Somewhere Between Denial and Depression in Fibromyalgia

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My lifelong experience with fibromyalgia has seen me slide up and down this continuum. My energy is often spent trying desperately to avoid these two extremes.

At times I find myself trying desperately to remain positive and focus on what I can do. I walk around repeating Hawking’s words do not look at your feet look up at the stars. I avoid the fibromyalgia groups like the plague for fear that they will bring me down. I mumble releasing mantras and try to let go of things like grief and fear. I focus my attention on all those many blessings that I am so deeply grateful for.

If all goes well it works and I come very close to that elusive place called normal. Inevitably though I cross the invisible line of denial. When I end up in that place I make less intelligent decisions regarding my physical strength and capacity. The hype of believing in oneself and that all things are possible lead you to push yourself beyond reason. In the process I hurt something, reinjure something and successfully manage to bring on a fibro flare which feels like my body is taking revenge on me.

At other times and often when I am remembering what I was capable of, I remind myself that this condition is real and if not managed it becomes debilitating. I notice how I move around like a 70 year old. I feel despondent with all my half projects and all the things that I never got started. To cope with the disappointment and sense of failure, I remind myself of the nature of this condition and what it can do.

In some ways I find comfort in others’ stories knowing I am not alone and many people have this battle too. It remains however a very dangerous place to be because crossing the fine line that leads to depression happens so quickly. In that place life seems unfair and cruel and punitive. All the things that I have had to give up and all my plans that I have to pack away impact the psyche in an altogether negative way and you spiral down into a very gloomy place. It is a battle to get out of this place but over the years one develops the muscle for it and you somehow manage to make it out.

Managing the psyche takes as much effort if not more than managing the body. Navigating the perils of denying your condition on the one hand and being overcome by your condition on the other requires energy. Harmony has always been my sacred word. Harmony with self, others and the earth is a life goal. Sliding up and down between denial and depression is one aspect of the up and down nature of fibromyalgia. 

Source: Shared and Written by Michelene Dianne Benson in our facebook group “Living with fibromyalgia and chronic illness” Click here to join via Facebook.

Also Read: 

Jim Carrey explains depression in the best way i’ve ever heard.

#fibromyalgia #depression #denial #awarenessday #invisible #cfs

Different types of Depression

Many studies link fibromyalgia and depression. Depression leads to changes in brain chemistry. Some researchers look at abnormalities of the sympathetic nervous system the part of the nervous system that decides how you handle anxiety and emergencies.

They dare that these abnormalities may lead to the release of substances that is the cause increased sensitivity to pain. The result is fibromyalgia with its chronic pain and feelings of depression. Same pathophysiology is shared by Fibromyalgia and depression and they are mostly embattled by the same drugs with double action on serotoninergic and noradrenergic systems.

Genetic and environmental factors that predispose, precipitate, and are responsible for fibromyalgia and depression and include laboratory result on the role of depression in fibromyalgia are going to be evaluated now. Additionally, we talk about various aspects of fibromyalgia which support the development of immediate depression, considerably more so than in other chronic pain syndromes. Consequently fibromyalgia may, be more correctly grouped together with other functional pain disorders.

Comparison of signs and symptoms of fibromyalgia and depression

Tender points located on the body are the key distinguishing symptoms of fibromyalgia. Long term muscle ache, muscle spasms or tautness, modest or severe exhaustion, decreased energy, sleeplessness, waking up feeling unrefreshed, firmness upon waking or after staying in one position for too long, concentration problems, difficulty remembering and performing easy mental tasks (“fibro fog“), abdominal pain, bloating, nausea, constipation alternating with diarrhea (irritable bowel syndrome), tension or migraine headaches, jaw and facial tenderness are some signs and symptoms of fibromyalgia.

With fibromyalgia comes sensitivity to odors, noises, bright lights, medications, certain foods, and cold. Fibromyalgia patients presents with symptoms of feeling nervous or unhappy, lack of sensation or stinging in the face, arms, hands, legs, or feet, increase in urinary stress or frequency (irritable bladder), reduced tolerance for work out and muscle pain after exercise, and a feeling of inflammation (without actual swelling) in the hands and feet.

