This is a topic that has been on my mind lately...the link between stress, depression and fibro. I think for most it is hard to say which came first, like the chicken or the egg question. For me though, I used to handle stress very well. I made it through a lot of stressful stuff (job, teenager, alcoholic husband, losing my mom, caring for my grandmother, deaing with a severely mentally ill younger brother who held himself hostage, and other stuff) without having any distinquishable fibro or depression issues. In 2002 TMJ hit me suddenly and hard. It was during a stressful business trip. All down hill from there. I think I reached a burn out point. I was in the fight or flight mode for way too long and my cortisol levels were going crazy. I was not diagnosed with fibro until two and a half years ago, but that was after struggling with pelvic pain that took two years to pin down (endometriosis and eventually a hysterectomy and ovaries removed). I think that really kicked in the fibro. All sorts of hormone changes now mixed in to the picture. I did not stop having pelvic pain for two years after the surgery and then was diagnosed with fibro. Who knows when the depression really started. Chronic pain of any kind leads to that, and so does the frustration of trying to get a diagnosis for pain. Specialist after specialist. It actually took three different OBGYNs before I convinced one to actually do a laparoscopy and look inside and lo and behold I had endometriosis. And it turned out later, adenomyosis.
Now I am at a point of major depression. Stress at work (and going through divorce). Chronic pain. They are all related, for me anyway. The comment about seratonin I find very interesting. I cannot take any of the 3 classes of anti-depressants. Even buspar (anti-anxiety med) started to send me into early seratonin syndrome (too much seratonin). They make me absolutely crazy-I can't think straight, sleep, I get jittery, tremors, anxious, etc. Yet docs want to treat fibro with ADs, now I understand why. Maybe I don't have fibro, or I am an odd-ball where low seratonin levels are not evident in my version of it. Or maybe the fact that I am on tramadol (max dose of 400mg/day) is already providing a seratonin boost (the jury is still out on that one). But long before I started tramadol I could not take ADs, so I am not sure if the tramadol is playing a role now or not.
I have tried a new doc, a rhuemy, and even after telling him I cannot take ADs he gave me a very low dose of Elavil to take only at bedtime. "So the muscles will relax and hurt less". What I was really hoping for was stronger pain meds. I just started klonopin for the stress and the first week was great...almost felt like my old self except for pain, but then the crying started again. Well, big mistake with the Elavil, I woke up not knowing who I was, wondered where my brain had gone, was walking into walls, etc. I should know better by now and just refuse ADs. Still have a follow up with him to see if he has any other bright ideas.
Sorry, got to rambling, but for me, stress makes both my depression and fibro worse. Depression makes my stress and fibro worse. And when my fibro is worse, so is my stress and depression. That is not too say any of it is "in my head" - I very much believe it is related to body chemicals including hormones and neurotransmitters. What happens in my head affects my body and vice versa. It's really a complicated situation and I hoped breaking the cycle of one element would help but not yet.
I would love to see a breakthrough with this illness, but sad to say there are so many illnesses that just don't get money for research and this is one of them. Especially since it is not terminal and it gets thrown in the "too hard pile" Too many unknowns, too many varitaions, etc.
Rose