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The overlap of pain with mental health disorders can be overwhelming and confusing to those experiencing it. The chronic condition known as “fibromyalgia” is one example. It is characterized by a constellation of symptoms, including anxiety, depression, poor sleep, neuropathy, and nerve pain. Read on to learn more about this interplay of nerve pain and the mind and the challenges of living with the disorder.
What Is Fibromyalgia?
Fibromyalgia is a muscle and soft tissue disorder. It is characterized by chronic widespread musculoskeletal pain, fatigue, sleep disturbances, and tenderness. Those with fibromyalgia will experience the condition throughout their life. More than four million adults in the United States have fibromyalgia, which is very common.
What Causes Fibromyalgia
According to many researchers, repetitive nerve stimulation causes changes in the spinal cord and brain of individuals with fibromyalgia. What is believed to happen is that certain brain chemicals signaling pain undergo an abnormal increase. This would be akin to a dopamine flood that intensifies pleasure but instead involves brain chemicals that signal pain.
Also, these same brain receptors then appear to form a pain memory, which becomes sensitized. As a result, the receptors can be overreactive to nonpainful and painful signals.
While there is no current cure, treatment for fibromyalgia can help manage the symptoms.
Impact of Fibromyalgia on Individuals
Gender-wise, women are more likely to develop fibromyalgia than men, as 90 percent of those with fibromyalgia are women. The condition is common for individuals ages 35 to 50, affecting 2-3 percent of the population. A family history of fibromyalgia may increase a person’s likelihood of developing the condition due to genetic mutations that may increase susceptibility. Therefore, someone with a parent or sibling with the disorder may eventually develop it.
The presence of other disorders is also a risk. Someone with rheumatoid arthritis, lupus, or osteoarthritis may be at a higher risk of developing fibromyalgia.
Physical trauma, infection, surgery, or emotional and psychological stress, especially prolonged stress, often precipitate fibromyalgia symptoms. Other individuals with fibromyalgia may not experience a triggering event, with their symptoms gradually accumulating.
Fibromyalgia Mental Health
Individuals experiencing chronic pain associated with fibromyalgia commonly must deal with mental health issues brought on or worsened by nonstop pain.
Someone with fibromyalgia may have difficulty paying attention or focusing. This is often referred to as fibro fog. They may also experience other cognitive dysfunctions, including:
- Difficulty remembering
- Concentration problems
- Trouble planning
- Decreased vocabulary
- Lowered verbal fluency
- Slowness in mental ability
- Challenges in decision-making
Besides, dealing with chronic pain is frustrating. So little is known about fibromyalgia, and the condition can be misunderstood by family members, friends, work associates, and others—as well as the person with the disorder, who may develop fibromyalgia depression and anxiety related to their health.
Chronic Pain and Its Effects
The chronic pain of fibromyalgia is typically described as a constant dull body pain. It lasts for more than three months. Knowing that fibromyalgia is a lifelong condition may amplify the pain and, in different ways, cause the pain.
Challenges of Living with Chronic Pain Caused by Fibromyalgia
There seems to be no escape from the dull chronic pain that fibromyalgia causes. As such, daily living can become an increasingly difficult challenge. The pain is widespread, occurring on both body sides and below and above the waist. While fibromyalgia may affect many body parts, the main areas are the upper chest, neck, upper back, arms, lower back, buttocks, and knees.
Besides fibromyalgia, those affected with the disorder may also have irritable bowel syndrome (IBS), painful bladder syndrome, migraine, tension and other headaches, and temporomandibular joint (TMJ) disorders. Fibromyalgia and depression and fibromyalgia and anxiety commonly co-occur.
With no relief from chronic pain, unrelenting fatigue, and disrupted or poor sleep, those with fibromyalgia may find it harder to function and perform their regular duties at work or home. This can result in accelerated stress, anxiety, fibromyalgia depression, and unhealthy behaviors to relieve pain, such as excessive alcohol consumption and misuse or abuse of prescription drugs or illicit substances.
Shared Neurobiology
Since it is known that there are shared neurobiological pathways and mechanisms involved in pain and anxiety, researchers believe that oxidative stress may play a crucial role in fibromyalgia. They suggest that elevated levels of prooxidative factors (such as lipid peroxidation, nitric oxide, and mitophagy) can cause fibromyalgia pain sensitization.
Because there is a lack of effective treatment therapy for fibromyalgia, many treatments aim to reduce fatigue and pain while improving quality of life. However, some antioxidative procedures may be effective in reducing specific fibromyalgia symptoms. These include physical activity, diet modifications, and hyperbaric oxygen therapy.
