A chronic illness like fibromyalgia (FM) changes your life. It can be hard to accept those changes, especially when it means giving up things you care about.
When you're adapting your life to chronic illness, it's normal to go through a grieving process, just as if someone close to you had died.
The final phase of the grief cycle is acceptance. Some people confuse "acceptance" with "giving up," but acceptance actually is a means of looking at your situation realistically so you can set reachable goals.
The physician-trusted website UpToDate examines the need for acceptance in people living with FM. An excerpt from UpToDate:
"Acceptance of chronic pain is a coping strategy that includes both direct action and passive components that may be particularly helpful to patients with FM. This strategy involves (a) acceptance that it is unlikely that medical/behavioral treatments will completely eliminate one's pain; (b) acceptance of the need to shift one's attention from pain to non-pain aspects of life; and (c) such acceptance does not signify personal failure.
"Indeed, acceptance of persistent pain may be necessary for individuals to stop searching for treatments that provide complete relief of pain and begin to adopt changes in their behavior that may help them to better manage persistent pain and improve their quality of life. A study of a small group of patients with fibromyalgia revealed that scores on a measure of pain acceptance was negatively associated with ratings of pain severity and catastrophizing and was positively associated with mental health scores on the SF-36. A subsequent study of patients with chronic pain revealed that higher levels of acceptance were associated with less attention to pain, greater engagement with daily activities, higher motivation to complete activities, and higher self-efficacy regarding performance of daily activities."
Working Toward Acceptance"Acceptance that it is unlikely that medical/behavioral treatments will completely eliminate one's pain."
You might ask, "Isn't that pessimistic?" Sadly, no -- it's realistic. So far, we don't have treatments that completely eliminate fibromyalgia pain, and no existing treatment works for everyone. It's likely that those of us with FM will have to live with some degree of pain, possibly for the rest of our lives. That doesn't mean that we have to accept living with severe pain. Instead, it means that we shouldn't expect any single treatment to alleviate all of our pain and other symptoms.
A more realistic goal is to find a combination of treatments that, together, lessen your symptoms and help you increase your functionality and quality of life. That could involve multiple forms of treatment, including:
- One or more drugs
- dietary changes
- moderate exercise
- complementary/alternative therapies such as massage or other bodywork, chiropractic, physical therapy, biofeedback, hypnotherapy, or acupuncture
Many people also benefit from mental health counseling or cognitive behavioral therapy to help them cope with and accept the changes imposed by their illness.
It may be disheartening to think about living with pain forever. After the kind of pain you've experienced, though, think what a difference it would be to just have mild pain. Once you stop expecting the next treatment to be "the answer," you can start being happy about making small improvements, one at a time, that eventually add up to making you feel a lot better.
"Acceptance of the need to shift one's attention from pain to non-pain aspects of life."
No doubt, this one is hard. FM pain can demand your attention and, especially when combined with fibro fog, can make it hard to concentrate on anything else. The study mentioned above shows that paying less attention to your pain can help you become more motivated, more interested in what's going on around you, and improve self-efficacy (doing things that help you feel better).
Things that can help distract you from pain include video games, hobbies/arts and crafts, reading (when fibro fog is bad, try a magazine or short stories), or anything else that you can enjoy without making yourself feel worse. The more your brain is engaged with what it's doing, the more successful you're likely to be, so TV and movies may not be very effective.
The quote above talks about acceptance versus catastrophizing. Catastrophizing is a distorted belief that things are worse than they are, or that the situation is hopeless. People who catastrophize may feel like they'll never get better, that no treatment will ever be effective. Research demonstrates that people who accept pain do better than those who catastrophize.
"Such acceptance does not signify personal failure."
It's important to remember that acceptance doesn't mean giving in to your illness, nor does modifying your life because of it.
For example, when I was diagnosed with FM, I was determined to keep it from changing my life. I continued working at a very stressful full-time job that kept me in a near-constant flare. My life consisted of working and trying to recover from work -- which meant laying on the couch, on pain killers and still in agony. Once I accepted that I had to make some changes and manage my FM instead of fighting against it, I was able to make the changes that have allowed me to improve. I left my job, and that felt like failure. However, my decision allowed me to be more successful as a wife, mother, friend, and overall person. I also recovered to the point that I could work from home.
By changing my life, I got back my quality of life.
If you're having a hard time accepting your illness and the changes it imposes on your life, you may benefit from counseling. It can also help to talk to other people who've gone through the same thing, such as in a support group or an online chat room such as About.com's Fibromyalgia & Chronic Fatigue Syndrome Forum.
Want to learn more? See UpToDate’s topic, "Psychosocial factors and rheumatic disease," for additional in-depth, current and unbiased medical information on fibromyalgia, including expert physician recommendations.
Source: "Psychosocial factors and rheumatic disease" UpToDate. Accessed: February 2009.
"Psychosocial factors and rheumatic disease" UpToDate. Accessed: February 2009.