depression and fibromyalgia

Depression – an Invisible Symptom of Fibromyalgia

fibromyalgia and depression

“How are you? You look great! Gosh, I wish I were as healthy as you are! I got a cold two weeks ago. That was the worst! You’re so lucky you don’t have to deal with the kind of stuffy nose I had!”

“You’re still in bed? What’s wrong with you?!? Get up already!”

“What do you mean, ‘you don’t feel like going out?’ You never have fun!”

If I had a dollar for every time I have wanted to snap back at people when I hear these things, I would be super rich. But I’m not rich yet because some (small) part of me still considers it bad manners to bark at people.

Here is the deal. Fibro Warriors have to deal with a laundry list of symptoms that no one can see. I mean, there is no doubt for example that when you see someone walking with crutches, their leg or foot might hurt.

If you have a sling, you hurt your arm or your shoulder. Back brace, your back hurts. Eyepatch, you may be a pirate, or you may have eye problems. Those things are obvious.

But with fibromyalgia, no one – and I mean absolutely no one – can tell that you’re hurting by just looking at you. Of course, people can read your pain symptoms when they see you cringe or when you have a hard time getting up.

But the fact remains: you can never tell by looking at someone if they are depressed or not.

It will never end

Every day, all day long, even when I’m in bed, I am reminded that fibromyalgia will never ever end. At this point in my life, and given the medical research of today, there is no cure.

There. Is. No. Cure.

NO CURE.

Let that sink in for a minute. I am guaranteed a lifetime of physical pain with minimal relief.

And if that’s not a good enough reason for me to be depressed, then I don’t know what is.

Depression is real

Depression is a very real condition. Unfortunately, many people around the world suffer from depression.

Now, I don’t mean a bit of the blues here and there. I don’t mean being down because the coffee shop didn’t have your favorite biscotti in stock. I am not even talking about the deep sorrow you may feel when a friend passes away.

Depression is a clinical diagnosis, and while people sometimes tend to throw the word around like it’s a juggling ball, depression is defined by specific medical criteria.

Before I continue, I want you all to know that you are loved, you are worthy and you matter. If you think you may be clinically depressed, consider consulting a medical professional. The internet is wonderful and thefibrowarriors.com has amazing resources, but your health is important.

There is no shame

Look, no one would blame a person suffering from psoriasis for their symptoms. By the same token, no one should blame you for your fibromyalgia symptoms.

And you shouldn’t blame yourself either.

Mental health is an important part of the whole approach to wellness. You did not choose to be sick. But you can take steps to alleviate the symptoms.

What does depression look like?

Depression looks like you and me! There is no outward sign of depression, unlike chicken pox or a broken bone.

The National Institute for Mental Health has defined the possible symptoms of depression as follows:

  • Difficulty concentrating, remembering details, and making decisions
  • Fatigue and decreased energy
  • Feelings of guilt, worthlessness, and/or helplessness
  • Feelings of hopelessness and/or pessimism
  • Insomnia, early-morning wakefulness, or excessive sleeping
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable, including sex
  • Overeating or appetite loss
  • Persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment
  • Persistent sad, anxious, or “empty” feelings
  • Thoughts of suicide, suicide attempts

As you can see, depression is like a chameleon. It disguises itself in pernicious ways, often mimicking symptoms of other ailments. Many depression symptoms actually resemble plain ol’ fibromyalgia symptoms. That makes it quite hard to identify what is due to fibromyalgia and what is due to depression itself.

One thing is for sure: knowing that you have a lifelong affliction can (and will!) take a toll on your morale, unfortunately.

Depression can lead to suicidal thoughts

Before I go further, let me stress the point that if you feel like your depression symptoms are getting out of hand, do not hesitate to contact your local suicide prevention resources. They are highly trained people who will help you sort through your feelings.

There is NEVER a call “in vain,” or a “bothering” call. Don’t ever feel like your story is less valuable than someone else’s. Kind of like the adage saying there are no stupid questions, there are no stupid calls.

Depression feelings can spiral out of control very, very fast.

In the US – Call 1-800-SUICIDE (1-800-784-2433) or 1-800-273-TALK (1-800-273-8255); or the deaf hotline at 1-800-799-4TTY (1-800-799-4889).

