Fibromyalgia Depression

An estimated thirty percent of fibromyalgia patients, compared to about thirteen percent of the general U.S. population, have been diagnosed with major or chronic depression. Research links both fibromyalgia and depression to genetic factors, but they are inherited independently. That is, if a parent has both conditions, offspring may inherit a predisposition to either one without the other. Both conditions also appear in patients with no known genetic risk. We know with some certainty that fibromyalgia is not caused or worsened directly by depression, but depression can be caused or complicated by fibromyalgia just as any chronic illness is a risk factor for depression.
Because both conditions usually lack outwardly visible physical symptoms, too many people view the two as faults of character or disposition and the presence of both fibromyalgia and depression together as mutually confirming faults. This lack of understanding among some medical professionals, family members, and community places a third burden of stigma upon the patient who suffers both fibromyalgia and depression. Unfortunately, the underlying conditions worsened by the stigma can greatly interfere with a patient's resolve to seek and manage effective treatments.

Relieving the symptoms of fibromyalgia often helps to decrease feelings of depression. The three prescription medications approved specifically for use in treating fibromyalgia in chronological order of approval are:

Pregabalin (Lyrica) an anticonvulsant and pain drug which slows down impulses in the brain that cause seizures. Lyrica also affects chemicals in the brain that send pain signals across the nervous system.

Duloxetine (Cymbalta) is a serotonin-norepinephrine reuptake inhibitor (elevator). Serotonin and norepinephrine mediate mood symptoms and help regulate the perception of pain.

Milnacipran (Savella) a selective serotonin and norepinephrine dual reuptake inhibitor (SSNRI) originally developed to treat depression.

Other drugs prescribed but not approved specifically for treatment of fibromyalgia include a variety of anti-depressants and pain medications. In addition to cautionary statements for each drug used in the treatment of fibromyalgia, some of these drugs may complicate or worsen depression. In any case, effective treatment of fibromyalgia and depression requires more than a medication or two.

Treatments that have shown varying degrees of success in lessening depression caused or worsened by fibromyalgia include biofeedback, cognitive behavioral therapy, massage, nutrition, and exercise. Because treatment of either condition is complicated by the existence of the other, it is even more important than usual to seek qualified medical advice before beginning any course of treatment, no matter how common.

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