Psychiatrists Admit Fibromyalgia is Neuropathic - Not a Form of Depression

by Karen Lee Richards Patient Advocate

I have long been frustrated by how many studies are conducted by the psychiatric community trying to show that fibromyalgia is an emotional problem or a form of depression. While that may have been understandable 25 years ago when very little was known about FM, there is no excuse for it today with all of the solid evidence that fibromyalgia is a very real physical illness.

In recent months, there seemed to be a rash of psychiatric studies on FM - so much so that I honestly began to wonder if the psychiatric community was starting to panic because they were afraid they were losing us as potential clients.

Don't get me wrong - a significant number of people with FM do suffer with depression and/or anxiety and I have no problem with studies that focus on better ways to treat them. What I have a problem with is trying to prove that FM is caused by depression or a psychological disorder.

But maybe those days will soon be behind us. An article, posted as an alert, in Psychiatric News, a publication of the American Psychiatric Association, was titled, "New Findings Suggest Fibromyalgia is Neuropathic, Not Depression Variant." The article reported on a German study showing that the small nerve fibers in people with fibromyalgia are impaired. It also acknowledged that other research has pointed to similar conclusions, citing examples of biological abnormalities in FM such as low levels of the neurotransmitters serotonin and norepinephrine and high levels of the pain amplifier substance P.

I applaud the APA for finally acknowledging that fibromyalgia is a neurological, not a psychological, illness. After all, it's not like we will no longer need their services. A chronic illness like FM takes a huge toll on us physically and emotionally. We can still benefit from psychologists and psychiatrists who can help us learn healthy ways to cope with the changes FM brings into our lives and can treat depression and anxiety when they occur.

More About the Study

The study the APA referred to was published in the June issue of Brain, a journal of neurology. The researchers investigated the function and structure of small nerve fibers in 25 FM patients, 10 patients with monopolar depression without pain and with healthy control subjects. Using three different methods of testing, the researchers found that compared with control subjects, patients with fibromyalgia, but not patients with depression, had impaired small fiber function.

The Psychiatric News alert quoted the study authors saying, "This strengthens the notion that fibromyalgia syndrome is not a variant of depression, but rather represents an independent entity that may be associated with depressive symptoms," the researchers said. Furthermore, the findings point "towards a neuropathic nature of pain in fibromyalgia syndrome."

Small Nerve Fibers - An Exciting Area of Study

This is the third study I've read about in just the last month or so that has found various abnormalities in the small nerve fibers of people with fibromyalgia. Is it possible that scientists are finally unlocking some of the secrets as to exactly what is going on in the fibromyalgia body that causes so much pain? I hope we will see many more studies in the near future that will delve into what is causing these small nerve fiber abnormalities and how they can be treated.


"New Findings Suggest Fibromyalgia is Neuropathic, Not Depression Variant." Psychiatric News. June 19, 2013.

Üçeyler N, et al. Small fibre pathology in patients with fibromyalgia syndrome. Brain. 2013 Jun;136(Pt 6):1857-67.


Karen Lee Richards
Meet Our Writer
Karen Lee Richards

Karen is the co-founder of the National Fibromyalgia Association. She writes for HealthCentral as a patient expert for Pain Management.