For other countries, you can refer to this webpage listing the suicide prevention hotlines throughout the world – http://togetherweare-strong.tumblr.com/helpline

Common suicidal thoughts or tendencies will have classic narratives, such as thinking the world would be better off without you, your loved ones would have an easier life, the suffering would end, losing interest in your hobbies, not finding joy in things that used to make you happy, and feeling worthless. Of course, these are just examples. There are many more manifestations of extreme depressive thoughts that could lead to suicidal thoughts.

If you have persistent suicidal thoughts, strong suicidal urges, or if someone you know is feeling that way, you can always go to your local hospital, or call your local emergency services.

One more time for good measure: you are worthy, you are loved and you have not done anything to be ashamed of.

Who can diagnose depression?

Depression is a clinical diagnosis. It goes further than just feeling down for a little while. Depression can have serious repercussions on your own life and on your loved ones’ lives.

Consulting a medical professional is the only proper way to ascertain a depression diagnosis.

Generally speaking, the appointment will follow pretty many universal guidelines to determine the severity of your depression.

After taking down a medical and family history, your health care provider will discuss with you the symptoms you have been feeling, as well as what triggers the symptoms if they are intermittent.

You will need to come prepared for your appointment with the answers to the following questions.

Keep in mind your doctor may need more or less information than what is below, depending on how well he or she knows you, how long you have been seeing him or her, and how severe your symptoms are.

Prepare your answers ahead of time so you’re not taken by surprise. It is super easy to forget what you wanted to say once you’re in that office. And of course, you’ll remember these things right when you step out!

  • What do you think your symptoms are?
  • When did the symptoms start?
  • What medications do you currently take?
  • Do you have another diagnosis that could influence your depression symptoms?
  • How long have you suffered from fibromyalgia?
  • Are there days you feel better than others, physically and mentally?
  • Do you know what could make you feel better, but you just can’t do it?
  • Do you sleep too much? Too little?
  • Do you have racing negative thoughts you can’t shut down?
  • Are you aware of a family history of depression?
  • Have you ever been diagnosed with depression yourself? If so, what helped?
  • Is there a history of mental health challenges, either for yourself or your family?
  • Is there a history of drug abuse or alcohol abuse?
  • Have you suffered from any kind trauma in your past that may be resurfacing now?
  • Are there sources of stress in your life, aside from Fibromyalgia, that may make it difficult for you to be positive?
  • Do your symptoms affect your daily routine (sleeping, eating, going out with friends, etc)?
  • Are your symptoms overwhelming at times, to the point of canceling plans or staying in bed all day?
  • Do your symptoms affect your relationships with others?
  • Do you ever feel helpless, worthless or like no one understands you?
  • Do you think you have a good support system at home? At work?
  • Do you know who to turn to or who to reach if your symptoms become life-threatening?
  • Have you ever thought about hurting yourself or others?

It is likely that additional information will be collected by your healthcare professional. Also, if you can think of anything else you can tell your doctor that you feel may be affecting your mood or symptoms, write it down.

It may seem insignificant right now, but it could be the missing piece for your doctor to help you. Remember: there is no such thing as stupid facts. Everything matters.

In the end, the diagnosis can only be confirmed by a medical professional.

depressed woman and fibromyalgia

I am clinically depressed. Now what?

Now, the rest of your life starts! A diagnosis is not an end in itself, but it is like a life raft that is going to take you to shore.

In my personal experience, when I was diagnosed with depression, things just started to make sense. My symptoms, such as staying in bed all day even on the days I could physically get up, and not finding joy in my kids’ accomplishments, these things now made sense.

In a way, the diagnosis in itself gave me a little push in the right direction. I felt less guilty about not being able to keep up the way I used to before. And that little fact gave me a glimpse of light at the end of the tunnel.

After my diagnosis, I was given antidepressants. Over the years, the dose has been adjusted up and down, depending on how I feel. Some days (or even weeks!) get bad, but I don’t beat myself up as much as I used to.

I am able to hang on to that raft to go back to shore! And as a result, instead of a downward spiral, I just ride the storm, confident that soon things will be better.

Antidepressants are not miracle pills. They do not work for everyone. They have worked for me personally, but only your medical professional can assess your need for medication.

There are countless brands and active agents on the market, and finding the right one for you, at the right dose for you, may take a few tries. Don’t give up!

