How to Handle Depression and Fibromyalgia

Learn the triggers of depression when living with fibromyalgia and how to overcome the symptoms.

How to Handle Depression and Fibromyalgia

For so many with fibromyalgia, depression is a fact of life. In fact, depression is one of the most common complications of chronic illness. Just the idea of facing a long life with illness brings about uncertainty, grief, anger and sadness. While some of this is a normal part of living with chronic disease, it is when you continue to experience these feelings and they start to affect your daily life that you should seek medical help.

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Fibromyalgia: Three Things You Need to Know about Patient Empowerment

Learn how to take your fibromyalgia healthcare into your own hands and approach your doctor in a more confident, educated way.

Fibromyalgia: Three Things You Need to Know about Patient Empowerment

It is very difficult for patients to do what they don’t understand. Therefore, it is vital to arm yourself with the knowledge necessary to take a more active role in your healthcare.

Patient empowerment allows patients to take an active role in the decisions they make about their health. Moreover, empowerment requires patients to take responsibility through open communication with their doctors, taking medications as prescribed,eating healthy and exercising regularly. It also allows them to create a joint partnership with their doctors where change can actually be long lasting.

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Overcoming Arthritis in the Bedroom

Sex is a hot topic and it is also a taboo topic. Whether you are talking freely among friends or for educational purpose, there will be controversy. As it pertains to arthritis, many of you have found yourselves wondering whether arthritis and sex can even go together, but it is not a topic you want to be open about. In general, people do not want to discuss what goes on behind closed doors. Even couples in meaningful relationships can relate to this as they hide their feelings from one another.

What is Intimacy?

What does intimacy requires and includes? Ideally, it includes love. It can also include romance. Two additional critical components are mood and setting. Last, intimacy includes the act, with positions and physical attributes.

In addition to the requirements of intimacy, we can also look to why intimacy fails and why breakups and failed relationships occur. In looking at the reasons for failure, we find challenges to successful relationships and that once successful relationships can fail. Moreover, when we consider the reasons for failure, we often forget that in addition to emotional factors, physical factors can play a part in the success or failure of a relationship. Emotional factors are a given, as are intimacy issues. Physical factors can include arthritis and chronic pain conditions.

Intimacy and Arthritis

The problems faced by arthritis sufferers are both emotional and physical. Emotional factors include self-doubt and poor body image. Physical factors include joint pain and other symptoms that are characteristic of a person’s specific arthritis condition. These concerns not only affect the patient, but they also affect that person’s partner as well. Barriers include physical pain, the inability to perform because of joint pain or other symptoms, expectations and personal needs — both sexual and emotional. This complete consensus can have strong complications in a relationship.

What it all comes down to is that sex is supposed to be enjoyable, but for arthritis sufferers, it can be difficult. In additional to physical pain, psychological factors come into play. The nature of a couple’s sexual lifestyle prior to the diagnosis further complicates the situation. This can result into resentment, worry and fear for both partners.

The Effect of Arthritis on Sexual Intimacy

The effects of arthritis pain, stiffness, fatigue, lack of mobility, and swelled joints can make sex difficult, painful and unappealing. When arthritis affects your back, your knees, your hips, ankles, etc., sex cannot possibly be enjoyable. In addition, side effects of medications can diminish sexual desire and cause other problems such as vaginal dryness, erectile dysfunction, inability to orgasm, and fatigue that also lessen the desire to be intimate. As the sufferer, you feel sexually unattractive and, as a result, you cannot feel relaxed enough to enjoy the actual act. These feelings bring with them anxiety and stress and further worsen our symptoms.

When you sufferer from arthritis, your partner may not necessarily be aware of the changes happening to your body — both physical and emotional. Your partner cannot understand your pain levels, nor can he or she know whether you are using pain levels as an excuse not to be intimate or whether your excuses are legit. All of these factors can lead to the failure of a relationship when the real and best answer comes down to communication.

What Can You Do?

