Fibromyalgia and Depression

Reviewed by QualityHealth's Medical Advisory Board
About 30 to 40 percent of people who have fibromyalgia also suffer from depression, according to the National Fibromyalgia Association (NFA). The link between the two conditions is not clear, and health professionals believe that depression in fibromyalgia is often poorly treated.
Some research suggests that major depression and fibromyalgia have similar genetic risk factors, including a dysfunction in the serotonin neurotransmitter system. Researchers also suggest that the predisposition to depression may actually trigger fibromyalgia.
In addition, fibromyalgia also causes chronic pain, which is a leading cause of depression. Although this mood disorder and fibromyalgia are linked, the NFA states that they are two separate conditions that have their own causes and require their own treatment. Other research presented at an American College of Rheumatology Scientific Meeting a few years ago backs up the NFA's position.
In the study, researchers found that there was no direct association between depression, severe sensitivity to pain, and how pain is processed in the brain in people with fibromyalgia - who had or didn't have the mood disorder.
The researchers point out that some physicians mistakenly treat the depression, assuming it's the cause of fibromyalgia pain. However, their findings indicate that the two conditions are separate and those who suffer from chronic pain with depression do not process pain differently compared to those without the mood disorder.
How to Cope with Depression When You Have Fibromyalgia
Within the medical community the jury is still out about the best ways to treat fibromyalgia in general - but also when it's combined with depression. You must be proactive about your care.
• Recognize the symptoms of depression. This can be tricky, as the NFA points out, because some symptoms of fibromyalgia are similar to this mood disorder. They include loss of interest in activities, feeling empty or constantly sad, fatigue, and suicidal thoughts. A specialist can conduct several tests to determine if your symptoms are major depression.
• Don't be ashamed to seek treatment. Many people who experience depression initially feel embarrassed or guilty about getting help. Remember that it is a medical condition that needs to be professionally treated, such as cancer or diabetes. The NFA states that treatment for depression will improve fibromyalgia symptoms in general.
• Fine-tune your treatment. Fibromyalgia symptoms vary from person to person. Make sure your doctor is prescribing treatment that specifically targets your range of symptoms. For instance, pain isn't the only symptoms that can worsen depression; fatigue and insomnia can play a role.
• Improve pain management. Even if chronic pain of fibromyalgia isn't directly responsible for depression, it can limit your ability to cope. If your pain medication regimen isn't effective, ask your doctor about more effective drugs.
Or, try alternative pain management techniques such as acupuncture, infrared sauna therapy—or naprapathy, which involves manipulating connective tissue.
• Seek counselling. Treatments for depression may include psychotherapy or cognitive behavioral therapy to improve coping mechanisms and stress management, biofeedback, individual counselling, or support group participation.
• Exercise. Physical activity provides several benefits when you have fibromyalgia: It helps to reduce pain, increases the production of hormones that improve your mood, and may alleviate fatigue or insomnia.