I’ve looked at several studies that have shown that while there is not an overall increase in the risk of death for those with illnesses like fibromyalgia and migraine, there is an increase risk of suicide.
Why is there an increased risk of suicide for those with chronic pain?
When you read the question it almost seems like it answers itself.
A 2010 Danish study found that the risk of suicide among those with fibromyalgia was about 10-fold. That’s a pretty big number. The risk is highest immediately after diagnosis and for the first five years.
Fibromyalgia and migraine are not mutually exclusive. In fact, they are comorbid, meaning that they are likely to appear together. About 17 percent of patients with chronic migraine also have fibromyalgia, according to another 2015 study.
According to that same study, the risk of suicidal thoughts and actions almost doubles for those with both fibromyalgia and migraine, compared to just migraine alone.
As someone who lives with both, I can’t say I’m ever surprised by these studies. The study points out that those with both fibromyalgia and migraine report more severe symptoms, overall, including depression, anxiety, and poor sleep quality.
In 2012 I went through a severe bout of depression. I can’t say how much was caused by my illness and how much may have been caused by some of the medications I was taking. Unfortunately, many anti-depressants have side effects of increased depression and even suicidal thoughts/tendencies.
Why is the risk of suicide higher among those with fibromyalgia?
The obvious answers would seem to be depression/anxiety, higher psychiatric distress, increased functional disability, and poor sleep. However, even when the study controlled for these symptoms, the risk was higher among those with fibromyalgia.
So, what does that leave? The researchers next point to studies linking helpless, hopelessness, pain catastrophizing, and problem-solving deficits to increased risk of suicide when chronic pain was involved.
Additionally, they point at the differences in how the fibromyalgia brain responds to stress. Recent studies have found that certain proteins involved in stress response are less expressed in those with mood disorders.
As I think about my experience with depression and suicidal thoughts, I would say that hopelessness and helplessness definitely played a role. After months of trying so many different medications that only seemed to make me feel worse. I did feel hopeless that I’d ever get better. I felt like a failure.
I felt helpless to do anything to improve my situation and if that was to be my life forever I saw no reason to keep going on.
What is pain catastrophizing?
Pain catastrophizing is a negative mind-set wherein you get focused completely on your pain. You ruminate on the pain, thinking of little else, you magnify your pain, and generally believe it won’t get better. This would lead to both hopelessness and helplessness.
But, it’s not that simple. It’s a bit of a catch-22. It’s also really hard to say that someone is magnifying their pain. However, studies do show (and I believe) that the more we focus on the pain (ruminate) the more we tend to feel/notice that pain. If all you are thinking about is pain, you are going to hurt more.
I think that issues with coping techniques and problem-solving could definitely be linked to hopelessness/helplessness as well as the increased risk of suicide. There are a few studies on fibromyalgia and coping methods pointing out that those who use active coping methods and who try to take charge of their treatment tend to have better outcomes.
It makes sense, if you feel you have control, you’ll have better outcomes. You’ll feel more positive in general, and likely be less depressed.
I don’t explain any of this to discount the likely biological implications. First off, we still don’t know the extent of the biological changes that come with fibromyalgia. But, study after study has found brain differences in how we process pain, stress, and even depression.
I don’t have the answer to why the risk of suicide is so much higher among those of us with chronic pain, especially fibromyalgia. I don’t think there is one single answer… but I can definitely understand why the numbers look the way they do.
If you are struggling with depression and suicidal thoughts, please know that things can get better. Keep looking for answers and reach out for help. You can call the suicide prevention lifeline at anytime 24/7 at 1-800-273-8255 if you need someone to talk to. Visit their website for more ways to contact them including online chat and special lines for the deaf and hard of hearing.
- Fibromyalgia and brain function
- Altered brain activity related to fibro fog
- Fibromyalgia is NOT just depression
- The connection between stress, depression, and fibromyalgia
- Chronic illness does not make you a failure, you are a success story