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    Fibromyalgia and Depression

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    Do People With Fibromyalgia Know They're Depressed?

    Some people with fibromyalgia and chronic pain may be aware they are depressed. Others may not be sure they are depressed. Nevertheless, they know something is wrong.

    The signs of depression with chronic pain may include:

    • decreased energy
    • difficulty concentrating or making decisions
    • feelings of hopelessness, guilt, or irritability
    • loss of interest in nearly all activities
    • persistent sad or anxious mood
    • uncontrollable tearfulness

    In severe cases, depression with chronic pain can lead to thoughts of death or suicide.

    Does Stress Increase Depression With Fibromyalgia?

    The stress of living with chronic pain and relentless fatigue can put a person into "overload." That can result in overwhelming feelings of nervousness and anxiety. What isn't clear is whether a stressful life brings about the fibromyalgia or if having fibromyalgia leads to stress.

    No matter which comes first, stress adds to problems of anger, distractibility, and irritability. Most patients feel worsening of pain and fatigue when they have more stress. Sometimes, severe stress occurs just before the disease starts.

    Is Depression Common With Chronic Pain Conditions?

    Feelings of depression are common with all types of chronic pain, including headache, back and neck pain, hip pain, shoulder pain, and the pain of fibromyalgia. For example, the prevalence of major depression in people with chronic low back pain is three to four times greater than in the general population.

    By the same token, having a depressive disorder also increases the risk of developing chronic pain. Patients who are depressed have greater pain. They describe greater hindrance from pain and display more pain behaviors than pain patients who are not depressed.

    People with chronic pain such as fibromyalgia often become depressed and isolated. As a result, they spend more time away from other people, even people they love, such as family and friends. Instead of focusing on their personal lives or the lives of their loved ones, they become increasingly focused on their pain and suffering, which is very real. Adding to the frustration are the repeated appointments with health care providers to try to find relief and the resulting costs.

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