Posted by: Concerned mom (for cyber doc) | 2008/08/01

Is Fibromyalgia a mental disorder?

My daughter, 17yrs old has been diagnosed with FMS. The rheumatologist prescribed a few anti inflammatories (not effective as there is no inflammation) SNRI anti depressant(for sleep/pain/depression)and a -|- tail of drugs to relieve the symptoms. What I' ve learnt from web research is that FMS is psychosomatic /somatoform. Ive asked my GP to prescribe Lyrica &  eliminate the anti inflammatories. Should GP' s/Specialist rhematologists not direct patients then for psychiatric evaluation? Patients need doctors to perform a rounded approach to treatment, combining mental and physical health

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Our expert says:
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It is a psychosomatic condition ( though if one looks closely, all illnesses are psychosomatic to a degree --- in that they involve the soma ( body ) and the psyche ( one's mind ). Pain is depressing ; Depression enhances and amplifies pain from any cause, and even when there is no depression, there's good evidence that older antidepressants can help relieve pain anyway ( I haven't seen any specific evidence on SNRI's having this specific property, but it would make sense that they ought to.
Sounds like you really have been doing your homework, as Pregabalin ( Lyrica ) does seem to potentially have special advantages in neuropathic pain an could be helpful in FMS. I agree that a psych evaluation should be thought of ( not necessarily implemented in every case ) in psychosomatic and chronic pain conditions.

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Posted by: Concerned Mom | 2008/08/01

Thanks doc, Ive deduced from your reply that not all FMS sufferers have the same symptoms and that in a case like my daughter, having had a few traumic incidences in her life &  a genetic predisposition to depression, (her dad overcame anxiety disorder through CBT) her FMS could then be as a result of major depression and not as Ive understood, necessarily the other way around.
Im hopeful now, that dealing with her trauma (although she has had intense psycho therapy), and the subsequent depression from that, the FMS will gradually disappear. Im holding thumbs!!!

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