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What you should read First

What you should read Second.

Start with "Fibromyalgia Definition"and and then move on to the rest of the posts of dated April 24th

Sunday, January 4, 2015

Depression doesn’t make you sad all the time

ne of the most popular, enduring, and irritating myths about depression is that it means depressed people are sad all the time – and that by extension, people who are happy can’t be experiencing depression, even if they say they are. It is a skewed and horrible version of depression, and it’s one that further stigmatises the condition and isolates people with depression and related mental health conditions. This is because, put bluntly, depression doesn’t make you sad all the time – though the level of sadness a patient experiences can of course vary depending on the individual and the severity of depression.


When I’m having a depressive episode, I’m not walking around in tattered black clothes, weeping and wailing. I go out with friends. I crack jokes (especially sardonic ones). I keep working, and have friendly chats with the people I work with. I often manage to feed and clothe myself, I read books. Above all, I experience moments of happiness: a flash of delight as I’m walking on the beach with a friend and the sun is perfect and the breeze is just right; a surge somewhere deep inside when I’m surrounded by beautiful trees and it’s raining and I feel my heart swelling to encompass the whole world; a warm, friendly, affectionate sensation at the touch of a friend, a hug at the end of an evening or a hand placed over mine as we lean forward to see something better.


Yet I feel a strange conflicting pressure. On the one hand, I feel like I need to engage in a sort of relentless performative sadness to be taken seriously, for people to understand that I really am depressed and that each day – each moment of each day – is a struggle for me, that even when I am happy, I am still fighting the monster. I feel like I need to darken everything around me, to stop communicating with the world, to stop publishing anything, to just stop. Because that way I will appear suitably, certifiably sad, and thus, depressed – and then maybe people will recognise that I’m depressed and perhaps they’ll even offer support and assistance. The jokes die in my throat, the smile never reaches my lips, I don’t share that moment of happiness on the beach by turning to my friend and expressing joy.


I don’t, in other words, do the things that can help ameliorate depression, encourage people to reach out, and help depressed people with functioning, completing daily tasks of life, and finding a reason to live again. I don’t find and build a rich community of people who can offer support (and whom I can support in turn), because I have to be so wrapped up in performing my sadness at all times to prove that I’m depressed enough – even as I want to scream that this is a reinforcement of stereotypes that hurt people, that by doing this I am hurting not just myself but others.


On the other, I feel an extreme pressure to perform just the opposite, because sad depressed people are boring and no fun, as I am continually reminded every time I speak openly about depression or express feelings of sadness and frustration. I’m caught in a trap where if I don’t perform sadness, I’m not really depressed, but if I express sadness at all to any degree, I’m annoying and boring and should stop being so self-centred. Thus I’m effectively pushed into fronting, putting a face on it even when I am depressed and deeply sad – when I feel like I am choking on my own misery, I put up a cheeky Tweet. When I hate myself and I want to die, I post a link to something fun, or I write up something silly to run somewhere – even though as I write it, I am drawn deeper and deeper into my unhappiness.



Depression is an asshole, and it can become your master, but you can slip out from under it occasionally. And many depressed people in the midst of an episode don’t actually spend it fainting dramatically on the couch and talking about how miserable they are. Some are high-functioning (bolstered by the need to put a face on it), others are into morbid jokes, others try to reach out for help (isn’t that what we’re “supposed” to do?) from friends and try to make their depression less scary. Depression isn’t an all-or-nothing deal – seeing a person who identifies with depression cracking a joke or having fun or dancing with a friend isn’t evidence that the person is faking it, whether the person is experiencing a moment of genuine happiness, or fronting. Conversely, jollying up people with depression to demand that they start being more fun is equally revolting, a refusal to acknowledge that people experiencing a rough day, or a rough week, or a rough few hours aren’t going to be your trained monkeys.
Depression manifests differently in everyone and at different times. Various behaviours are not proof positive that someone is or isn’t depressed, and, as with any armchair diagnosis, insisting that someone is not actually depressed just because of a show of something other than deep, entrenched sadness is actively harmful.


Look at the woman above, joyously cycling on a beach, hair fluttering in the breeze. You can’t judge her emotional state or her larger mental health picture, nor should you.


By SE Smith.

Sunday, November 9, 2014

Fibromyalgia and Exercise: Yes, You Can

 
By Denise Mann
Reviewed by Louise Chang, MD


Exercise eases the pain of fibromyalgia. Getting started may not be easy, but it’s worth it


Fibromyalgia and Exercise: Slow and Steady

“Exercise improves a person’s overall sense of well-being and reduces pain and tenderness over time,” says Lesley M. Arnold, M.D. a psychiatrist and fibromyalgia expert at the University of Cincinnati College of Medicine in Ohio. 

