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Brace yourselves for a heavy but super important topic this week: depression and its relationship to fibromyalgia. In this post, we’re going to cover symptoms of clinical depression, how fibro fits in, and some ideas for how to break free from its worst effects. As unfortunate as it is, depression and fibromyalgia are so interconnected that it can seem like there’s a complete overlap. I struggled with depression myself for many years as a result of my fibro pain. But trust me, it’s not as hopeless as it might seem at first.
Alright. What exactly do we mean by “depression” in general? For starters, there’s a difference between depressive feelings and clinical depression, also called major depressive disorder. Even the most bubbly person – think Chris Trainer from Parks and Rec – has feelings of sadness or feeling down from time to time. This certainly could be labeled depression or depressive feelings. But sadly, what’s more common in the fibro community is a more lasting form of depression – clinical depression.
Clinical depression is not just feeling down from time to time. It’s persistently having feelings of flattened mood, worthlessness, or guilt. To be diagnosed, you must have been feeling this way for three months or more. In addition, other symptoms include feelings of hopelessness, angry outbursts, loss of interest or pleasure in normal activities such as sex, hobbies, or sports, sleep disturbances, tiredness, reduced appetite – or on the flip side – overeating leading to weight gain, anxiety, trouble thinking and concentrating, and recurrent thoughts of death or suicide.
Relationship to Fibromyalgia
Sound familiar? A lot of these symptoms go hand in hand or overlap with fibromyalgia. Even physical pain itself, like back pain or headaches, can be general symptoms of depression. It’s important to point out, however, that not everyone with fibromyalgia is clinically depressed, and depression does not cause fibro. But there is a correlation: physical pain can make depression worse and depression can make pain worse. Let’s face it: being in pain all the time is just straight-up depressing. So much so that studies have shown that about 90% of fibro patients also suffer from depressive symptoms and 62-86% of fibro patients meet the criteria for major depressive disorder. This is at least three times higher than the general population.
The link goes deeper. Studies have shown that those with fibromyalgia have altered brain chemistry that makes them more susceptible to depression. These elevated levels of inflammatory chemicals continue to worsen depression as time goes on. Not only that, but hormonal imbalances such as low thyroid and adrenal burnout make depression more likely as well.
My Battles with Depression
I have firsthand experience with how devastating clinical depression can be coupled with the chronic pain of fibromyalgia. I was 15 when I was diagnosed with fibro after a terrible case of mono that I never fully recovered from. Intense feelings of depression followed not long after. For me, it was this incredible heaviness weighing down my whole life. It was like the sun was behind the clouds and I couldn’t see the light. Even when the light peaked through for brief moments, it was blinding, like when you wake up in the morning and the sun gets in your eye, making you really uncomfortable. To be honest, the mental pain was worse than the physical pain. It was torture. I thought, “How can I live like this for 60 more years?” It was unthinkable.
Even with all that, I was lucky enough to have a supportive family and good health care at the time, so my doctor started the process of finding the right antidepressant prescription medication relatively early. Really though, all it came down to was trial and error. It took a while to find one that worked consistently with manageable side effects. And even then, it essentially just made me feel well enough to function and get through the day. I wouldn’t have even been able to get out of bed in the morning without it! With the medication, even though I still had rough patches, I was able to push through. My doctor said it would take about 6 years before I was able to wean myself off of it.
It turns out he was right. I never was a big fan of pharmaceuticals, so it was unsettling to have to take not only the antidepressant, but about a dozen other medications on top of that. I was able to cut out nearly everything after a few years, but I learned the hard way that the one that I absolutely could not afford to get rid of was the antidepressant. On two separate occasions I tried to quit the it early based on my intuition at the time. However, each time the feelings of intense depression and hopelessness creeped back in to the point where I was nonfunctional again. So it wasn’t until the third try, about 6 years after starting, that I was finally able to hobble my way off that medication too.
The silver lining to all of this is that our brains have this thing called “neuronal plasticity,” which means that, with training and the right treatment, we can regain healthy modes of seeing the world and possibly recover from even the deepest depression. So besides medication, what are some other treatments for dealing with depression when you have fibromyalgia?
Let’s start with over-the-counter supplements since we were just talking about biochemistry a minute ago. There are a couple such supplements that are known to provide a mood boosting effect. The first of these is folic acid. Folic acid is something that our body produces naturally so that our brains can make serotonin, which is a critical mood-boosting neurochemical. Fibro patients and depressed people in general are lacking folic acid in their system, so taking the activated form of folic acid as a supplement can really help. This one is especially good to take alongside prescription antidepressants as a complement to them.
Another supplement to consider is 5-HTP. Like folic acid, 5-HTP is something your body produces naturally and converts into serotonin. However, it can be a bit dangerous to combine with prescription antidepressants because it can lead to an overload of serotonin called serotonin syndrome if you’re not careful. So definitely talk with your doctor about this one if you’re already on antidepressants.
Depression is one of those problems that Western medicine has a good handle on since so much of it boils down to neurochemistry. It would be a bit naive to dismiss the advances in Western medicine that led to prescription antidepressants. However, there are some alternative, non-pill solutions that did help me along to get that last 10-15% of the recovery from depression. I know we have mentioned these many times before, but they are in fact useful treatments to fight depression along with everything else: yoga, meditation, and a good diet. I know I personally feel significantly less depressed when I get my body moving and my endorphins flowing with a good yoga session. Meditation does wonders to smooth out my thoughts and emotions. And eating well boosts my mood by making me feel light rather than heavy.
A Glimmer of Hope
A lot of us with fibro, myself included, have experienced that the first 7 years are the hardest, in large part due to depression. But in the long run, amazingly, a lot of us have been able to recover most of our lives. I wish I would’ve known at 19 when I was super depressed and in a lot of pain that even though there’s no cure, one day I would feel 80-90% recovered. Even just knowing that there was the potential for that would’ve made a huge difference in my outlook. But there was simply not enough information back then. Now we understand fibromyalgia a lot better, so if you’ve just been diagnosed and are feeling majorly depressed, just remember that there is hope if you can persevere through the first few most difficult years.
Hang in there and let’s continue to face fibromyalgia together.
- The Fibro Manual by Dr. Ginevra Liptan (2016) http://www.drliptan.com/book/