Cognitive-Behavioural Therapy

As Fibromyalgia (FM) sufferers we are often made to feel like our pain is “all in your head”, but research has consistently proven that Fibromyalgia is not a form of depression or hypochondria. IT IS REAL!  However, there is a connection between FM and other chronic pain conditions to depression and anxiety.  Treatment is important because both can make FM worse and interfere with symptom management.

There is some debate by medical and mental professionals about what causes what.  The “What came first?  The chicken or the egg” debate translates into “What came first?  The chronic pain or the depression?”  TRUE Fibromyalgia experts, researchers and others know that the chronic pain of FM & overlapping conditions leads to depression and anxiety. 

Fibromyalgia is a common condition in which a person suffers from chronic musculoskeletal pain. There are points called tender points, sometimes all over the body, and these tender and painful points are used as part of the diagnosis of FM. Individuals with FM may also be more susceptible to pain in general. Whenever the tender points are simply touched, they can send sharp pain impulses. Many Fibromyalgia sufferers experience pain all over and some experience pain only in specific regions. It can involve the muscles and the joints. Sometimes, there is so much pain that it is hard to pinpoint exactly where the pain originates.  Fibromyalgia is often accompanied by other overlapping conditions such as chronic myofascial pain (CMP), chronic fatigue syndrome (CFS), irritable bowel syndrome (IBS), restless legs syndrome (RLS), migraine & tension headaches, interstitial cystitis (IC), mitral valve prolapse (MVP), cognitive dysfunction, depression, anxiety and more.  The symptoms of Fibromyalgia, alone, are wide-ranging and debilitating.  Do they really think that depression and anxiety is the CAUSE for ALL of the above?

Depression is a mental illness characterized by feelings of profound sadness and lack of interest in enjoyable activities. It is a constant low mood that interferes with the ability to function and appreciate things in life. It may cause a wide range of symptoms, both physical and emotional. It can last for weeks, months, or years. People with depression rarely recover without treatment and if you have Fibromyalgia, you may have to fight it for the rest of your life.

Anxiety is a normal state of apprehension, tension, and uneasiness in response to a real or perceived threat.  Although anxiety is considered a normal response to temporary periods of stress or uncertain situations, prolonged, intense, periods of anxiety may indicate an anxiety disorder. Other indicators of an anxiety disorder are anxiety that occurs without an external threat and anxiety that impairs daily functioning.

What can cause depression & anxiety?  Stressful life events, chronic stress, low self-esteem, imbalances in brain chemicals and hormones, lack of control over circumstances (helplessness and hopelessness), negative thought patterns and beliefs, chronic pain, chronic physical or mental illness, including thyroid disease & headaches can ALL cause both.  Little or no social  and familial support can be a main factor in depression for FM patients. Family history of depression & anxiety can also be a factor.

Lack of quality sleep is also believed to have an influence on depression.  Since FM & Chronic Fatigue Syndrome patients tend to have insomnia and/or other sleep disorders, it stands to reason that poor sleep can lead to depression.

There is a wide variety of medications, vitamins, minerals, herbs and therapies that can help ease the impact of pain, anxiety and depression.  With so many out there, you and your doctor may have to go through the process of trial and error to find what works best for you!

Exercise is not only good for FM, it is also highly beneficial for depression and anxiety.  Recent studies suggest exercise can change your brain chemistry. Exercising can boost your level of serotonin, a brain chemical that is effects mood and pain perception. It can also stimulate the production of endorphins, natural painkillers that can give you an overall feeling of well-being.

Exercise is a great for stress, too. It relieves muscle tension and it gets the heart rate up. The combination makes us more relaxed and alert, which helps us deal with our problems in a calmer and more controlled way.

There are several other methods you can use to combat stress, including: meditation, deep breathing exercises, progressive muscle relaxation, mental imagery relaxation, relaxation to music, biofeedback, counseling – to help you recognize and release stress. 

You can learn more about this topic, medications, supplements, alternative therapies and more at my website AND I will be writing more articles – so check back here!

As Fibromyalgia (FM) sufferers we are often made to feel like our pain is “all in your head”, but research has consistently proven that Fibromyalgia is not a form of depression or hypochondria. IT IS REAL!  However, there is a connection between FM and other chronic pain conditions to depression and anxiety.  Treatment is important because both can make FM worse and interfere with symptom management.

There is some debate by medical and mental professionals about what causes what.  The “What came first?  The chicken or the egg” debate translates into “What came first?  The chronic pain or the depression?”  TRUE Fibromyalgia experts, researchers and others know that the chronic pain of FM & overlapping conditions leads to depression and anxiety. 

Fibromyalgia is a common condition in which a person suffers from chronic musculoskeletal pain. There are points called tender points, sometimes all over the body, and these tender and painful points are used as part of the diagnosis of FM. Individuals with FM may also be more susceptible to pain in general. Whenever the tender points are simply touched, they can send sharp pain impulses. Many Fibromyalgia sufferers experience pain all over and some experience pain only in specific regions. It can involve the muscles and the joints. Sometimes, there is so much pain that it is hard to pinpoint exactly where the pain originates.  Fibromyalgia is often accompanied by other overlapping conditions such as chronic myofascial pain (CMP), chronic fatigue syndrome (CFS), irritable bowel syndrome (IBS), restless legs syndrome (RLS), migraine & tension headaches, interstitial cystitis (IC), mitral valve prolapse (MVP), cognitive dysfunction, depression, anxiety and more.  The symptoms of Fibromyalgia, alone, are wide-ranging and debilitating.  Do they really think that depression and anxiety is the CAUSE for ALL of the above?