Signs and symptoms of depression include feeling dependent or desperate, loss of concentration in daily activities or once favorite hobbies changes, changes in hunger or weight, changes in sleep, anger or bad temper loss of energy, self-loathing, irresponsible behavior, problems concentrating, and mysterious aches and pains. As you can see, there are many alike symptoms in both conditions, giving way to uncertainty in diagnosis.


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Types of depression

1. Major depression

Major depression is occasionally called major depressive disorder, clinical depression, unipolar depression or just ‘depression’. Low mood and/or loss of interest and contentment in normal activities, as well as other symptoms are included.  Most of the day’s people feel symptoms and they last for at least two weeks. Symptoms of depression interfere with all areas of a person’s life, including work and social relationships.

2. Subsyndromal depression

Some people are suffering from depressive symptoms but don’t reasonably check all the boxes for a diagnosis of major depression may be deemed “subsyndromal.” Maybe she’s been depressed for a week, not two, or maybe she has three or four symptoms, not five Dr. Noble explains. “Rather than look at symptoms, I usually look at functionality,” she says. Is the patient able to go to work and take care of day-to-day responsibilities? If the person is struggling, they may still benefit from treatment, including with medication, she says.

3. Psychotic depression

Sometimes people with a depressive disorder can lose touch with reality and experience psychosis. Seeing or hearing things that aren’t there known as hallucinations or delusions (fake beliefs that aren’t shared by others), such as believing they are terrible or evil, or that they’re being watched or followed are included in this type. They can also be suspicious, feeling as though everyone is not in favor of them or that they are the cause of poor health or terrible events happening around them.

4. Antenatal and postnatal depression

Women who are pregnant have increased chances of depression (known as the antenatal or prenatal period) and in the year next to childbirth (known as the postnatal period). May be you will hear about the term ‘perinatal’, which tells about the period covered by pregnancy and the foremost year after the baby’s birth.

5. Premenstrual dysphoric disorder

Premenstrual dysphoric disorder (PMDD) is experienced women of childbearing age. Depression, grief, nervousness, or bad temper, as well as other extreme symptoms may be caused by this extreme form of PMS, in the week before a woman’s period.

6. Disruptive mood dysregulation disorder

Symptoms of disruptive mood dysregulation disorder (DMDD) includes shouting and loose temper, it is a type of depression diagnosed in children who fight back with their regulating emotions. Other symptoms include an irritable or angry mood most of the day nearly every day and trouble getting along in school, at home, or with their peers.

7. Persistent depressive disorder 

Most of the time it is known as dysthymia, persistent depressive disorder is a long-term depression but it is not a severe type of depression. This not so severe depressive disorder can be chronic and keep you away from living a normal life.

8. Bipolar I and II disorders

Bipolar I and bipolar II disorders include mood swings that range from highs (hypomania or mania) to lows (major depression). Bipolar disorder and depression is hard to distinguish because most people don’t go to their doctor when they have elevated or ecstatic moods; they only look for medical treatment for the low, depressive moods.

9. Cyclothymic disorder

Cyclothymic disorder involves slightly milder highs and lows than those of bipolar I or bipolar II disorders.


Anti aging medical specialist Pamela W. smith, MD, MPH, director of The Centre For Healthy Living Longevity in Michigan, says, “95 per people with fibro have low thyroid function and 100 per have low adrenal function and both conditions can lead to depression and anxiety. Luckily hypothyroidism is easy to diagnose. Complete blood tests for thyroid levels can detect if there is some problem.


Some treatment methods for depression include talk therapy and medications.  Cognitive behavioral therapy, problem-solving therapy, and interpersonal therapy are included in talk therapy. Talk therapy helps you recognize any underlying issues and discuss them with a professional to come up with solutions and provide you with strategies to deal with upcoming and future situations that may arise. You can work through your present feelings as a means of accurately dealing with them in a healthy matter.


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  • Types of depression via Health
  • Fibromyalgia and Depression via WebMD

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