Change Expectations. Sexual intimacy is not just about achieving an orgasm or the act itself. If we can change this perception, we can change our expectations. Taking a slower approach to intimacy works best for partners when they share mutual respect, care, trust and love for each other. Moreover, barriers can be approached through communication on what is comfortable and what is not. Arthritis does not necessarily affect sexual organs but the physical effects of the disease can make intercourse painful. Moreover, emotions come into play because of those physical aspects. Therefore, couples must address the emotional aspects, as well as the physical, openly and honestly.

Communicate. Expressing fears and concerns allows the partner without arthritis to support and reassure. In addition, talking about fears will allow the arthritis sufferer to let go. What the arthritis sufferer must take in mind is that his or her fears can be viewed as rejection to his or her partner. That rejection turns into distance and emotional breakdown of the relationship. If these topics are sensitive initially, writing a letter to a partner to express fears and concerns can be another approach, but the next step would be to talk openly about what has been written down.

Sexual Wellbeing and Changing Habits

Psychological wellbeing and social support can contribute to a fulfilling sexual life. By learning to separate the emotional aspects of arthritis and working creatively to deal with the physical aspects, couples can take a more practical approach in dealing with changes brought about by arthritis and in turn, make accommodations for one another when dealing sexual intimacy.

Changing sexual habits and planning is the first place a couple can start in order to continue to have a fulfilling sex life. For example, if the arthritis sufferer wakes up stiff and in pain in the morning, sexual intercourse can be saved for later in the day or at night prior to bedtime. If being rested helps, perhaps the arthritis sufferer can take a nap beforehand rather than avoiding the act altogether simply because of factors that contribute to the inability to perform. If muscles and joint become tense during sex, then a perhaps considering a warm bath to sooth muscles prior to sexual intimacy may help to ease those tensions.

Other considerations can include taking pain medications so that its maximum effects happen during sex, using massage to help ease muscles and joints as foreplay, using pillows or rolled sheets to support joints, or even pacing yourself to conserve your energy for you and your partner. Vaginal dryness can be addressed by using an over the counter lubricant. Other more difficult issues, such as erectile dysfunction, may require a medical perspective. What it all comes down to is that couples have to be willing to work together in order to allow for intimacy to be fulfilling for both partners.

The Bottom Line

Sexual intimacy should not make arthritis worse. By focusing on the physical and emotional aspects rather than the act itself, being open and honest with each another, and changing habits, couples affected by arthritis can continue to find satisfaction with sexual intimacy.

A Cheat Sheet for Coping with Rheumatoid Arthritis Flares

It may seem as if flares are the most difficult tests of all to endure. Every time I experience a flare, I think that I know what to expect but regardless of experience, it seems that every flare is different.

Yet, in some ways, they are all the same. In the moments where I feel a great deal of pain, the fatigue is at its worst and I am extremely overwhelmed, it is hard to have a clear perspective. What I have found, however, is that having a plan, or a cheat sheet, for dealing with a flare makes coping so much easier.

What ignites a flare?

What we all know about rheumatoid arthritis (RA) flare-ups is that they are unpredictable. Sometimes they come often, and other times you can enjoy longer periods of remission with only sporadic attacks of inflammation and fatigue. A flare can occur in few joints or it can affect the whole body, and it can last for days or even weeks.

Any number of things can trigger flares and they are not necessary specific to certain foods, hormones or even stress. Other factors that can ignite flares include smoking and the weather. That is why it is so important to educate yourself on living with RA and dealing with its effects. Further, being informed allows you to quickly evaluate an oncoming flare and to work towards coping through it successfully.

My cheat sheet for coping

I have a yellow post-it note in my medicine cabinet (taped to the inside part of the door) that has the following written on it: “For Flares: No drugs, rest and exercise, watch what you eat, try alternative therapies, drug options and call your doctor.” When a flare happens, I try to follow these in order depending on the severity of the flare, and then continue them throughout the duration of the flare.