Depression is a mental illness characterized by feelings of profound sadness and lack of interest in enjoyable activities. It is a constant low mood that interferes with the ability to function and appreciate things in life. It may cause a wide range of symptoms, both physical and emotional. It can last for weeks, months, or years. People with depression rarely recover without treatment and if you have Fibromyalgia, you may have to fight it for the rest of your life.

Anxiety is a normal state of apprehension, tension, and uneasiness in response to a real or perceived threat.  Although anxiety is considered a normal response to temporary periods of stress or uncertain situations, prolonged, intense, periods of anxiety may indicate an anxiety disorder. Other indicators of an anxiety disorder are anxiety that occurs without an external threat and anxiety that impairs daily functioning.

What can cause depression & anxiety?  Stressful life events, chronic stress, low self-esteem, imbalances in brain chemicals and hormones, lack of control over circumstances (helplessness and hopelessness), negative thought patterns and beliefs, chronic pain, chronic physical or mental illness, including thyroid disease & headaches can ALL cause both.  Little or no social  and familial support can be a main factor in depression for FM patients. Family history of depression & anxiety can also be a factor.

Lack of quality sleep is also believed to have an influence on depression.  Since FM & Chronic Fatigue Syndrome patients tend to have insomnia and/or other sleep disorders, it stands to reason that poor sleep can lead to depression.

There is a wide variety of medications, vitamins, minerals, herbs and therapies that can help ease the impact of pain, anxiety and depression.  With so many out there, you and your doctor may have to go through the process of trial and error to find what works best for you!

Exercise is not only good for FM, it is also highly beneficial for depression and anxiety.  Recent studies suggest exercise can change your brain chemistry. Exercising can boost your level of serotonin, a brain chemical that is effects mood and pain perception. It can also stimulate the production of endorphins, natural painkillers that can give you an overall feeling of well-being.

Exercise is a great for stress, too. It relieves muscle tension and it gets the heart rate up. The combination makes us more relaxed and alert, which helps us deal with our problems in a calmer and more controlled way.

There are several other methods you can use to combat stress, including: meditation, deep breathing exercises, progressive muscle relaxation, mental imagery relaxation, relaxation to music, biofeedback, counseling – to help you recognize and release stress. 

You can learn more about this topic, medications, supplements, alternative therapies and more at my website AND I will be writing more articles – so check back here!

Cognitive-behavioral therapy (CBT) tries to reduce a person’s misconceptions about sleep, as well as teach more positive sleep behaviors. The therapy consists of talking with a therapist (alone or with a group) to address your beliefs, assumptions and behaviors regarding sleep, and is often used in conjunction with stimulus control, sleep restriction and good sleep hygiene. Several studies have shown that CBT is an effective way of treating insomnia and that the therapy can reduce the number of long term medical issues associated with insomnia. Cognitive behavioral therapy addresses a person’s beliefs about sleep and helps replace negative or unhelpful behaviors with positive ones. The significance of one’s thinking about sleep is often underestimated. Sleep problems which start as isolated incidents can become chronic because of mental hang-ups.How we think about sleep can play an important role in how we deal with sleep difficulties. For this reason, an essential part of your sleep treatment involves identifying your thoughts about sleep that tend to make sleeping more difficult and replacing these thoughts with more helpful thinking. One technique for examining your thinking is to treat your thoughts as scientific hypotheses or ideas. You may have had certain beliefs about your sleep for a long time. At this time you are being asked to consider alternative beliefs and determine which of these beliefs is best supported by the information available to you. As you pay attention to your thinking about sleep and consider alternatives, you will probably notice two issues to address:1.    The more important it is to get a good night’s sleep, the less you sleep. Believing that a poor night’s sleep is a disaster only generates more anxiety and worry about your sleep. Challenge this thinking and consider alternative thoughts that reduce the importance of sleeping on the rest of your life (i.e. “It’s no big deal”, “I’ll be a little tired and cranky tomorrow but nothing I can’t handle.”). 2.    The more you try to control your sleep, the less you sleep. Sleep is a natural body response. Telling yourself that you must sleep and trying to force yourself to sleep only puts pressure on you and makes your sleep worse. Focusing on what you can control (sleep habits, schedule, when you are in or out of bed) and letting go of what you can not control will allow falling asleep and staying asleep to happen naturally. Now that you’ve become aware of the thoughts that make your sleep worse and have considered alternative ways of thinking, the next step is to practice these new thoughts. This challenging of new thoughts replacing old thoughts will take some effort because our thoughts are typically automatic and we are not accustomed to deliberately noticing them. Scheduling a time each day to examine the ways you think about your sleeping will be helpful in getting you to notice and challenge any maladaptive thought patterns. It is important to do this on a regular basis, as it can be easy to fall into old thought habits if you are not actively monitoring your thoughts. Like any new skill, it is important to practice it. Keep a diary of your sleep-related thoughts and your ideas on how to think differently. Once you have become accustomed to examining your thoughts, you will find that this is an excellent skill that will prove useful for helping you to approach your sleeping difficulties differently as well as for learning a healthier approach to other life problems as well.