Plus, you want to make sure you tell your doctor about all of the other meds you are taking. The last thing you need is to have some major medicament interaction with your fibromyalgia meds

What if you don’t want pharmaceutical medications?

There are several other options to treat depression. To list them all would be impossible!  The most common ones are talk therapy, where you would interact with a mental health professional who would guide you toward a different way of thinking, and remind you of your self-worth.

There are also in-patient programs, where you go in and take up residence in a home or group housing setting, where you can receive intensive help through therapy, group talks and/or medication adjustment.

There are numerous support groups online on social media, like Facebook or Reddit. There are also dedicated sites that act like forums or discussion platforms where people can help one another and encourage each other to seek help when needed.

The one site that comes to mind is www.sevencupsofcoffee.com It is a great resource group for depression sufferers.

You can also find apps for your phone that will allow you to connect with a mental health professional in case of crisis, or for some continued support.

Small fees may apply to the services, but some insurances will consider the apps as a viable alternative to face to face therapy sessions, thus helping with the financial aspect of the apps.

You will find many options in your phone’s App Store or Market. Take your time to look them up and find the one that will suit your lifestyle best.

Can I work it out on my own?

Depression is not something that you can just snap out of. If you are indeed clinically depressed, you will without a doubt need the help of a medical professional.

However, whether you think this is just a phase or whether you want to try to work it out on your own before seeking the help of a healthcare provider, there are a few things you can try.

Just to be clear: I am not telling you to not see a doctor. This is a very personal decision and you need to stop and evaluate your needs objectively before trying anything. It would be unrealistic to think you can wish yourself out of depression.

From my own personal experience, the following have been tips and tricks I have used in complement to more traditional approaches. In the end, you know deep down what you need, so trust that little inner voice telling you what you should or should not try.

With that said, I have found relief of my depression symptoms by doing some of the following things.

Take it slow

You cannot rush recovery. So don’t be too hard on yourself if it takes longer than you had hoped to feel yourself again.

For whatever reason, there are chemical imbalances in your brain and they will not rectify themselves unless you give them time. I know it can get discouraging, but truly it will get better.

On a side note, do not be ashamed to talk about it. There is nothing wrong with being open about your depression. The people who judge you for it don’t deserve you anyway. So there.

depression and fibromyalgia

Out with the trash!

Remove known toxic elements in your life. This one is tricky because if the toxic element is your boss, it’s. It easy to remove them. But you can limit interactions to a civil minimum and go about your day.

Plus, removing toxic elements can be done from the “inside.”  What I mean by that is, don’t allow the toxicity to spoil your mood. No one can control how you think.

So when something bothers you, try to turn your thoughts around at the first sign of frustration or sadness. How do you do that? Check out this next point!

Find your happy place

This is about to sound cheesy. You’ve been warned. But hey, it works for me! You’ve all heard of the proverbial happy place. Here is the deal though: finding that happy place can be tricky.

You’ll sometimes hear people picture yourself on a sandy beach with a warm summer breeze…. That never worked for me. Don’t get me wrong. If that beach is where you want to find your peace, go for it.

But here is what no one had told me before: your happy place does not have to be a cookie cutter idyllic beach on a warm island. I have never been on a said idyllic beach.

So there is no way for me to really visualize it. Yet for the longest time, I was finding myself trying to imagine a place I’d never seen before, with the understanding that it was supposed to bring me calm and happy. It did not. It brought me stress and feelings of inadequacy.

So I started remembering being on the top of a hill near my home when I was a kid. I’d stay there for hours, taking in the sights of the fog lifting on a cold Fall afternoon.

A far cry from a paradise beach! But this is the place that brought me calm and allowed me to recenter my thoughts.

Once I understood that my happy place did not have to be everyone else’s happy place, closing my eyes to imagine myself there became a treat. My own island of sanity in a sea of negativity!

Do what you like!

Too often in today’s world, we either do things to make other people happy, or we don’t do things by fear of upsetting others. But you know what? It needs to stop!

You are in charge of your own life. You have responsibilities to others, but even more so to yourself! And you owe it to yourself to lead the life you need.

Now I’m not saying you should just run off somewhere and avoid your obligations. Of course, we all need to pay rent, buy groceries, raise our kids, whatever it is you have going on in your life.

