This is a kind of sticky topic, and I never really know how exactly I feel about it.
There is a bit of a conundrum in the Fibromyalgia world: emotions. The problem is that because of the nature of this syndrome and the stigmas associated with it we hit a wall when dealing with the psychological side of pain. Most of us experienced a lot of doubt and skepticism in our early stages of this disease, some of us face it still.
That doubt is centered around the legitimacy of our condition; is it real or are we just making it up? Because of that a lot of us tend to side-step the emotional side of this illness. We know our pain is real and we are afraid any acknowledgement that we are suffering emotionally would confirm to our doctors and friends that we are indeed just depressed and making it up. you see the problem?
Like any negative reinforcement we learned to avoid the sting of this particular kind of burn. We tip-toe around terms like anxiety and depression because early in our treatment a doctor asked are you depressed or feeling sad? We were thinking: I'm in pain every freaking day of course I'm depressed! but the doctor heard: I'm in pain because I'm depressed -and so we learned if we say depressed we won't get help with pain and other treatments instead we get anti-depressants and dismissals.
Admitting you are depressed when you have a chronic pain condition is akin to pressing pause on any forward medical momentum. The truth is that a lot of us suffer from bouts of depression but the burden is determining whether your depression is primary or secondary. Both need addressed but if it is secondary (from excessive pain, fatigue) than addressing the pain and fatigue first should help with the depression. The assumption that is most often made though is that it is primary and therefore the cause of your pain and fatigue.
The worst part of this nasty little conundrum is that we often decide we aren't going to mention our depression because we want to get the right treatment only were not getting the right treatment because we can't mention our depression. Yikes.
I think there is definitely an emotional component to our pain. Add isolation, feelings of guilt or shame, financial worries, and the constant reinforcement of doubt and depression isn't just possible, it's likely.
So how do we deal with this? Well, I have learned that my depression is secondary and I have found ways to manage it without anti-depressants, but I also don't tolerate them. I also know a lot of people find that anti-depressants help their pain regardless of depression (we often lack serotonin and norepinephrine so it makes sense) and then finally there are the ones that need anti-depressants with or without fibromyalgia, mental illness is as much a disease as anything physical. Sometimes the only way to get the help you need is to divide these things; see your primary care for physical concerns; pain, bloodwork, and research. See mental health professionals for mental concerns, and alternative therapists for everything in between.
Some day doctors/insurance and the world will work the collective but until then we still have to decide what information we share with whom. I feel comfortable talking with my doctors now about my mental health concerns, I still make sure I address the physical long before I mention the mental when starting with a new doctor.
Don't neglect your mental health, it is so important. Be careful about discussing your mental health when your physical problems are your primary concern. That is so sticky because an un-diagnosed mental health problem is just as dangerous as a physical one, but unfortunately most doctors get selective hearing especially when fibromyalgia is the diagnosis.
There are always extremes, people who believe emotional trauma is the only reason you are sick and that addressing some long ago emotional trauma is the only goal, but your brain and body changed, chemically and physically, or people who believe it's purely physical trauma -injury or illness, but you can't experience pain like this and not be affected mentally. Every system is involved it's a multifaceted approach that works best.
Look at the blood (infection inflammation, disease) the body (injury to organs, nerves, muscles, tissues or bones, postural, exercise) the gut (absorption, motility, inflammation, disease) the brain (inflammation, infection, imbalance, signaling) your emotions (depression, anxiety, tendencies and dependencies) and your nutrition (toxins, allergens, vitamins, minerals, balances) all of it makes the whole and ignoring anything will make you unbalanced.
Learning who to talk to about what can make a huge difference in healing.