Counseling for Anxiety and Depression in Fibromyalgia Patients

Counseling for anxiety and depression may be the answer to your need for mental and emotional help, if you are one of the many fibromyalgia patients that experience these symptoms. It is not uncommon for fibromyalgia patients to have bouts of deep depression and anxiety or panic that go along with their chronic disease. Both anxiety and depression are often diagnosed along with the disease and with other more recognized symptoms such as widespread chronic pain, fatigue, sleep disorders, and the fibromyalgia fog.

According to published reports, depression and anxiety in can occur as frequently as 30-50% of the time in patients diagnosed with fibromyalgia. How do depression and anxiety manifest themselves in fibromyalgia patients? And, if you are having these symptoms, what can you do?

Depression and Fibromyalgia

While small bouts of depression are common to almost everyone, it is abnormal for it to become debilitating. A chronic type of sadness that permeates your life is not acceptable. Major depression is the clinical diagnosis for patients who feel depressed for two weeks or longer.

Depression can change your mood, your emotions, and your physical health. You may feel sad, worthless and empty. Behaviorally, you may have trouble concentrating, not be able to make decisions, not want to participate in activities, be irritable, or desire to cause harm to yourself. Physical symptoms can range from nausea and indigestion to trouble sleeping. You can lose weight and gain weight with depression.

There are many factors that cause depression and several of these appear to be linked with fibromyalgia. This makes it more likely for a fibro patient to experience bouts of depression. With fibromyalgia, it looks like there are several factors at work:

  • Chronic Pain: The persistent pain felt by fibromyalgia patients often leads to deep depression (even more often than other chronic pain conditions such as rheumatoid arthritis)
  • Reduced Neurotransmitters: A low level of neurotransmitters such as serotonin in the brain, which help monitor pain sensations, may lead to depressed feelings-fibro patients often have a depleted amount of neurotransmitters in the brain due to loss of sleep and other symptoms of their disease
  • Genetics: Many studies show that genetics play a huge role in depression and that patients with fibromyalgia and depression  have depression in their family history

Anxiety and Fibromyalgia

As with depression, everyone can become anxious at some point. However, with fibromyalgia sufferers, it can become chronic. When this happens it can become a brutal cycle as it will heighten fibromyalgia symptoms.

Anxiety is commonly described as feelings of worry or fear. You may experience anxiety if you are apprehensive. Symptoms of anxiety include muscle tension, increased sweating, headaches, nausea, trouble sleeping and trouble sleeping.

If you have severe bouts of anxiety you might have panic attacks. This form of anxiety comes on suddenly and will last for around ten minutes. It normally includes sweating, dizziness, heart palpitations, and more.

For fibromyalgia patients anxiety can become a real problem. It can cause the pain to increase and cause migraine headaches to set in along with depression. Many fibromyalgia patients become very anxious when thinking about when the next bout of pain will come. Even when their pain is minimal, their anxiety about the pain makes it difficult to function.

Counseling and Fibromyalgia

Counseling for anxiety and depression offers the best route to treatment. If you suffer from fibromyalgia and from anxiety and depression, counseling will help you identify the underlying problems and lead you to solutions.

One of the most successful forms of counseling and treatment for fibromyalgia patients suffering from anxiety and depression is cognitive behavior therapy. This type of psychotherapy identifies patterns of thinking and emotions and ties them to behaviors. The goal is to change negative thought patterns and behaviors that are found to be linked to fibromyalgia symptoms.

With cognitive behavior therapy your goal is to identify thought patterns that are causing behaviors. These behaviors lead to stress which leads to your fibromyalgia symptoms becoming inflamed. Once you identify these thoughts and behaviors, you can work with your counselor to make changes that will ease your depression, your pain, and help control your disease.

The normal cognitive behavior counseling appointment will take one hour. As a fibromyalgia patient, you can expect to attend up to twenty sessions to make changes in your thought patterns and behaviors.[2] While every counselor is unique, all sessions share some similarities. You will discuss your chronic disease and what you hope to gain with your counselor at your first meeting. During your time together you will explore the connection your thoughts and behaviors have on your disease.

During cognitive behavior therapy you, the fibromyalgia patient, will be an active participant during treatment. You may be required to keep a diary. This will allow you to note any factors that are causing you stress such as personal relationships or your job. Your counselor might ask you to be active in confronting negative thoughts. If you constantly think you are a failure due to your disease, your counselor will help your change these thought patterns and find places in your life where you are currently succeeding. You will use this as a stepping stone on which to build.

You will learn to set limits in cognitive behavioral therapy. These limits will help you deal with stress every day.[3] Many fibromyalgia patients find this to be one of the most satisfying and successful parts of the treatment. They learn to take life one step at a time. Cognitive behavioral therapy will help you discover your priorities in life and find new activities that you enjoy.

Does cognitive behavioral therapy show results? Twenty-five percent of patients with fibromyalgia experience relief from chronic pain when undergoing this form of counseling for anxiety and depression. [4]

In addition to counselling, many patients will need additional help from their doctor. It is sometimes necessary to start anti-depression medications to treat feelings of depression or anxiety. While these medications can help, they work best when combined with counselling in a dual treatment approach.

If you are experiencing the symptoms of anxiety and depression help is available. Do not let it make your fibromyalgia symptoms worse than they already are. Counseling for anxiety and depression is available and works.


[1]  Burckhardt, C. (2005). Assessing Depression in Fibromyalgia Patients. Arthritis and Rheumatism , 35-39.

[2]  Bennett, R. N. (2006). Cognitive Behavioral Therapy for Fibromyalgia. Nature Clinical Practice Rheumatology , 416-24.

[3]  Fibromyalgia Behavioral Therapy. (n.d.). Retrieved from University of Maryland:

[4]  Vlaeyen, J. (2005). Cognitive Behavioral Treatments for Chronic Pain What Works for Whom. clinical Journal of Pain , 1-8.

Vlaeyen, J. (2005). Cognitive Behavioral Treatments for Chronic Pain What Works for Whom. clinical Journal of Pain , 1-8.

This article was originally published on July 11, 2012 and last revision and update of it was 9/7/2015