Fibromyalgia or Depression?

There are many peo­ple, espe­cial­ly doc­tors, who claim that fibromyal­gia is just a symp­tom of depres­sion. I’ve had both, and I know the dif­fer­ence quite well. They are very, very dif­fer­ent.

Being in pain all the time can cer­tain­ly lead to depres­sion. That’s just log­i­cal. There are, how­ev­er, peo­ple who have fibromyal­gia who are not clin­i­cal­ly depressed. Depres­sion can also man­i­fest as phys­i­cal pain, but it is does not meet the cri­te­ria for fibromyal­gia.

I was treat­ed for depres­sion for years before I devel­oped FMS, though, and I tru­ly believe that if I’d got­ten prop­er treat­ment for men­tal health issues in my child­hood (post-trau­mat­ic stress dis­or­der and all the com­pli­ca­tions it brought, includ­ing major depres­sive dis­or­der) I prob­a­bly would­n’t have devel­oped FMS.

I nev­er have trou­ble dis­tin­guish­ing between the two, or between either of them and CFS/ME, which I also have. They’re all quite dif­fer­ent.

With FMS, the pain caus­es fatigue, and togeth­er they can (but don’t always) have an affect on your emo­tions. You may feel like doing some­thing, but your body absolute­ly will not coop­er­ate. There have been times when I’ve been feel­ing great, gone out to do some­thing I was SO look­ing for­ward to–and near­ly col­lapsed in the mid­dle of every­thing when my body said, “All right, that’s it, no more. Done. Where’s the bed?” (We’ve joked that if I ever man­age to get a scoot­er or elec­tric wheel­chair, it will have to have a remote con­trol fea­ture so that Sam can steer me on home when I’ve passed out.)

But seri­ous clin­i­cal depression…it does­n’t mat­ter whether you’ve got the phys­i­cal ener­gy or not. Log­ic does­n’t mat­ter. Know­ing that you’d feel bet­ter for hav­ing a nice, hot show­er is utter­ly irrel­e­vant. The fact that the tele­phone ring­ing is con­tribut­ing to your headache, and you could make it stop by mere­ly lift­ing up your arm up push­ing a but­ton, is irrel­e­vant, because lift­ing your arm would take too much damned effort. Yes, some­where, on some lev­el, you may know that you’ll lose yet more func­tion for not get­ting up and doing your exer­cis­es, but it’s less impor­tant than star­ing at the ceil­ing, or the pil­low, or what­ev­er is in front of your face right now. Not that you real­ly make any kind of con­scious val­ue judg­ment or any­thing, but the star­ing has iner­tia going for it. Even if noth­ing IS hurt­ing, even if you have all the ener­gy in the world and you could do any­thing you just don’t care.

Remem­ber that, the next time you hear some­one claim­ing that FMS and depres­sion are the same.

TotD: Thomas Szasz on Language

The Untamed TongueReli­gion and the jar­gon of the helping/hindering pro­fes­sions are com­prised large­ly of lit­er­al­ized metaphors. That is why they are the per­fect tools for legit­imiz­ing and ille­git­imiz­ing ideas, behav­iors, and per­sons.

Ordi­nary lan­guage com­bines all of these qual­i­ties. It can be used lit­er­al­ly and pre­cise­ly, to con­vey mean­ing; metaphor­i­cal­ly or poet­i­cal­ly, to move peo­ple; or ‘reli­gious­ly,’ to blind and numb peo­ple, mak­ing them feel ele­vat­ed or debased.
“In the nat­ur­al sci­ences, lan­guage (math­e­mat­ics) is a use­ful tool: like the micro­scope or tele­scope, it enables us to see what is oth­er­wise invis­i­ble. In the social sci­ences, lan­guage (lit­er­al­ized metaphor) is an imped­i­ment: like a dis­tort­ing mir­ror, it pre­vents us from see­ing the obvi­ous.

That is why in the nat­ur­al sci­ences, knowl­edge can be gained only with the mas­tery of their spe­cial lan­guages; where­as in human affairs, knowl­edge can be gained only by reject­ing the pre­ten­tious jar­gons of the social sci­ences.

Thomas Sza­sz, The Untamed Tongue: A Dis­sent­ing Dic­tio­nary

Review: Writing to Change the World by Mary Pipher

Writing to Change the World
I haven’t actu­al­ly fin­ished Mary Pipher’s Writ­ing to Change the World yet, so it’s prob­a­bly weird for me to be doing a review. It’s a real­ly meaty lit­tle book, though, and I haven’t fin­ished it because I keep going back to re-read sec­tions or copy some of the quotes scat­tered through the text.

The focus of the book is on per­sua­sive writ­ing. I like the fact that Pipher acknowl­edges the pow­er of sto­ries and fic­tion to inspire change.

I’ve got to return it to the library (it’s way late, because I did­n’t want to let go of it), but I’m def­i­nite­ly going to find a copy of my own soon. As I real­ly don’t buy that many books, pre­fer­ring to read them from the library, buy­ing a copy after I read the library’s copy is pret­ty high praise.

I’ve admired Pipher for years, since read­ing Reviv­ing Ophe­lia and The Shel­ter of Each Oth­er, but some­thing I learned today rais­es her even high­er in my esteem. Last year, she returned an award she received from the Amer­i­can Psy­cho­log­i­cal Asso­ci­a­tion to protest the APA’s con­tin­u­ing sup­port of tor­ture by the U.S. gov­ern­ment. The arti­cle includes her let­ter to the APA, and I encour­age you to read it.

No! Don’t Wanna!

My ther­a­pist, L, is no longer with the prac­tice I’ve been see­ing for the last cou­ple of years. It took a year to get to her — first, they assigned me to M, who was a total pain in the ass and did­n’t lis­ten. Not that I was inclined to talk to her, any­way. And she did­n’t return phone calls.

So I final­ly got beyond the “get­ting to know you” stage with L, and she under­stands our fam­i­ly and some his­to­ry and such, so she can put things in con­text. And I think they fired her! They weren’t even going to tell me she would­n’t be there for my appoint­ment this evening. I called to ask her some­thing and her num­ber had been dis­con­nect­ed, which prompt­ed me to talk to the office idiots.

I. Am. Not. HAPPY! It’s a major PITA to break in a new ther­a­pist. I mean, it is for any­body, but when you have a bunch of inter­lock­ing issues and heavy his­to­ry crap, then you add in chron­ic illness/disability, and just for fun mix in that whole bi/pagan/poly thing, believe me, it’s worse. And some ther­a­pists aren’t up to it. In fact, the one I saw a cou­ple of times before see­ing some­one at this prac­tice told me and Sam at the sec­ond ses­sion that she was in over her head and need­ed to refer me else­where.

Oh — the new per­son does­n’t do evening appoint­ments, either. Which means that the only way I can be sure of get­ting there is to take a taxi, as I have not had good expe­ri­ences with using MARTA for any­thing time-sen­si­tive. Expen­sive, but not as dif­fi­cult as hav­ing Sam take time off from work. But L coor­di­nat­ed my appoint­ments with Katie’s appoint­ments with anoth­er ther­a­pist in the same prac­tice, which was nice. Who knows if this one will be as help­ful?

Grrrr.