“We try to pace it slowly and make sure that their symptoms of pain and fatigue are under control before we introduce it.”

The first step is typically an assessment of the person’s current fitness level. “We like to start them on a program that is a level or two below their current level, improve their stamina, and build up to 20 to 30 minutes of moderate aerobic activity on most days of the week,” Arnold tells WebMD. “We really encourage them to pace things and set reasonable goals.”

Water Aerobics Soothe and Strengthen

For people with fibromyalgia, low-impact aerobics is the way to go. “We really like an aerobic water class and people tend to go back,” Arnold says.

The research backs her up. A study in Arthritis Research & Therapy found that water aerobics improve health-related quality of life in women with fibromyalgia.

These classes often start in warm-water pools, which can be soothing. What’s more, they are typically group-based, so people can garner support and motivation from other members of the group. 

Holthaun says that this helps people stick to a program. “People with fibromyalgia tend to isolate, but being in a group helps motivation,” she says.


Strength Training and Low-Impact Exercise

What if you don’t have access to a pool? Don’t despair: Walking, biking, and other forms of low-impact aerobic activity also provide benefits. “Grab a buddy, take a class, or look into physical therapy,” Arnold suggests.

And don’t rule out strength training. Although doctors once believed that strength training could worsen pain in people with fibromyalgia, new research suggests that this is not the case. 

In fact, the latest research -- presented at the 2008 annual meeting of the American Society of Anesthesiologists in Orlando -- suggests that strength training can have the same ameliorating effect on pain as aerobic exercise.

Lynne Matallana, president and founder of the National Fibromyalgia Association in Anaheim, Calif., says the benefits of exercise for people with the condition are tremendous. “This has been shown scientifically and anecdotally,” she says.

Matallana’s own experience has shown her that exercise can also soothe the mind. 

A former dancer, she was diagnosed with fibromyalgia in 1995. “I have watched how exercise has improved my symptoms and my overall outlook,” she says. “When I got in water, I could do movements that were almost like dance. That touched my soul again.”

Getting Over the Mental Hurdles

Let’s face it: It may hurt just to think about going from couch potato to marathon runner. To avoid getting overwhelmed, take it in stages.

“If you have fibromyalgia, you have this amplified pain signal telling you that something is wrong,” Mattalana says. 

“It’s a natural instinct to want to protect your body by going to bed, but that actually makes pain worse.”

Try these two tips to get your mind on board:
  • Give yourself a pep talk. 
  • “Tell yourself that this is going to be beneficial,” Mattalana says. “Say, ‘Today I will do just this amount because I know this will help me feel better.” 
  •  
  • Set realistic goals. Arnold often prescribes five minutes of walking to start.
  •  
  •  “People may think that won’t be too difficult, but it can be if you have fibromyalgia,” she says. 
  • “We start very slow and build up from there, and emphasize that there is no hurry.”

From Skeptic to Believer

In the beginning, Mattalana scoffed at the thought of doing only three minutes on the treadmill, but it wasn’t as easy as she thought it would be. 

“I slowly got my body conditioned and got to a point where I could add more exercise,” she says. “It is a slow process, but every time you get up, stretch, walk, get into a pool, or take a yoga class, you are one step closer to feeling better.”

“Once you convince people to start exercising, they become believers,” says Daniel J. Clauw, MD, professor of anesthesiology and medicine at the University of Michigan in Ann Arbor. 

“It’s not until they do it and see how much it helps that they embrace it.”

How long does that usually take? 

“Some people will notice changes right away, but for others, it may take a couple of weeks,” he says.

Exercise is not a panacea for fibromyalgia, Clauw says. But, he says, “it works in more people than anything else. I can’t remember an instance where someone got into an exercise program and didn’t notice a significant improvement in symptoms.”

Fibromyalgia and Diet Will changing your diet help you cope with fibromyalgia?

 
By Jen Uscher
WebMD Feature
Reviewed by Melinda Ratini, DO, MS
 
If you have fibromyalgia, you've probably wondered if there are ways to modify your diet to improve symptoms such as fatigue and muscle pain.

Research hasn't shown that there are specific foods that all fibromyalgia patients should avoid or add to their diets. But it may still be worthwhile to take a closer look at how foods impact the way you feel.

