Fibromyalgia And DEPRESSION

Preventing Fibromyalgia-Related Depression and Anxiety
Certain tactics can help keep depression and anxiety at bay when you have fibromyalgia
by Nancy Christie

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Depression and anxiety frequently accompany fibromyalgia. If your day-to-day functioning is impaired by either of these conditions, you may need to talk to your doctor about specific medications or professional psychotherapy. On the other hand, if your symptoms are mild, and you just feel sort of blue or mildly stressed out, taking proactive measures on your own may be all you need to do to feel better. Here are some suggestions for where to start.
Look for Hidden Culprits
The first step, says Pamela W. Smith, M.D., MPH, director of the Center for Healthy Living and Longevity and author of the bestselling book, HRT: The Answers and What You Must Know About Women’s Hormones, is to rule out any underlying physiological conditions that might be triggering your depression or anxiety symptoms. These might include such things as an underactive thyroid or hormonal or biochemical imbalances.
Talk to your doctor about getting tested. Often, appropriate medication can improve these conditions, and that in turn will help reduce mild accompanying symptoms of depression and anxiety. In some cases, physicians may also prescribe specific medications (usually antidepressants) to help increase levels of a brain chemical called serotonin. Serotonin, an important neurotransmitter, affects many basic psychological functions that seem to go awry in fibromyalgia, including mood, anxiety, and the sleep/wake cycle.
Make Lifestyle Changes
While any type of illness puts a strain on your body’s systems, chronic illnesses such as fibromyalgia can drain your body of the energy it needs to function well. A healthy diet, moderate amounts of gentle exercise, and plenty of restorative sleep will not only improve your overall health but also have a corresponding positive impact on your mood and attitude.  

 Diet — According to Lynne Matallana, founder and president of the National Fibromyalgia Association (NFA), fatigue is the second most commonly cited fibromyalgia symptom. Not only can this ongoing lack of energy cause patients to feel depressed, it can also lead to “self-medicating” with foods containing sugar or caffeine, eaten in an effort to counter the pervasive tiredness. Unfortunately, these choices can interfere with sleep patterns or cause “sugar highs,” which are followed by increased anxiety. Instead, the NFA recommends following a healthy diet rich in low-fat and high antioxidant foods. This will help maximize your energy and alertness and minimize constant fatigue — which should help counter or reduce episodes of depression and/or anxiety. Dr. Smith also recommends avoiding alcohol, which is a depressant, and using sugar only in moderation. “Fibromyalgia patients, particularly those with mitochondrial and adrenal issues, report having insomnia and intense anxiety, especially if they have sugar at night.”  

 Exercise — Studies have shown that exercise is linked to increased feelings of well-being in patients with fibromyalgia. An individually tailored program of gentle stretching and mild exercise can be very helpful but should be done under the guidance of a physician or a personal trainer experienced in dealing with fibromyalgia. If possible, schedule your exercise sessions at least five hours before bedtime. Because the body’s temperature rises during a workout, allowing a proper interval between exercise and bedtime will ensure that your temperature drops before you go to bed, making it easier to fall sleep.  

 Sleep — According to a report by The National Sleep Foundation, “Studies show a growing link between sleep duration and a variety of serious health problems, including obesity, diabetes, hypertension, and depression.” Some studies indicate patients with fibromyalgia have trouble going into REM sleep, possibly due to muscle pain, says Dr. Smith. There is also research exploring the link between low melatonin levels and fibromyalgia, which could be improved with melatonin supplements. Patients with fibromyalgia should also practice healthy sleep habits. Examples from the NFA include avoiding bright lights at bedtime (since they can inhibit melatonin production) and keeping to a regular sleep schedule.
Consider De-Stressing Therapies
Practicing classic de-stressing techniques, such as prayer, meditation, yoga, breathing exercises, tai chi and qi gong, can help people with fibromyalgia deal with their occasional periods of depression or anxiety. Think about signing up for a class to learn the basics, or check with your doctor about local practitioners.
Talk to a Counselor
Another approach for dealing with depression and anxiety is cognitive behavioral therapy (CBT). According to the American College of Rheumatology (ACR), CBT can help you redefine your “illness beliefs” and, through learning symptom reduction skills, enable you to change your behavioral response to pain as well as symptoms like depression. You might also want to consult a psychotherapist to determine if there are other causes, unrelated to the fibromyalgia, that may be causing your depression or anxiety.
Seek Support
Perhaps the best ally in fighting depression and anxiety is to have a strong support network: friends and family members with whom you can share your feelings. Joining a fibromyalgia or chronic pain support group is another good option. According to the ACR, associating with others who also have fibromyalgia can be very reassuring. Depression and anxiety are often very isolating, and in a group setting, people with fibromyalgia discover that they are not alone in what they are feeling, both physically and emotionally. Often, participants also hear about new coping strategies and learn the latest research results through contact with such a group.