Chronic Pain | Chronic Fatigue | Depression | Anxiety
Sleep Dysfunction | Vitamin and Mineral Deficiency


Depression and Fibromyalgia Causes of Depression Treatment of Depression

Depression is a medical illness involving the mind and body that affects how one feels, thinks and behaves. One may have trouble doing daily activities and even feel as if life is not worth living.  Depression is a real condition with physiological factors including genetic predisposition and neurotransmitter imbalances.

Depressive (and also anxiety) states are frequently observed in patients with fibromyalgia and chronic fatigue. The rate of lifetime major depression and anxiety disorders in patients with Fibromyalgia Syndrome and Chronic Fatigue Syndrome ranges from 26 to 71%.

How is Depression Associated with Fibromyalgia?

This association is a sensitive issue with people who have Fibromyalgia Syndrome and Chronic Fatigue Syndrome. In the past many physicians have told these patients who presented with pain and fatigue that they either had depression or anxiety. Physicians dismissed the physiology, neurology, and data available from FMS studies. Many patients were also told over and over again that their disease was "in their heads". Which resulted in a lack of trust, and irritable and resentful feelings, which lead into secondary depression and/or anxiety. Knowing what we know today, patients surrounded by invalidating family, friends, medical community, and environment, start to doubt themselves.

Symptoms of Depression

Feelings of sadness or unhappiness
Irritability or frustration even over small matters
Reduced sex drive
Insomnia or excess sleeping
Changes in appetite: decreased appetite with weight loss or increased appetite with weight gain
Agitation or restlessness (i.e. pacing, hand-wringing or inability to sit still)
Slowed thinking, speaking, or bodily movements
Indecisiveness, distractibility, and decreased concentration
Fatigue, loss of energy
Feelings of worthlessness or guilt, fixation on past failures, or blaming oneself when things aren't going well
Trouble thinking, concentrating, making decisions, and remembering
Thoughts of death, dying, or suicide
Crying spells for no apparent reason
Increased pain

Causes of Depression


Changes in levels of neurotransmitters in the brain such as serotonin and norepinephrine (the same neurotransmitters that are involved in fFibromyalgia Syndrome and Chronic Fatigue Syndrome in about 80% of patients). Alterations in serotonergic neurotransmission is not only involved with depression but is also involved with chronic pain and fatigue, which are common complaints of patients with Fibromyalgia Syndrome and Chronic Fatigue Syndrome. Sleep disturbances are also a result of serotonin deficiency.


Biological differences. People with depression appear to have physical changes in their brains.


Hormone Imbalances: for example thyroid hormones or hormonal changes in menopause.


Inherited Traits: Depression is more common in people whose family members also have depression


Life Events and Triggers:
  (a) chronic pain - inability to predict timing and severity as in fms and cfs
  (b) chronic fatigue - which interfered with work, family, and self-care
  (c) non-restorative sleep - which leads to fatigue, pain, and cognitive problems
  (d) social and family pressures - due to inability to commit to scheduled events
  (e) possible personal loss of "the healthy/strong self" which leads to grieving
  (f) possible loss of functional abilities
  (g) isolation of self by others and from others
  (h) loss of self-worth
  (i) hopelessness, especially in the ability to heal and preserve life


Early childhood trauma - traumatic events in childhood such as abuse, neglect, or loss of parent is commonly found in the history of Fibromyalgia Syndrome and Chronic Fatigue Syndrome patients.

Treatment of Depression and Anxiety


Medications such as SSRIs and/or SNRIs slow down the reabsorption of the body's own neurotransmitters (serotonin or norepinephrine) enabling them to stay active in the blood longer, hence decreasing anxiety and depression. The action of these medications also help decrease pain and enhance sleep. Medications that are commonly used are Lexapro, Effexor, Savella, and Cymbalta.


Cognitive behavioral therapy helps reduced depression by reducing negative beliefs and attitudes.


Exercise - Movement in warm water, walking, yoga, Tai Chi, and/or using cardio machines decrease stress, increase serotonin thus decreasing depression and anxiety.


Relaxation Techniques - The relaxation response of the parasympathetic nervous system lowers blood pressure, heart rate, and anxiety. Techniques that relax the body and mind are meditation, yoga, breathing exercises, Tai Chi, acupuncture, massage therapy, aromatherapy, hot baths with mineral salts, and more.


Mariposa Dreams

Plymouth Integrative Medicine Center
Fibromyalgia Doctor ~ Irene Metro MD
44670 Ann Arbor Rd, Ste 100, Plymouth, MI 48170

Call 734.432.1900 for an appointment with Fibromyalgia Doctor ~ Irene C. Metro MD

The information contained on this web site is not intended to treat, diagnose, cure or prevent any disease, nor is it intended to replace proper medical care. All material provided in this web site is provided for educational purposes only. Always seek the advice of your physician or other qualified health care provider with any questions you have regarding a medical condition, and before undertaking any diet, exercise or other health program.

Fibromyalgia doctor Irene C. Metro, MD, Board Certified Internal Medicine, Board Certified American Board of Integrative & Holistic Medicine, is the medical director of the Plymouth Integrative Medicine Center in Livonia, Michigan. This medical clinic has internal medicine, integrative medicine, physical therapy, acupuncture, lifestyle coaching, nutritional counseling, and psychotherapy, and specializes in fibromyalgia, chronic fatigue syndrome, hypertension, high blood pressure, insomnia, anxiety, depression, chronic pain, trigger point therapy, vitamin therapy, and pain relief. This medical clinic is located across from St. Mary Mercy Hospital and is easily accessible from Plymouth, Livonia, Canton, Northville, Redford, Westland, Farmington Hills, Southfield, Dearborn Heights, and other locations in Oakland County and Wayne County Michigan. Call 734-432-1900 to make an appointment with the fibromyalgia doctor MI today!