How to help someone with fibromyalgia

If you really want to help someone with fibromyalgia you need to know how fibromyalgia affects daily life.  And to know how fibromyalgia affects daily life, it is necessary to know what fibromyalgia is. Only then can you really start to help someone with fibromyalgia?

Many parts of a patient’s life are touched by fibromyalgia, including their relationships with those around them.

People with fibromyalgia often struggle to control symptoms and to adapt to the limitations and stresses brought by their illness. Also, they must deal with loss, uncertainty, and often a lack of understanding from others. 

Family members must also come to terms with loss and take on new responsibilities. There are usually financial consequences for families as many people with fibromyalgia stop working, reduce their hours, or retire early. 

If you want to know how to help someone with fibromyalgia, you need to make sure you know what it is.

When thinking about how to help someone with fibromyalgia one of the most things to think about is keep it practical without neglecting the need to support them emotionally.

The critical fact about fibromyalgia is that the course of the illness, and the severity of symptoms, are affected by how a person lives his or her life. The effects are so high that changes in the person’s lifestyle are often the treatment of choice.

In the words of well-known fibromyalgia physician Dr. Charles Lapp, fibromyalgia is “best managed with adaptation and lifestyle changes…There is no drug, potion, supplement, herb, or diet that even competes with lifestyle change for the treatment of fibromyalgia.”

As a friend or family member of someone with fibromyalgia, how you interact with them will significantly affect them: you will either help them gain control over their condition or make attaining that goal more difficult." 

Helping someone with fibromyalgia is also likely to bring benefits to you as well as to your loved one. For example, if you help your loved ones pace themselves, they will likely have a much more predictable life. This helps reduce uncertainty for themselves and those around them.

They are also much more likely to be able to expand their activity level and therefore be able to do more without necessarily making their symptoms worse. And if you help them sleep better, they are less likely to be irritable and able to think more clearly. To help you understand this approach, I would recommend you read Christine Miserendino's spoon theory of chronic pain.

But perhaps the most significant way you can help someone with fibromyalgia is by supporting them to maintain their overall quality of life.

Pacing for fibromyalgia is the most critical lifestyle change for helping to control fibromyalgia symptoms and increasing the likelihood of improvement.

Rather than fighting their body with repeated cycles of pushing themselves to the limit and then crashing, the person with fibromyalgia adapts to the limits the illness imposes on them. To put it simply, pacing for fibromyalgia means reducing one’s overall activity level.

A pacing strategy can help someone with fibromyalgia live better with their condition. How much it can help often depends on the severity of the fibromyalgia symptoms but is usually between 50% and 80%.

Pacing also usually includes including regular rest periods into the day and other strategies such as having short activity periods; recognizing limits on the mental, social and emotional activity as well as physical; switching between high-intensity and low-intensity activities; and taking extra rest and reducing activity for vacations and other special events.

Read more: Sexual Intimacy with Fibromyalgia

With pacing, people with fibromyalgia can live their life according to a plan, rather than in response to their symptoms. 

People with fibromyalgia find this approach gives them a better sense of managing their illness (as opposed to the illness leading them). 

Learning to pace is a gradual process, usually taking a number of years and involving the use of multiple strategies.

To give an example of the value of pacing. One person reported that she had week-long visits from her daughter and granddaughter for several years that triggered relapses lasting up to six months. Since she learned to use pacing during the visits, her recovery time had been reduced to two days per visit.

Family and friends can help the person with fibromyalgia to adapt by accepting that they can do less than before. And by acknowledging that they will need to spend more time at rest and do things in new ways (such as alternating activity and rest).

Read more: How to do housework with fibromyalgia

Poor sleep is one of the most common and troublesome ways of how fibromyalgia affects day-to-day living for someone with fibromyalgia. Patients often experience sleep as unrefreshing. They may spend a night in bed but wake up as tired as before. Other sleep problems are common as well, such as difficulty getting to sleep, waking in the middle of the night or early in the morning, and oversleeping.

To help someone with fibromyalgia, developing a sleep management plan is important, especially if you are sleeping in the same bed. A sleep management plan usually includes a combination of strategies from three categories:

1.  Sleep environment and habits

2.  Medications

3.  Sleep disorders

Sleep can be improved by having an environment conducive to sleep and by having good sleep habits, such as a regular time to go to bed each night. A comfortable sleep environment includes a good mattress and light, noise, and temperature control.