Here my cheat sheets tips for coping with a flare:

Start with No Drugs. The reason I keep my cheat sheet in my medicine cabinet is to remind myself to consider non-drug therapies before medicinal approaches. Heating pads and cold packs can be applied to affected areas to reduce pain and swelling.

Doctors recommend resting affected joints and applying ice for 20 minutes on and 20 minutes off for a period of two hours. Alternate between hot and cold every two hours with the same schedule – 20 minutes on and 20 minutes off.

Alternate Between Rest and Exercise. We know that rest is essential during a flare period, but so is exercise. This is because if you do nothing, your joints will become stiff. Having a flare-up is not a reason to avoid activity. In fact, it is necessary to keep moving as well. However, avoid strength training and endurance exercises as you deal with the flare. Instead, try gentle stretches to maintain a range of motion.

Watch What You Eat. While eating is the last thing on your mind during a flare period, eating foods rich in fish and plant oils and avoiding meat can help to reduce inflammation. If you take an omega-3 supplement, increase your intake to 3,000 milligrams daily. Most likely, that consists of taking two omega-3 supplement capsules. However, check the bottle’s label to confirm.

Try Alternative Therapies. As you know, chronic pain and RA patients have found relief in practicing relaxation techniques, mediation, yoga and acupuncture. While I have not tried acupuncture, I have tried and benefited from relaxation, meditation and yoga. All three help during a flare by alleviating stress, relaxing the mind, and relieving pain. When you first try these therapies, becoming relaxed can seem like a nearly impossible task, but it is something that can in fact be learned.

As for acupuncture, researchers have questioned whether it holds any helpful value, but according to many it is a practical alternative for managing arthritis pain. If available during the flare period, it is a viable option that can relieve RA related pain and help to minimize stress and anxiety.

Drug Therapies. When all else fails, it is time to call the big guns. I consider medicinal approaches a last option. RA patients already take plenty of medications to slow down and the stop the progression of the disease, so it makes sense to consider non-medicinal approaches when possible.

Start with over the counter (OTC) anti-inflammatory gels that can be applied to inflamed joints. Use sparingly because overuse of gels can cause skin irritation. If gels are not working, your next option can be anti-inflammatory OTC medications (e.g., Advil or Aleve). Please note that the overuse of anti-inflammatory OTC medications can cause additional risks such as stomach irritation and ulcers so, as with gels, use in moderation.

Call your Doctor. When non-medicinal approaches, exercise and rest, watching diet, alternative therapies, and anti-inflammatory gels and pain relievers are not working, work with your doctor to create a plan that will help you bounce back quickly. Your doctor can raise the dosage of RA medications and prescribe additional medications to help with pain and reduce inflammation. If your flare is especially severe, strong anti-inflammatory corticosteroids can be temporarily used.

Having your own Cheat Sheet

Having rheumatoid arthritis requires you to constantly be on top of your game. This is because a flare-up can keep you out of commission for days on end. As a result, planning for a flare is critical and it is similar to planning for a disaster. Prepare your own cheat sheet even if it is as simple as a post-it note reminder. Keep in mind that planning for flares will help you to cope from the first onset and will allow you to remain capable and focused during a flare period. It will also save you time and energy that is better suited for coping.

What’s on your flare-up cheat sheet?

Can rheumatoid arthritis affect the eyes?

Rheumatoid arthritis is primarily a joint disease. However, RA occasionally affects other parts of the including the eyes. Eye conditions associated with RA include:

(1) Dry eyes – you can use preservative free artificial eye drops to ease the discomfort of dry eyes. It is also possible that this could be a symptom of Sjogren’s, an autoimmune disease associated with RA. If you suspect this may be the case, follow up with your doctor.

(2) Uveitis – inflammation of the interior part of the eye. Symptoms of uveitis include redness and pain, light sensitivity and blurred vision.

(3) Episcleritis – inflammation of the white part of the eye. Symptoms include sudden eye discomfort and/or redness.

(4) Glaucoma – inflammation of the eye’s drainage system leads to glaucoma, a condition that can result in blindness. Signs and symptoms include gradual vision loss, eye pain or blurred vision.