But once in a while, be the one who decides what to have for dinner. Tell your friends what movie you want to see. And go see it, with or without them! Don’t always settle for what other people want. You are equally as important as anyone else in your circle.

Do things for you!

And likewise, while you’re at it, hang out with people you like. Don’t simply settle for your friend’s friends for your partner’s friends.

It is essential to your well being to find people with whom you can be yourself, without the fear of doing something wrong or saying something they won’t agree with.

So go out there and make friends, then do stuff you like with these friends. Or vice versa, really. Because if you go and find things you enjoy, chances are you’ll meet people at the same time!

Here comes another cliché…

I like clichés. It’s like, they have to be rooted in truth, otherwise how would have anyone been able to come up with them?

But I digress. Here goes to nothing.

Enjoy the great outdoors! Exercise! Go outside when the sun is out!

There is such a thing as seasonal depression, a syndrome I am well aware of living in Minnesota.

With the short winter days or the gloomy fall days, by the time the day is over, most of us are lucky if we’ve seen 20 minutes of sunshine.

Yet sunshine is essential in the transformation of multiple vitamins, including vitamin D.  And guess what? Vitamin D is essential in the processes attached to melatonin and endorphins. In other words: no vitamin D = no happy feelings.

Likewise, exercising relieves feel-good chemicals that help your brain produce happy responses. Ever heard of the runner’s high? It’s when someone who engages in a long foot race reaches a turning point in his or her metabolism.

Suddenly, the body pumps adrenaline and endorphins galore in the runner’s brain to help get over any type of pain in order to keep running. It is remarkable, truly.

Of course, I would have no clue what that feels like. Last time I ran was 1989. Gym class. I was 13. Hated it.

But you don’t need to push your body to extremes to reap the benefits exercising can have on your mental state. Try to walk around the block a couple of times.

Gradually increase the amount of time you walk for. If you’re feeling adventurous, go to your local gym and ask the manager to point you in the direction of an appropriate routine for your athletic level.

Find your ying and ying

I know, it’s supposed to be ying and yang. Bear with me. I’m not a zen expert, but my understanding is that one is good and the other is not and that’s what creates balance in the universe. Or I could be way off. But for the sake of my argument, let’s pretend I’m totally smart and know what I’m talking about.

And what I am talking about here is yoga and meditation. You don’t have to have crazy good physical abilities to practice yoga, and you don’t need six hours a day to meditate. Be creative. There are many tutorials online available for all levels

In both yoga and meditation.

The idea in both exercises is to focus on nothing but the present moment. Your mind needs to rest sometimes and to do that, you need to stop thinking about what upsets you or what affects you. By practicing mindfulness, you can find a great ally in keeping your thoughts from dragging you down.

Get into a routine

This one is a bit different, and I’ll be honest. I got it from my kid. She is 11 and has the wisdom of a great-grandmother!

Anyways, she once told me that sometimes, it looks like I don’t want to do stuff. Like it’s too hard to get going. So she told me that I should force myself to do these things.

She clarified that I didn’t need to go and wash the car or stuff like that, but at least get out of bed, make a meal, read a book, take a shower.

That kind of things.

You know, a routine. Sort of a lifeline I can hang on to when thoughts are swirling around in my brain. A constant.

And I agree with her. When I am depressed, everything seems overwhelming. But when I break it down in small tasks, then next thing I know, I am getting things done! And, I know what is going to come next. And that, my friends, is reassuring.

Gosh, I love that kid!

What about herbal supplements?

Herbal or natural supplements are available for any and all kinds of ailments, so it comes as no surprise that there are supplements for depression as well.

That’s all I’ve got.

I’m not a doctor. I know herbs and supplements can interact with pharmaceutical medications.

I’m not going to give you advice that could be potentially dangerous for you. So if that is the route you want to take, consult with your local herbalist, your pharmacist or your doctor.

In the end, depression is very real and can be scary. But if there is one thing you should remember from reading this article, it’s that you are amazing. You are beautiful. You are smart. You are totally worthy. You are a Warrior!

Ok, that was more than one thing. But it’s pretty tough to describe you in just one word! It will get better. Your story is not over.

Keep fighting the good fight, fellow Fibro Warrior!

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