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Depression is common in people with CFS and fibromyalgia. Some of the depression is situational, a reaction to the limits, disruption, losses and uncertainty brought by long-term illness. Self-management strategies are usually helpful with this type of depression. 

Depression may be biochemical as well, created by changes in the functioning of the brain. Self-management strategies may be useful for this type of depression, but treatment for biochemically-caused depression normally also includes medication.

You'll find self-management strategies below, but if you are seriously depressed, suicidal or have been depressed for some time, get help now. Phone a suicide prevention center, talk to your doctor, see a psychologist or call a friend. For resources, see the article Killing Me Softly: FM/CFS and Suicide on the self-help program website.

If your situation is not urgent but depression reduces your ability to do your normal daily activities, we suggest you consider professional help: counseling, medications or both.

A therapist can provide an outside view of your situation, help you to accept your illness, and support you in your efforts to improve. If you have family tension because of illness, couples or family counseling may be helpful.

Planning for Depression

Everyone has times when they feel unhappy or sad. By recognizing that these feelings are likely to occur from time to time, you can plan how to respond. Here's a menu of options:

  • Be Active: Depression produces hopelessness, an attitude that becomes a self-fulfilling prophecy. Doing something constructive changes mood and counteracts those feelings. For an example, see "Two Special Anti-Depression Strategies" (below).
  • Stay Connected: Supportive human contact is very soothing. Time with positive people counteracts isolation and preoccupation with problems. Contact can be as simple as a phone call or an exchange of emails. Conversely, reaching out to help others and getting involved with something larger than yourself are other ways to counteract isolation and preoccupation with self.
  • Consider Medications: If your depression is biochemical in origin, you may be helped by an anti-depressant medication. On the other hand, tranquilizers and narcotic painkillers intensify depression, so if you are depressed, it may be due partially to a medication side effect.
  • Use Positive Self-Talk: If you have a tendency to think of the worst that might happen, you can retrain yourself to speak soothingly and realistically when you’re worried or depressed. For example, remind yourself when you’re feeling low that periods of bad feelings end. For a detailed explanation, see the article Changing Self-Talk on the program website. 
  • Maintain a Schedule: Keeping to a daily routine regardless of how you feel can help counteract depression. Forcing yourself to do things, even if you don’t want to, counteracts the inertia of depression. Also, maintaining your usual self-management strategies helps minimize symptoms, taking away a possible additional source of depression.
  • Do Something Pleasant: Pleasurable activities offer a distraction from symptoms and help create a good mood. The key is to find things that will absorb your attention. Such activities might include reading, listening to music, sitting in the sun, taking a walk, doing crafts, solving puzzles, watching a movie, and spending time with friends.
  • Keep a Gratitude Journal: Some people find it helpful to keep a journal in which they note positive notes every day. Over time, they find that their attitude toward their illness and their life changes in a positive direction. For a personal story, see the article The Healing Power of Gratitude.

Two Special Anti-Depression Strategies

One person has created two special strategies she uses when depression hits. The first, called "The Treasure Box of Plesantries," is a notebook containing compliments she has received, photos of places she has visited, plus treasured notes, photos and cards. When her mood is low, she picks it up by going through the box.

Her second strategy, "The 100 Hours Program," is a script of up to 100 hours of "every special, pleasant and meaningful activity I can think of." It's all worked into a schedule she keeps in a binder. She says, "I don't think 'what do I do now?' I've planned it all our beforehand."

Letter to Myself

Another person has written a "letter to myself," which she can read when depresson hits and temporrily clouds her judgment.

It begins, "I am writring to you from a peaceful place of acceptance, but I remember very clearly what it was like to be gripped by fear and isolation. I am writring this in the hope that I can inspire you to retain (or regain) a clear connection to the insights and tools which can help you to avoid being sucked down into the swamp again."

She goes on to challenge herself not to give in to self-pity and she reminds herself in detail of what has helped her thought difficult perods in the past.

She concludes, "I hope you will choose faith and hope and ilfe. I hope you will choose to reach deep inside yourself to access all of those decades of growth and learning. I hope that you remember that you are loved. You have so much more to give. Reach into your heart and find a way to survive and thrive again."

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