When you live with fibromyalgia, it's common to also live with depression, anxiety, or feelings of hopelessness. About 50% of people with fibromyalgia also have an anxiety disorder or depression. In fact, depression is the most common comorbidity (condition that happens alongside another condition) of fibromyalgia.
Fibromyalgia affects the way the brain and nervous system process pain. As a result, ordinary sensations can feel painful or overwhelming. Constant discomfort and fatigue can lead to frustration, fear, and social isolation — all of which can feed anxiety and depression.
This pain-depression connection means your emotional health and your pain aren't separate issues — they affect each other every day. Understanding this relationship, learning the warning signs of depression and anxiety, and finding supportive resources can help you care for your mental health as you live with fibromyalgia.
Why Mental Health Challenges Are Common With Fibromyalgia
Pain and depression often go hand in hand, says Lynne Matallana, founder and CEO of the National Fibromyalgia Association (NFA).
"Part of the reason why is because the brain centers that are responsible for pain are also in the same part of the brain that are responsible for emotions," says Matallana. "So there's a very close connection."
Pain is an experience that has both a sensory and emotional component. When you feel pain, two parts of your brain react: the part that interprets the pain and the part that has the negative effect.
Fibromyalgia pain is also chronic, which makes it much more likely to affect your mood, relationships, movement, and all parts of your daily life. Pain can make it harder to work, do necessary tasks, and enjoy activities. When you can't take part in your life the way you want, your mental health suffers.
Besides the pain-depression link in the brain, fibromyalgia can also come with stigma and other barriers. It can be hard to find doctors who are familiar with your condition or who take your pain seriously.
"People with fibromyalgia are often told they're crazy, lazy, or that their illness doesn't really exist," says Matallana. "That stigma can make people hesitant to admit they have depression or anxiety."
You can also easily overlook depression and anxiety when you don't know the signs and symptoms, especially if you're already dealing with symptoms of fibromyalgia.
Warning Signs of Depression and Anxiety
Because fibromyalgia symptoms overlap with those of depression and anxiety, like fatigue, trouble concentrating, or sleep issues, it's easy to miss them. Here are some red flags to look for:
- Persistent sadness or hopelessness
- Loss of interest in hobbies, relationships, or things that once brought joy
- Changes in sleep or appetite (too much or too little)
- A hard time concentrating or making decisions
- Feeling worthless, guilty, or like a burden
- Restlessness, crankiness, or constant worry
- Withdrawing from friends or social activities
The signs can sometimes be subtle, and you may not realize you're isolating yourself from others, for example, until you look at your behavior over time. Tracking your mood can be a helpful tool to see the big picture.
Matallana, who has lived with fibromyalgia since 1993, recommends doing a visualization exercise where you picture a place or time that makes you happy and use it as a benchmark for a "happiness scale" so you have something to compare to.
"When I realized that my happiness scale was really low, it helped me see there was something wrong," she says.
If you notice these symptoms for two weeks or more, or if they interfere with your daily life, it's important to reach out for help.
How to Care for Your Mental Health
An effective doctor will take into account your emotional wellness as part of your overall fibromyalgia care. Be open and honest with your doctor about your moods. If your doctor dismisses you, or you don't feel heard, go elsewhere, says Matallana.
"If your doctor is not listening to you, you need to find another doctor," she says. She suggests checking the American College of Rheumatology's patient resources for specialists familiar with fibromyalgia.
Go into your appointments with two or three key concerns and describe your symptoms clearly. Let your doctor know if you're struggling emotionally and ask for referrals to therapists or programs that understand chronic pain.
Also, there are steps you can take to support your mental wellness.
Move your body.
Movement like stretching, tai chi, yoga, or short walks has been shown to reduce fibromyalgia pain and boost mood. Exercise releases endorphins, which are natural mood lifters. If full workouts feel impossible, start small with five-minute sessions and build from there.
Prioritize sleep.
Poor sleep can worsen both pain and mood. Try consistent sleep hygiene: Go to bed and wake up at the same time daily, keep your room cool and dark, and avoid screens an hour before bed.
Use self-care support.
Taking care of yourself can sometimes feel like another hurdle to overcome in your fibromyalgia management. In recognition of this struggle, Matallana and her team at the NFA developed a program called Pain Tools. This program provides daily guidance and community support to help people stay engaged with activities like gentle movement, better sleep hygiene, and positive visualization.
Matallana says that in testing, people taking part in Pain Tools reported more than 30% improvement in sleep, fatigue, and anxiety after four months of the program.
"I really do think if you approach it from the standpoint of working on the things you can, you can start to get your life back," she says. "And that's what I hope people start to believe, because when they believe it, then things change."
Find Support and Connection
Isolation can quietly worsen depression. Even small interactions such as chatting with a friend, taking part in your spiritual community, or joining an online support group can make a difference.
Even though in-person support groups have become rarer, several organizations offer resources and communities:
The NFA offers articles, podcasts, and evidence-based tools for newly diagnosed patients and caregivers. They also link you to advocacy opportunities, education, and online communities.
Pain Connection (U.S. Pain Foundation) has support groups and peer mentoring for people with chronic pain.
Mental Health America provides screening tools and resources for depression and anxiety.
If you feel hopeless or think about harming yourself, help is out there for you. Call or text 988 to connect with the Suicide and Crisis Lifeline — it's free and available 24/7.
Show Sources
Photo Credit: iStock/Getty Images
SOURCES:
Lynne Matallana, founder/CEO, National Fibromyalgia Association (NFA).
Cureus: "Fibromyalgia and Depression: A Literature Review of Their Shared Aspects."
Mayo Clinic: "Fibromyalgia."
National Institute of Neurological Disorders and Stroke: "Pain."
National Health Service (U.K.): "Fibromyalgia."
American College of Rheumatology: "Find a Rheumatology Professional."
Sleep Foundation: "Fibromyalgia and Sleep."
National Fibromyalgia Association.
Pain Connection.
Mental Health America.