(5) Cataracts – clouding of the lens of the eye as a result of inflammation within the eye and long term use of corticosteroid medications often prescribed to treat rheumatoid arthritis. Symptoms include blurred, cloudy or dim vision.

If have RA and experience eye pain, vision changes or other eye problems, consult an ophthalmologist for evaluation. Also, let your rheumatologist know. Early treatment can prevent vision consequences.

Do you worry about the future?

 

When you are diagnosed with arthritis, regardless of the type you have, you begin to have feelings of uncertainty. You also have many questions, many which are unanswerable especially at the time of diagnosis. The important thing that patients look for when it comes to a prognosis is measurable results. However, that is not something that anyone can provide.

In my case, after being diagnosed with rheumatoid arthritis, I wanted to know whether things would get worse for me and whether I would continue to be able to work and to take care of my family. I desperately wanted someone to give me a response that was measurable and the only response I received from my doctor was that she did not know and that the course of the disease was different for everyone.

Most doctors inform patients that arthritis is not the same for everyone that symptoms can range from mild to severe. This includes periods of flares as well as periods of remission. The fact is that there no way of predicting the future and as a result, patients have fears that set in.

The questions that stood out for me were:

• Will I become disabled?

• How will having arthritis affect my life and my future?

• Will I continue to work and take care of my children?

Those answers came later. I don’t necessarily know at this point in my life where I will be in five or ten years. I just know that the plan is to continue to focus on managing my disease and putting aside my fears. I have done everything I can to learn about my disease. I have worked closely with my rheumatologist on my treatment plan and I have focused on adhering to it. I have kept a positive attitude and I have surrounded myself with support. As far as I am concerned, I have done everything that is necessary to set my fears aside.

What I do know for sure is that my fears are normal. At the time of diagnosis, however, I needed a clear perspective. If I were to focus too much on the fear, I wouldn’t be able to cope and manage my disease. Fears can elicit feelings of stress and that stress has a negative impact on your disease and overall health. By accepting your situation, you give yourself best chance of having a good outcome.

I still worry about the future but what I have learned in the past few years is that I can make things work. I have had to change some of my dreams as a result of having been diagnosed with RA but I still have dreams! My dreams changed because of having had to make lifestyle adjustments but also because of seeing life in a different perspective once I made those changes. For example, I gave up going to law school but having had the opportunity to find a job that was less stressful, I decided law school was not part of my future and I made different plans. Additionally, I gave up volunteer commitments but had more time with my kids. In my view, everything happens for a reason. So yes, I still have fears but I know now that I can overcome those fears and any limitations that stand in my way.

What fears have you had? What fears do you have now that you have had an opportunity to access your situation? Do you still worry about the future?

What Does it Mean to Accept Your Chronic Illness Diagnosis

Acceptance is one the toughest things that anyone of us has to do. Whether we are accepting the loss of loved one, moving to new town because of a job transfer, getting divorced, or accepting that we have to live with sickness and pain, acceptance isn’t easy. With chronic illness, the sooner you accept your diagnosis, the sooner you can work on being healthy. 

I know that this really does make much sense but from experience, I know that it is a process and it takes time and trial and error to learn to how to best live with chronic illness. 

My diagnosis 

When I received my rheumatoid arthritis (RA) diagnosis, I promised myself that RA would not win and I remember the feelings of fear, denial, numbness and skepticism. My emotions changed from day to day and even several times a day. Feeling hopeful or optimistic were a long ways down the road and acceptance–well, that was something I never thought would happen. 

In the beginning, I promised myself that RA wouldn’t win but all that happened was that I became depressed even though I insisted to everyone in my life that I wasn’t. The only thing that kept me going was that I knew that my children needed me to be their mother and chronic illness didn’t change that. My new RA diagnosis felt like a death sentence and the information on the internet make me feel that the disease would disable and disfigure me in five years’ time and end my life in ten years. A few months after my rheumatoid arthritis diagnosis, I was also diagnosed with fibromyalgia syndrome (FMS) and the blurry reality of what was my life started to become clearer. 

