Depression with FMS and CFS

Depression can be viewed as both a symptom of fibro and a co-morbid condition. Often when a teenager is finally referred to me for fibro he will report a long-standing depression. Childhood onset depression is slippery and often overlooked. Interestingly enough, symptoms of depression in children and teenagers can include vague aches and pains,[1] particularly headaches and back pain often associated with fibro. As a co-morbid condition, depression is virtually indistinguishable from fibro. Chronic pain and illness are depressing. The question may be whether fibro is a symptom of depression or depression a symptom of fibro, or whether they are simply partners. In either case, it is important to note:

-       Fibro symptoms are known to be alleviated in many cases by SSRIs (like Prozac), SNRIs (like Cymbalta) and other anti-depressant groups[2]

-       SSRIs can cause detrimental side effects and suicidal ideation

-       While psychodynamic therapy might help adults with depression, it is not a good therapeutic choice for an adolescent. Go with CBT.

-       Ritalin can cause or exacerbate depression in teens[3]

-       A severe depression may require hospitalization

 In every case, depression should be taken seriously; it's a serious matter.

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[1] http://www.mayoclinic.com/health/teendepression/DS01188/DSECTION=symptoms Your adolescent - depressive disorders. American Academy of Child and Adolescent Psychiatry. 

[2] http://www.scientificamerican.com/article.cfm?id=new-study-antidepressants-fibromyalgia

[3] Talking Back to Ritalin, Revised : 
What Doctors Aren't Telling You About Stimulants and ADHD
by Peter Breggin, M.D.  Perseus Books, 2001