Fibromyalgia is a syndrome characterized by the presence of chronic, generalized musculoskeletal pain. In addition to pain, other symptoms are associated, such as fatigue, sleep disturbances, paresthesia in the extremities, a feeling of swelling in the hands, or morning stiffness.
To date, no therapy/intervention cures fibromyalgia, so existing treatments focus exclusively on attenuating or cushioning the impact of different symptoms, such as pain, sleep problems, or emotional discomfort.
Regarding psychopathology, it has been observed that the prevalence of depression is higher in the group of patients with fibromyalgia than in the rest of the patients. Thus, in this article, we will delve a little deeper into this relationship.
What comes first, fibromyalgia or depression?
There are lines of research that describe a possible relationship between pain and certain personality variables, finding evidence that supports the theory according to which there is a high relationship between some personality traits and chronic pain.
On the other hand, a high incidence of depressed mood is also observed among patients with pain, and it is often assumed that the mood is the cause.
Among the pain-related disorders, we will focus on fibromyalgia. A rheumatological syndrome characterized by generalized pain, which is considered chronic and whose main symptom is central sensitization that manifests itself with diffuse pain that affects the entire body.
Among the causes of this syndrome, factors of an emotional nature have been proposed. In this sense, the involvement of emotional variables, such as anxiety or depression, is recognized, and it has been found that 30% of patients with fibromyalgia present depression at the time they come to the doctor’s office and 60% suffer from it at some point in their clinical history. Even so, the impact of these emotional disorders on either the etiology or the maintenance of fibromyalgia is not clear.
What does research say about the relationship between fibromyalgia and depression?
In 2004, a study was launched at the University of the Balearic Islands to corroborate the relationship between fibromyalgia and depression. The authors intended to verify whether patients suffering from fibromyalgia present a specific profile in the manifestation of this mood disorder.
Regarding depression, it was observed that there were no significant differences between patients suffering from fibromyalgia and healthy patients. This could be a sign that depression may precede or accompany fibromyalgia, although it is not a factor involved in the etiology (cause) of the syndrome.
What does seem to be certain is that the existence of a relationship between fibromyalgia and depression is rather a question of comorbidity (both disorders appear at the same time), or that the depressed mood may be a consequence of suffering from fibromyalgia. In this sense, the depressed mood in patients with fibromyalgia would be a consequence of the interference of pain and other symptoms in daily life.
The symptoms of the syndrome (for example, fatigue) would prevent the person from carrying out activities that had been normal until then, as well as causing the person to refrain from participating in certain projects due to the anticipation of pain. This would lead to a loss of reinforcers or motivating stimuli in the patient’s daily life, which would end up triggering the depressive disorder.
What implications does this relationship have in professional practice?
To carry out the prevention of depression we can use various tools such as the following:
- Reflect on your lifestyle. The key is to incorporate rewarding activities and improve your social life. Considering that these patients have specific difficulties, you should choose activities that are in line with their abilities.
- Identify how we think and try to change the thoughts that make us feel bad, replacing them with less harmful ones.
- Attend workshops or therapy groups. Meeting other people who are going through the same thing as you helps you feel understood and acquire some really useful tools for your problem in question.
- Going to a psychologist is always an option.
Thus, the results obtained may have important implications for professional practice. If depression is not a cause, but a consequence of fibromyalgia, this could lead to the development of specific prevention programs – based on the tools we have described – for this population.