Is there a link between depression and fibromyalgia?

Debra Fulghum Bruce PhD
Healthcare Specialist

Depression is a key symptom with most people with fibromyalgia. In fact, anxiety and depression severe enough to interfere with daily activities occur in as many as 50 percent or more of those with fibromyalgia. Stress from the constant pain and fatigue can cause anxiety. The chronic pain can result in less activity, becoming more withdrawn and can lead to depression. It is also possible that anxiety and depression may actually be a part of fibromyalgia, just like the pain.

No matter which case is eventually found to be correct, anxiety and depression can greatly interfere with a patient's activities at work and at home. The symptoms can be successfully treated with a combination of medication and therapy, so it is important to openly discuss these feelings with your doctor.

This is more likely a result of the frustration of the widespread pain syndrome, the lack of quickly diagnosing the illness, or the chronic nature of the syndrome.

It is not clear that depression causes fibromyalgia or fibromyalgia has depression as a part of the syndrome.

Dr. Stephen Q. Parker, MD
Physical Medicine & Rehabilitation Specialist

Fibromyalgia (FM) can be a very frustrating and mysterious disorder that can lead to depression. There are various theories as to how FM develops all of which have some merit. Despite this, FM is still being misdiagnosed, which results in wrong treatments and outcomes. As a result, depression could develop which can further exacerbate the symptoms of FM. It is important to treat the symptoms of FM and depression when at all possible to alleviate the symptoms.

Dr. David C. Fiore, MD
Family Practitioner

Depression and/or anxiety have been found to be in 30 to 50 percent of patients that have been diagnosed with fibromyalgia. Mood disturbances and difficulty concentrating have also been attributed to fibromyalgia, but are also common complaints with depression. It is important to be aware that depression is often seen with fibromyalgia, so that it can be addressed as well.

Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

Depression and fibromyalgia often go hand in hand. But it's the classic chicken-and-egg problem: What came first? Chronic pain, waking up feeling tired, having trouble sleeping and other symptoms of fibromyalgia are pretty debilitating, and can often contribute to depression.

But the more we get to understand how the brains of people with fibro are wired differently, the more we realize that the connection might go the other way too. The same imbalances of brain chemicals that make you more sensitive to pain signals may also make you more likely to develop depression. The important thing to remember is that the things that help with your pain and fatigue may also help with your depression. If you are depressed, make sure you get help for your depression as well as your fibromyalgia. Working on either condition will help you solve the other one.

Because fibromyalgia is a complex mind-body condition, the solutions for it need to involve your body and your mind. That means getting the medical care you need, including prescription medications, as well as following a healthy lifestyle that will help reduce your pain, improve your sleep, lower your stress and improve your moods. A healthy lifestyle includes getting regular gentle exercise, creating a routine time to eat, sleep and exercise, and finding ways to reduce stress. Mind-body practices such as yoga or tai chi provide exercise while teaching you how to relax and giving you new ways to cope, which can help break the negative cycle of stress, depression, sleep problems and fibromyalgia pain.

Dr. Dede Bonner
Health Education Specialist

Seattle-based fibromyalgia expert Dr. Patrick Wood offers, “I think there’s a risk in thinking that fibromyalgia is just an abnormal type of depression. Anxiety is a much more common part of living with fibromyalgia than ‘depressiveness.’ Anxiousness has a great impact on the daily functioning of fibromyalgia patients. It’s not unusual for anyone with a chronic, disabling condition to become discouraged.”

You can move beyond depression by proactively arming yourself with medical knowledge about fibromyalgia and making healthy lifestyle changes. If your depression is affecting your sleep with fibromyalgia, try to avoid getting too fixated and overreacting to your sleep problems. For some people, just seeing their bed fills them with despair.  If you are at this point, talk to your doctor or seek specialized help from a sleep medicine expert, neurologist, or psychologist. Also seek professional help if you have suicidal thoughts, your depression persists more than two weeks or you have no one to talk with.

