but that overall it was clear that meditation provided benefits for anxiety, depression, and pain relief that were not related to the placebo affect.
Managing your mental health issues
If you or someone you love has fibromyalgia and is also challenged with depression or anxiety, what have you found that helps with both? To learn more about how you can treat fibromyalgia and its related mental health issues, click the button below to find a pain doctor in your area.