Psychological Treatment

Since it is hard to find an effective treatment for fibromyalgia (FMS). your pain, fatigue and other symptoms may continue despite many visits to your health care provider. As frustrating as this can be, there is hope. Chronic pain is difficult to get rid of, but there are many things you can do to help yourself. You can learn techniques to control your pain, manage other FMS symptoms and improve your quality of life. The following are some things you can do to try to live a better life in spite of chronic pain:

• Follow the advice of your health care provider and/or health care team – Ask questions if you do not agree or do not understand what they are asking you to do.

• Keep a list of your medicines – Talk to your health care provider about the medicines you take. Ask for guidance on how to wean yourself off, or slowly stop taking, unnecessary medicines.

• Exercise regularly – Having a regular exercise program will help increase your stamina and ability to do normal daily activities. It can help you feel better about yourself and help decrease pain, stiffness and other FMS symptoms.

• Have a daily routine – This will help you organize your day and perform daily tasks more efficiently.

• Practice coping techniques – Find coping techniques such as cognitive behavioral therapy and biofeedback to learn to control and live with your pain. These can help relieve stress and promote relaxation.

• Be positive – Think about your strengths and capabilities, not just your limitations.

• Control or avoid things that make your FMS symptoms worse – Be aware of things or situations that make your symptoms worse. For example, if stress makes your symptoms worse, learn stress management techniques to keep your stress level low.

• Educate yourself about FMS and treatments – Ask questions and read about FMS. The more you know about your condition, the better equipped you are to help yourself and others. Learning more will help you work with your health care provider or team to make decisions about your care. It can help you understand and express the feelings pain creates.

• Do not isolate yourself from others – Even when you are not feeling well, stay in touch with family members and friends. Invite someone to your home, send an e-mail or use the phone to stay in communication with the people you care about. Teach them about FMS so they can better understand how it affects you. Find a counselor, friend, pastor or family member who you can talk to about your feelings.

• Practice good health habits – This includes eating a nutritious diet, managing your weight, and going to bed at a regular time each night.

These steps can be hard to accomplish on your own, especially if pain has been in control of your life for a long time. Sometimes the assistance of a multidisciplinary pain rehabilitation program is required to get back in control of your life. These programs typically last for three weeks with six or more hours a day of group and individual treatment.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a technique that you may use to live a better quality of life in spite of your pain. CBT helps patients understand how their thoughts and expectations affect the way they feel and act. For example, if a person thinks she is too tired to go to a party, she may choose to not go (action). As a result, she feels depressed and isolated because she is missing time with her friends. Research results show that CBT can be very effective in helping people with FMS cope and control their pain.

CBT can help you focus on understanding your condition. It can help you train your mind and body to do the following:

• Function despite your pain
• Get rid of destructive behaviors and attitudes
• Learn how to approach your life in a positive (instead of negative) way
• You can use CBT to conserve energy and decrease pain. CBT relaxation techniques can help manage chronic pain and help you sleep better.

Counseling

If you are having difficulty coping with FMS and how it has changed your life, it may be helpful to talk to a mental health professional about your feelings. Ask your health care provider to suggest names of a psychologist or other type of counselor. Find a mental health professional who has experience working with people who have chronic pain.

Counseling and behavioral therapy alone or combined with medication are effective and important techniques in treating depression and pain. They also require your active participation in your care and recovery. Following are some suggestions for actively participating in your care. They can help you and your health care provider work together to treat your pain and depression:

• Keep a diary and record changes in your pain and emotions – Print out a personal pain journal and bring it with you to your medical appointments. It will help remind you of how you were feeling and when you were feeling better or worse.

• Form your own support network – Support persons may include family members, friends and support groups. Join the online support group hosted by the National Pain Foundation. You can write your thoughts and feelings, and meet and get support from other people who live with chronic pain.

• Try the stress management techniques you learn in counseling and use them regularly – Guided imagery, cognitive behavioral therapy, biofeedback and relaxation techniques really can work if you practice them and use them regularly.

Depression is an illness that often accompanies FMS. Ignoring it will not make it go away and will make it very difficult to make any progress in treating your FMS symptoms. Seeking the treatment you need will give you the best chance at successfully managing your FMS.