I had spent ten years trying to find answers and one day I had them. What I realized at that point was that I had the power to heal because I had already started to find out how by searching for and finding answers. 

As a result, I started to educate myself and arm myself with information about rheumatoid arthritis and fibromyalgia that made sense. I sought support from others who were living with the disease and I knew that if I wanted to get better, I had to accept that a handful of pills weren’t enough. 

Looking beyond the physical symptoms 

I also looked at my life as lesson after lesson of patience, strength and survival. Having RA and FMS were the same as any other struggle that I faced in my life and they would probably be easier than some of those struggles. When I looked at my diagnoses as just another thing that made me who I was, I learned to accept that I had no control of what happened but I had control of the response as I had when other obstacles impeded my life. 

The person that I was at that point in time was already prepared for RA and FMS and while it wasn’t easy or clear at first, I accepted RA and FMS in my life not because I wanted but because I had to. 

Of course, it wasn’t easy to get to that point because living with an invisible condition (or two or three or more) isn’t that simple. And steroids, a lack of energy, physical pain, and weight gain can take a toll on you and blur your perceptive. 

You lose a lot of friends and there are a lot of people who don’t understand but what the illness doesn’t control is how we respond, how we fight back and how we go on the defense against the war waging inside our bodies. The disease doesn’t get easy but we start to realize how exceptional we are to be able to overcome so much. 

Why you should accept your chronic illness diagnosis 

One you are diagnosed with any disease, invisible condition, and/or chronic illness, it will always be a part of your life and the sooner that you accept your diagnosis, the sooner you can learn how to live with your disease. It is also how you will cope and how you will learn to understand that your diagnosis isn’t a death sentence. The only thing that your diagnosis has to be is something you have to live with and once you accept it, you can learn how exactly you will do that. 

Chronic illness is kind of like life with its all ups and downs but living with an invisible chronic disease is like life multiplied and so very complicated. It is never ending roller coaster of pain and emotions. 

There is also about a lack of understanding amongst your family, your friends, your coworkers, and even complete strangers. It is about living life without knowing what tomorrow will bring and it is an emotional battle on a daily basis. Moreover, it is a bitter pill to swallow and unless you accept all these things, you will never be able to get past your diagnosis. 

How you accept chronic illness in your life 

In order to accept chronic illness, take a look at the advice you have received–pace yourself, manage your condition well, educate yourself, advocate for yourself, surround yourself with emotional support and don’t let the disease define you. This advice is your guide through the roller coaster of symptoms and emotional setbacks. The only thing that can prepare you for that next flare-up is experience. 

There will be days where your pain and fatigue are under control. There will be days when you feel productive and that you are in control of your life and your body again. It will not feel like a death sentence forever. On the other hand, there will be days that it will feel like the disease is in control when you are in pain, you are tired and you can’t focus or get anything done. The disease doesn’t get easier but getting through those really bad days does get easier. 

Make conscious decisions 

As a long time sufferer, I have learned that there can be more good days by making good choices. You have to do all the right things like eating right, taking your medications, being active on good days, and resting on bad ones. It is a learning process like anything else in your life and the setbacks–they are part of life too. You can’t control the setbacks regardless of how well you plan and a flare-up can come on at the worst possible time. 

All you can do is wait to feel better and you can’t always predict how many good days you will have so try not to overwork yourself because you don’t know when your next good day will be. 

Accept that it’s not all in your control 

Understand and remind yourself that a chronic illness is unpredictable. There is not much that you can do except to realize you have to adjust and adapt to the moments that the disease brings havoc to your life. While it doesn’t define you as a person, it can still define your life. 

The best thing you can do for yourself is to accept that you have to be flexible to live successfully with your chronic invisible disease. The disease might be your new reality but learning to be flexible means that you accept chronic illness in your life not that you give up. Your life will never go back to “before your diagnosis,” but it can get close to it if you open your mind to what you need to do to get to that point where you can accept diagnosis in a way that means you don’t give up. 

