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Depression is common in people with CFS and fibromyalgia. Some of the depression is situational, a reaction to the limits, disruption, losses and uncertainty brought by long-term illness. Self-management strategies are usually helpful with this type of depression.
Depression may be biochemical, as well, created by changes in the functioning of the brain. Self-management strategies may be useful for this type of depression, but treatment normally includes medication, too. (See the list of anti-depressants on the CFIDS Association of America website.)
Everyone has times when they feel unhappy or sad. By recognizing that these feelings are likely to occur from time to time, you can plan how to respond. You’ll find a menu of options below.
Special Note: If you are seriously depressed, suicidal or have been depressed for some time, get help now. Phone a suicide prevention center, talk to your doctor, see a psychologist or call a friend. For resources, see the article Killing Me Softly: FM/CFS and Suicide on the self-help program website.
If your situation is not urgent but depression reduces your ability to do your normal daily activities, you should consider professional help: counseling, medications or both. A therapist can provide an outside view of your situation, help you to accept your illness and support you in your efforts to improve. If you have family tension because of illness, couples or family counseling may be helpful.
Get active
Depression produces hopelessness, an attitude that becomes a self-fulfilling prophecy. Counteract those feelings by taking actions, such as those listed below, that have a good chance of helping. Being active changes mood; also, successes promote hope.
Establish good daily habits
Keeping to a daily routine regardless of how you feel can help counteract depression. Forcing yourself to do things, even if you don’t want to, counteracts the inertia of depression.
Exercise
Exercise is a natural anti-depressant. For how to exercise safely if you have CFS or FM, see our section on exercise.
Use problem solving
Taking action to solve a problem replaces helplessness with a sense of accomplishment.
Rest
Some depression is associated with physical symptoms, such as fatigue and pain. Resting to reduce these symptoms can also improve mood.
Change your thinking
If you have a tendency to think of the worst that might happen, you can retrain yourself to speak soothingly and realistically when you’re worried or depressed. For example, remind yourself when you’re feeling low that periods of bad feelings end. Change your mental climate by noticing what’s going well and congratulating yourself on your accomplishments.
This approach is called Cognitive Therapy. You can learn how to use it from therapists or on your own from books such as Learned Optimism by Martin Seligman or Feeling Good by David Burns. For a detailed explanation, see the article Taming Stressful Thoughts on the program website.
Do something pleasant
Pleasurable activities offer a distraction from symptoms and help create a good mood. The key is to find things that will absorb your attention.
Such activities might include reading, listening to music, sitting in the sun, taking a walk, doing crafts, solving puzzles, watching a movie and spending time with friends.
Stay connected
Supportive human contact is very soothing. Time with positive people counteracts isolation and preoccupation with problems. Contact can be as simple as a phone call or an exchange of emails.
Consider medications
If your depression is biochemical in origin, you may be helped by an anti-depressant medication. (For a list of options, see the anti-depressants page on the CFIDS Association of America website.) On the other hand, tranquilizers and narcotic painkillers intensify depression, so if you are depressed, it may be due partially to a medication side effect.
Help others
Get involved with something larger than yourself to counteract the isolation and preoccupation that often accompany illness and to rebuild self-esteem.
Helping others might involve a regular commitment, like doing volunteer work, something as simple as a phone call to a friend or trading favors (for example, baking for grocery shopping).
Manage stress
Controlling stress can help you manage your emotions, because stress tends to make emotions more intense. Living within your energy envelope and managing the stresses in your life will make emotions more manageable.
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