FIBROMYALGIA AND CHRONIC FATIGUE SYNDROME

Chronic Pain | Chronic Fatigue | Depression | Anxiety
Sleep Dysfunction | Vitamin and Mineral Deficiency

Depression

Depression and Fibromyalgia Causes of Depression Treatment of Depression

Depression is a medical illness involving the mind and body that affects how one feels, thinks and behaves. One may have trouble doing daily activities and even feel as if life is not worth living. Depression is a real condition with physiological factors including genetic predisposition and neurotransmitter imbalances.

Depressive (and also anxiety) states are frequently observed in patients with fibromyalgia and chronic fatigue. The rate of lifetime major depression and anxiety disorders in patients with Fibromyalgia Syndrome and Chronic Fatigue Syndrome ranges from 26 to 71%.

How is Depression Associated with Fibromyalgia?

This association is a sensitive issue with people who have Fibromyalgia Syndrome and Chronic Fatigue Syndrome. In the past many physicians have told these patients who presented with pain and fatigue that they either had depression or anxiety. Physicians dismissed the physiology, neurology, and data available from FMS studies. Many patients were also told over and over again that their disease was "in their heads". Which resulted in a lack of trust, and irritable and resentful feelings, which lead into secondary depression and/or anxiety. Knowing what we know today, patients surrounded by invalidating family, friends, medical community, and environment, start to doubt themselves.

Symptoms of Depression

Feelings of sadness or unhappiness
Irritability or frustration even over small matters
Reduced sex drive
Insomnia or excess sleeping
Changes in appetite: decreased appetite with weight loss or increased appetite with weight gain
Agitation or restlessness (i.e. pacing, hand-wringing or inability to sit still)
Slowed thinking, speaking, or bodily movements
Indecisiveness, distractibility, and decreased concentration
Fatigue, loss of energy
Feelings of worthlessness or guilt, fixation on past failures, or blaming oneself when things aren't going well
Trouble thinking, concentrating, making decisions, and remembering
Thoughts of death, dying, or suicide
Crying spells for no apparent reason
Increased pain

Causes of Depression

1.	Changes in levels of neurotransmitters in the brain such as serotonin and norepinephrine (the same neurotransmitters that are involved in fFibromyalgia Syndrome and Chronic Fatigue Syndrome in about 80% of patients). Alterations in serotonergic neurotransmission is not only involved with depression but is also involved with chronic pain and fatigue, which are common complaints of patients with Fibromyalgia Syndrome and Chronic Fatigue Syndrome. Sleep disturbances are also a result of serotonin deficiency.
2.	Biological differences. People with depression appear to have physical changes in their brains.
3.	Hormone Imbalances: for example thyroid hormones or hormonal changes in menopause.
4.	Inherited Traits: Depression is more common in people whose family members also have depression
5.	Life Events and Triggers: (a) chronic pain - inability to predict timing and severity as in fms and cfs (b) chronic fatigue - which interfered with work, family, and self-care (c) non-restorative sleep - which leads to fatigue, pain, and cognitive problems (d) social and family pressures - due to inability to commit to scheduled events (e) possible personal loss of "the healthy/strong self" which leads to grieving (f) possible loss of functional abilities (g) isolation of self by others and from others (h) loss of self-worth (i) hopelessness, especially in the ability to heal and preserve life
6.	Early childhood trauma - traumatic events in childhood such as abuse, neglect, or loss of parent is commonly found in the history of Fibromyalgia Syndrome and Chronic Fatigue Syndrome patients.

Treatment of Depression and Anxiety