The 10 Best Questions for Living with Fibromyalgia: The Script You Need to Take Control of Your Health

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The 10 Best Questions for Living with Fibromyalgia: The Script You Need to Take Control of Your Health

An indispensable resource that empowers fibromyalgia patients to take charge of a debilitating disease and get the health care they deserve. Fibromyalgia—a painful, exhausting, and often misdiagnosed disease—affects up to 12 million Americans (90 percent of them women). And because many health care professionals are still learning how to diagnosis and treat its confusing symptoms, patients living with the disorder must become proactive and informed consumers for their own health. The expert advice found within The 10 Best Questions™ for Living with Fibromyalgia gives readers the answers they need to get the best care possible and enjoy a more normal life. This essential book provides the Best Questions that patients should ask their doctors, partners, children, and friends, accompanied by the “best answers” drawn from cutting edge research and extensive interviews with the top experts in the field. There are chapters on what to ask about your diagnosis, test results, second opinions, for ongoing disease management, to lose weight, get more sleep, and to make other healthy lifestyle changes. This practical and holistic book also offers Best Questions and advice for fibromyalgia patients for their relationships with partners, children, friends to ensure emotional, financial, and spiritual health. Each chapter concludes with The Magic Question™, the one crucial question most people never think to ask until it’s too late.

Fibromyalgia can be painful and incredibly frustrating. It may limit your abilities and prevent you from doing things that you love. Not to mention the fact that it might affect your job performance. All of these things can lead to stress, which just makes fibromyalgia worse. People often develop depression as a result of their fibromyalgia. It's important to realize that this isn't uncommon.

People with fibromyalgia can lead happy and full lives and should not allow the condition to cause them to be alone. Staying active can help ease depression and anxiety. Exercise boosts endorphins, the "feel good" chemicals in your brain.

If you become depressed, talk to your doctor about finding a therapist who can help or a support group for people with fibromyalgia in your area. Your mental health is just as important as your physical health if you want to minimize your symptoms.

Dr. Devi E. Nampiaparampil, MD
Pain Medicine Specialist

Being diagnosed with any type of chronic condition, especially a painful one, can cause feelings of sadness and loss.

Many people with fibromyalgia also have symptoms of a clinical depression. These symptoms include change in sleep habits, change in appetite, and feelings of worthlessness or guilt. If you are experiencing those types of symptoms, it is worth getting the depression evaluated and treated. The depression and the fibromyalgia are two separate clinical conditions that need to be addressed. It will be difficult to treat one condition effectively without addressing the other one.

Yes, depression is a common symptom with fibromyalgia. Sometimes depression leads to changes in the chemistry of the brain. Or depression can cause abnormalities of the sympathetic nervous system that result in the release of substances that cause more sensitivity to pain. It is thought that the ongoing chronic pain of fibromyalgia may cause feelings of depression. Many chronic illnesses can lead to depression if the person has ongoing pain or other symptoms that disrupt their quality of life. With fibromyalgia, it is easy to miss the signs of depression. That's why a visit to the doctor to discuss the symptoms of fibromyalgia is vital to getting relief. There are newer medications available that treat fibromyalgia pain and depression, so talk with your doctor about your feelings and symptoms.

There is an association between fibromyalgia and depression. Depression and anxiety are included in the American College of Rheumatology criteria and clinical features of fibromyalgia. In four large clinical studies, 34 percent of patients with fibromyalgia were also found to have depression. It is important to recognize the link between fibromyalgia and depression, so that you may seek appropriate treatment from your doctor, including antidepressants.

Dr. Jacob Teitelbaum
Integrative Medicine Specialist

Although one out of eight people with fibromyalgia also have depression, these are two very different illnesses. Biochemically, for example, adrenal stress cortisol levels tend to be lower in fibromyalgia, but elevated in depression.

Answering the simple question "Do I have many interests?" will tell you if you are also depressed. If you have many interests but are frustrated that you're too sick to do them, you are likely not depressed.

Pain-induced mood swings are more than a nuisance. They can lead to clinical depression or anxiety, two mood disorders commonly seen in fibromyalgia patients. Sometimes antidepressant medications—often prescribed in lower doses to treat fibromyalgia pain—may also help reduce symptoms of anxiety or depression.

About 20 percent of people with fibromyalgia (FM) have a co-existing depression or anxiety state that needs to be appropriately treated with therapeutic doses of antidepressants or anti-anxiety drugs, often in conjunction with the help of a clinical psychologist or psychiatrist. Basically, people who have a concomitant psychiatric problem have a double burden to bear. They will find it easier to cope with their FM if the psychiatric condition is appropriately treated. It is important to understand that fibromyalgia itself is not a psychogenic pain problem, and that treatment of any underlying psychological problems does not cure FM.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.