Psychological Factors
Several psychological factors can influence a person’s experience of fibromyalgia. These include stress, anxiety, and depression. A study in 2018 found depression in 87.5 percent of fibromyalgia study participants and depression in 72.5 percent. Coupling the many physical components of the condition with the psychological ones significantly reduces the overall quality of life. And the psychological effects of fibromyalgia are essential considerations for the condition’s prognosis.
Pain Perception and Anxiety
Chronic pain can trigger or exacerbate anxiety symptoms, leading to heightened distress and decreased quality of life. When a person experiences pain that doesn’t go away and has lasted for months, there is an anticipation of pain. They wake up believing they’ll be in pain and go to bed feeling it.
This pain perception, in turn, worsens the anxiety the individual feels. The more they think about the pain, the worse they feel emotionally and physically.
Anxiety Sensitizing Pain
Anxiety can amplify pain perception, making it more intense and challenging to manage. Anxiety sensitivity is defined as being afraid about a situation or an event.
Suppose you know you’ll wake up with stiffness, feel weak, fatigued, and forgetful, and experience cognitive and other difficulties throughout the day. In that case, this anxiety sensitivity worsens the chronic fibromyalgia pain.
Seeking Support
Feeling alone in their suffering and finding it hard to talk about what they’re going through daily compounds the lowered quality of life of those with fibromyalgia. Discussing the pain and challenges of the condition with others familiar with it, treating it professionally, or having it themselves is tremendously helpful psychologically. For this reason, it is essential to seek professional support, such as therapy or support groups.
Treatment Approaches
There are no objective lab tests or imaging to diagnose fibromyalgia, and doctors generally use clinical markers to diagnose the condition. Furthermore, since fibromyalgia and depression, and other psychological components often coexist, treating them simultaneously, including multidisciplinary approaches, is crucial.
Medication
The treating physician may be able to prescribe medication to help with pain reduction and improve quality of life.
Antidepressants may be prescribed in the treatment of fibromyalgia and concurrent depression or anxiety.
Antiseizure medications, such as gabapentin or pregabalin, may help in symptom reduction.
Analgesics can be taken to alleviate body aches and pain. These include acetaminophen, ibuprofen, and Tramadol.
Therapy
Therapeutic approaches to treating pain and anxiety can be beneficial in reducing symptoms and symptom severity.
- Psychotherapy – Seeing a psychotherapist or counselor can help individuals with fibromyalgia understand the disorder better and give them hope and coping strategies for associated stress and pain. Cognitive-behavioral therapy (CBT) is frequently recommended to help treat fibromyalgia.
- Physical therapy – Combatting overall body weakness and reduced strength may involve seeing a physiotherapist to improve stamina and increase strength.
- Acupuncture – Studies exploring the effectiveness of acupuncture find that the ancient therapeutic technique is still effective as a treatment strategy for those with chronic musculoskeletal pain. As an alternative modality, acupuncture is increasingly integrated into a multidisciplinary approach to treating fibromyalgia. Results show considerable evidence of the effectiveness of acupuncture in treating fibromyalgia syndrome. Yet, researchers do not know which body areas benefit more from pain improvement using this technique.
- Occupational therapy – For work-related discomfort associated with fibromyalgia, seeing an occupational therapist can help by suggesting specific work-area adjustments.
- Neurorehabilitation – Those with fibromyalgia can help manage their symptoms and improve daily functioning with neurorehabilitation or neuro rehab.
Coping Strategies
Taking a proactive approach is essential with fibromyalgia and the pain and mental health symptoms associated with it. Some practical tips for managing fibromyalgia symptoms include:
Self-Care
It can be tough trying to adhere to a regular schedule of eating healthily, getting sufficient sleep, exercising, and staying hydrated when simultaneously being distracted and debilitated by constant fibromyalgia pain and new or recurring symptoms. Adopting and maintaining good self-care can be an enormously effective coping strategy.
Relaxation Techniques
Not only does it feel great to indulge in a whole-body massage, but this relaxation technique has also proven beneficial in helping to promote overall well-being, reduce stress and other fibromyalgia mental health issues, and, most importantly, alleviate chronic pain.
Other relaxation techniques include breathwork therapy, yoga, and fitness sessions.
Stress Management
In addition to relaxation techniques, individuals experiencing fibromyalgia pain and anxiety may find stress relief through mindfulness and participation in support networks.
