When you're diagnosed with fibromyalgia (FM), among the initial things you learn is that there's no cure and that it can be hard to find effective treatments. It's normal to feel sad, angry, helpless and confused. Once you're beyond the initial shock, however, the way you deal with your condition can make a big difference in how you feel.
Research on coping with rheumatic conditions -- including FM and rheumatoid arthritis (RA) -- demonstrates that people with certain coping skills have less pain and are more functional than people who feel helpless.
An article on the doctor-trusted medical reference website UpToDate identifies two important beliefs that can help us adapt to life with FM: self-efficacy and optimism. It also looks at "learned helplessness," which is the belief that you can't do anything to improve your health.
Self-Efficacy & Living With FibromyalgiaHere, an excerpt from UpToDate:
"Self-efficacy represents a belief that one can perform specific behaviors to achieve specific health-related goals. Whereas learned helplessness tends to represent a relatively consistent belief regarding a wide array of symptoms, an individual may vary with respect to self efficacy beliefs concerning different behaviors. As an example, a patient with RA may have high self-efficacy for pacing her daily activities to reduce pain and fatigue, but may display low self-efficacy for performing water-based exercises to improve physical function.
"Increases in self-efficacy are associated with improvements in depression, pain, and disease activity among RA patients. Lower self-efficacy in patients with chronic painful disorders is associated with the presence of symptoms of depression, longer duration of pain, more widespread pain, and lack of employment.
"Among patients with FM, high self-efficacy for pain is correlated with a high pain threshold and pain tolerance levels. It is associated with low frequencies of pain behavior."
This doesn't mean that just believing you can get better actually makes you better. That belief, however, leads to action (finding ways to manage symptoms and feel better), and the action leads to improvement. Some examples of behaviors that self-efficacy promotes include:
- Getting moderate, gentle exercise
- Eating a healthy diet
- Taking nutritional supplements
- Pacing yourself
Optimism & Living With FibromyalgiaTypically, we think of optimism as "looking on the bright side." When you're in bed with severe, unrelenting pain and your fibro fog is so bad you can hardly follow the plot of a sitcom, telling you to look on the bright side is both ridiculous and insulting.
That, however, isn't the true definition of optimism. It's really a consistent tendency to believe that you'll experience good outcomes rather than bad ones. It's the difference between thinking, "Nothing will ever get better," and, "As bad as this is, I know it won't always be like this."
In medical studies, optimism is associated with better psychological well-being; better coping with stressful health events, such as breast cancer and open heart surgery; and higher pain tolerance.
Learned Helplessness & Living With FibromyalgiaLearned helplessness is considered a cognitive distortion, which is an inaccurate thought or idea. For example, after trying 3 or 4 drugs that don't help, someone may develop the distorted idea that no drugs will ever work. These kinds of thoughts are sometimes called catastrophizing, and studies show they're linked to high levels of pain and psychological distress in people with FM, RA and osteoarthritis.
Does one of these statements describe your attitude?
- "Drugs didn't work, so there's nothing that will help me."
- "My doctor says nothing works well for fibromyalgia, so I guess I just have to live like this forever."
- "People who talk about thinking positive, exercising and looking for the joy in life just don't have this as bad as I do."
- "Doctors don't even understand FM, so what chance do I have?"
- "There's nothing I can do until someone finds the cure."
If so, you're definitely not alone. I see those kinds of statements all the time in About.com's Fibromyalgia & Chronic Fatigue Syndrome forum. While they may be a somewhat common reaction to FM, they can be barriers to coping and treatment.
Developing Better Coping Strategies for FibromyalgiaIt is possible to develop better coping skills, optimism and self-efficacy. Some people may be able to do it on their own, while others may need help. If you're having trouble coping, talk to your doctor about it.
The basic coping process consists of 4 steps:
- Identifying a stressor (something that makes your symptoms worse)
- Trying a new approach that could lessen the effect of the stressor
- Evaluating the effectiveness of your approach
- Adapting your approach as necessary
Sometimes you can eliminate the stressor from your life, but often you can't. That's when it's necessary to find ways to lessen the impact.
Here's an example:
- A stressful event causes my symptoms to flare for about 48 hours.
- After stressful events, I've tried to lessen the effect with deep breathing; meditating in a quiet place; light yoga; drinking tea; and taking a hot bath.
- Over time, I've discovered that all of these things help me to different degrees. When I'm able to do 2 or 3 right after the stressful event, it greatly lowers my symptom severity and the length of time it takes me to recover.
- Not all of these things are possible in every situation, so I try to do as many as possible.
The unfortunate fact is that, so far, we don't have a cure or universally effective treatments for fibromyalgia. Those are things you can't control. What you can control, however, is how you cope with the reality of your illness, and that can help determine whether you'll find effective ways to manage your symptoms and regain your quality of life.
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: January 2009.
"Psychosocial factors and rheumatic disease" UpToDate. Accessed: January 2009.