"There aren't many good studies that have looked at how diet can affect fibromyalgia symptoms. But I think we can gather a lot from anecdotal evidence -- from what patients tell us," says Ginevra Liptan, MD, medical director of the Frida Center for Fibromyalgia in Portland, Ore., and author of Figuring Out Fibromyalgia: Current Science and the Most Effective Treatments.

Here are some of the ways doctors say food can play a role in fibromyalgia and tips on how you can tweak your diet to support your overall health.

Pay Attention to How Food Makes You Feel

"A lot of people with fibromyalgia have sensitivities to particular foods, but it varies from person to person," Liptan tells WebMD.

"They might be sensitive to MSG, certain preservatives, eggs, gluten, dairy, or other common allergens."

In fact, in a survey published in the journal Clinical Rheumatology, 42% of fibromyalgia patients said their symptoms worsened after eating certain foods.

A good way to start identifying the foods that may aggravate your symptoms, Liptan and other experts say, is keeping a daily food journal.

"I have some patients keep a food journal for two weeks," says James McKoy, MD, chief of pain medicine, director of complementary medicine, and staff rheumatologist at Kaiser Permanente in Honolulu.

"They write down the foods they ate each day and whether they had symptoms like headaches, indigestion, or fatigue. It can be very helpful, because sometimes we see, for instance, that they have more fatigue when they eat a particular food."

Try Eliminating Certain Foods

If a fibromyalgia patient has a lot of irritable bowel symptoms, Liptan often recommends they try an elimination challenge diet.

They stop eating a certain food they suspect they're sensitive to for six to eight weeks. Then they add it back to their diet and see how they feel.

 Liptan's patients most often try eliminating dairy products or foods containing gluten.

"When you discover you're sensitive to a food and then eliminate it from your diet, it can make a huge difference," Liptan says. "Some people get a lot of benefit in terms of reduction of pain, but more often we see a reduction in fatigue and an improvement in irritable bowel symptoms like bloating and constipation."

If you think you might have food sensitivities or allergies, talk with your doctor.
In some cases, they may refer you to an allergist for food allergy testing.

You may also want to consult a dietitian to make sure you don't miss out on essential nutrients when you eliminate certain foods from your diet.

Make It Easier to Eat Healthfully

It makes sense for people with fibromyalgia -- just like everyone else -- to try to eat a diet high in fruits, vegetables, whole grains, and lean protein.

A well-balanced diet can give you more energy to stay physically active and can potentially improve your overall health.

If you're struggling with pain and exhaustion, however, it's hard to cook nutritious meals. Liptan says she encourages her patients to make it easier on themselves by seeking out healthy foods that don't require much preparation.

"Buy vegetables that are pre-washed and cut up," she suggests. "If you have a health food store nearby, go to the deli section and buy small portions of pre-prepared foods like beet salad or quinoa to vary your diet."

Use Food to Help Fight Fatigue

Choosing the right foods may help you keep your energy level more consistent and prevent fatigue.

"We know anecdotally that certain dietary choices -- like eating small meals frequently throughout the day -- can help energy levels," says Ann Vincent, MD, assistant professor of medicine and medical director of Mayo Clinic's Fibromyalgia Clinic in Rochester, Minn.

"It can help to eat a snack with a little protein, for example, when you're feeling tired at three in the afternoon," she says.

Make sure you eat breakfast, which should include some protein and whole grains, says Christine Gerbstadt, MD, RD, MPH, a spokeswoman for the Academy of Nutrition and Dietetics and a registered dietician and practicing physician in Sarasota, Fla.

"You could try eating a boiled egg and some oatmeal," Gerbstadt says. "That will prevent your blood sugar from spiking and will give you the right kind of energy to get you going through the morning, even if your body is aching and you're feeling tired."

Of course, diet is not the only factor in how much energy you have. Getting enough sleep and being active during the day can also help.

Check on Your Supplements

Always tell your health care providers about any supplements you're taking to treat your fibromyalgia. Some supplements, such as SAMe, can have significant side effects and may interact with medications, Vincent says.

In addition to checking on any possible interactions, your doctor should also be able to help you gauge any claims you might read about what supplements can, or cannot, do for your health.

Focus on Your Overall Well-Being

As you make changes to your diet, keep in mind that people with fibromyalgia tend to benefit most from taking a variety of approaches to managing their symptoms.

Along with leading a healthy lifestyle (including a nutritious diet) and taking any medications your doctor may prescribe for pain or other symptoms, there are many other therapies worth exploring.

"Look into trying things like yoga, massage, and deep-breathing exercises," says Gerbstadt. "Each individual with fibromyalgia has different symptoms and will need different solutions to get the best possible quality of life."