Light & Noise Sensitivity in Fibromyalgia Patients

Light and noise sensitivity is something that doctors and researchers have closely linked to fibromyalgia since the early 1990s when medicine started to recognize it as a real condition. However, despite its recognition, it is one of those fibro symptoms that are not priority on the long list of fibromyalgia symptoms that most of us experience.

If this is one of the symptoms you experience and that your doctor seems to downsize, you are not alone. Light and noise sensitivity in fibro patients have been scientifically known for quite some time but there is no real treatment option to help patients deal with this issue.

Some mornings, I am not affected by noise and sound and other mornings it feels like I have been run over by a monster truck. I have pain, nausea, dizziness, trembling and extreme sensitively to noise, light and even smell. No one really knows what causes light and noise sensitivity which is often called “generalized hypervigilance.”

There is not a lot of information out there about generalized hypervigilance or, at least, information that makes sense for us lay people, and most the information and research is directed towards the medical community. Basically, it is the amplification of sensation so it does not just apply to just noise and light. Those of us with this condition are oversensitive to external stimulation and preoccupied with pain sensation. There was a research study that compared fibromyalgia, rheumatoid arthritis and chronic pain patients. Of all three groups, the fibromyalgia patients were least tolerant and most sensitive to stimuli.

Common symptoms of generalized hypervigilance include anxiety, rapid heartbeat, trembling, rapid and labored breathing, sweating, irritability, fatigue, sleep disturbances and of course, sensitively to light, noise and even smell. Because there is not a lot of information out there, there is really no specific treatment for this symptom of fibromyalgia. Some natural supplements for anxiety and stress can help to deal with this symptom. Patients may also benefit from massage or acupuncture.

Some things you can do ease light and noise sensitivity include:
• Wearing sunglasses when you are outside
• Staying away from fluorescent lights if possible or wearing tinted sunglasses in that environment
• Wearing ear plugs in noisy environments
• Deep breathing and relaxation techniques during these episodes
• Explain the issue to family and friends so that they can be considerate in turning down the volume or turning lights off when you have these types of episodes.
• Adjust your computer screen if it is too bright.

What’s the most ridiculous thing you’ve heard about your arthritis condition?

In the first year after rheumatoid arthritis came into my life, I quickly got tired of hearing people downplay RA as “just” arthritis. Here I was struggling with this new diagnosis and I was in a lot of pain because I had not yet found a treatment plan that worked for me, and what I was going through was being minimized as “just” arthritis. I would hear things such as “we all get arthritis as we get older,” and “well let’s face it, you are getting older.” My favorite comment was “we all get arthritis eventually and we all suck it up.” Seriously, I was 32 when I was diagnosed. If I was 50, those words “may” have made some sense to me but I was in my early 30s and I had been diagnosed with a destructive and debilitating form of arthritis.

Hearing “it’s just arthritis” didn’t really help and even osteoarthritis can be pretty painful so to that something is “just” simple doesn’t minimize what the sufferer is going though. Even so, arthritis from age and wear is tear is osteoarthritis. Further, osteoarthritis is much different than RA which is an autoimmune disease. Not to downplay lupus, but if I told people I had lupus, I would most likely get more sympathy. However, RA was “just” arthritis and as a result, it seemed no one could understand my need for understanding and sympathy. I found myself constantly explaining the difference between osteoarthritis and RA and I also found it ignorant that people would downplay the significance or pain associated with osteoarthritis. Unless you have lived with this a disease, you have no way of knowing its effect on the sufferer and even if you have, you only know how the disease affects you.

Every day, doctors learn more about RA and autoimmune diseases. Also, new treatments are popping up every day and these medications continue to help people living with RA to have normal lives. I know that there is hope despite RA and the years have taught me quite well that RA isn’t “just” arthritis. That statement no longer bothers and I no longer feel the need to have to explain my disease to anyone. RA is a part of my life but it no longer dictates it.

What’s the most ridiculous thing you’ve heard about your arthritis condition?