Noise also includes snoring by the sleep partner. So, if this includes you, then it is best to seek treatment for the snoring or perhaps consider sleeping in a different room if feasible.

Medications are often used to treat poor sleep for people with fibromyalgia. Sometimes multiple drugs are used, such as one to help the person fall asleep and another to help her them asleep.

Third, sleep disorders are prevalent with fibromyalgia, affecting a majority of people with the condition, perhaps as high as 80%. Treating them can have a dramatic effect on symptoms.

Read more: How to explain fibromyalgia to my boss?

Managing stress with fibromyalgia

Stress is a challenge for everyone, but it is especially difficult for people with fibromyalgia. The conditions add new stressors and also make people more vulnerable to stress.  Fibromyalgia reset the physical basis of people’s “stress thermostat” so that the effects of a given level of stress are higher than they would be for a healthy person.

The combination of additional stressors and increased vulnerability creates a double challenge: stress is multiplied at the same time that stress takes a more significant toll. Controlling stress, pacing, and improving sleep are probably the top three approaches for managing fibromyalgia.

One of the best stress management strategies is preventive: avoidance of stressful situations. This can include avoiding foods and other substances that trigger allergic reactions and avoiding or minimizing exposure to bright light, noise, and crowds.

Many people with fibromyalgia are selective about their exposure to television and movies, avoiding emotionally arousing material and shows with rapid scene or sound changes. Excessive stimulation is one-way fibromyalgia affects everyday life for someone with fibromyalgia.

To help someone with fibromyalgia, family and friends can help reduce their loved one’s stress by learning what factors create stress and working together to find ways to reduce or avoid them.

Help may include supporting the loved one in taking rests and leading a structured life, adjusting the diet to avoid allergic reactions, and limiting exposure to over-stimulating environments by visiting restaurants when they are not busy or watching a movie at home rather than going to a movie theater.

Fighting the fibromyalgia fog (Cognitive Problems)

Most fibromyalgia patients experience cognitive difficulties, often called brain fog, fibromyalgia fog, or fibro fog. Problems caused. by fibro fog include confusion, difficulty concentrating, fumbling for words, and lapses in short-term memory.

One common technique for combatting fibro fog is the use of lists and other reminders. People with fibromyalgia often post notes to themselves in places like the refrigerator, bathroom mirror, or the inside of the front door.

Most people with fibromyalgia feel confused by sensory input from several sources simultaneously. Therefore, they are more likely to think more clearly if noise and light are at levels they can tolerate and if sensory data is limited to one source at a time.

To help someone with fibromyalgia and fibro fog, you are likely to have more productive discussions if you talk in a quiet environment free of distractions and be understanding if they are forgetful.

Another solution to sensory overload is to have an orderly physical environment. Removing clutter is a way to control brain fog by limiting sensory input. A related strategy is to live a predictable life using routines. For example, always putting keys in the same place and having meals at the same time every day.

A final strategy for reducing the effects of fibro fog is to be sensitive to the time of day. Most people with fibromyalgia have better and worse periods during the day. Someone with fibromyalgia may be able to get twice as much done if they schedule activities for good hours of the day.

Managing special events 

Anything out of the ordinary –a vacation, a holiday celebration, or even having people over for dinner– creates a special challenge for people with fibromyalgia. These non-routine events require more energy than everyday life and can easily lead to a relapse. A need to plan for non-routine events is one way how fibromyalgia affects day-to-day living for someone with fibromyalgia and their family.

Family members and friends can help someone with fibromyalgia in their use of coping strategies to help reduce the physical toll at a special event.

The most effective strategy is to take more rest than usual, storing up energy by taking extra rest before the event, limiting symptoms by taking extra rest during the event, and taking whatever extra rest is needed afterward. The best way to help them through the event is to understand and accept their need for more rest.

The other two strategies people with fibromyalgia often use are to plan their participation in the event in detail, and to discuss plans with others. For travel, planning may include scheduling the activities for each day of the trip in advance. It might also mean using a wheelchair or motorized cart in airports.

The discussion involves sharing plans so all involved understand and have the opportunity to identify what tasks can be shared or delegated to relieve the burden on the person who is ill.

All these strategies imply that the person with fibromyalgia, who is now more limited, will probably have to change their role or level of involvement. And that’s okay. They might stop cooking the meal for a holiday celebration and instead ask other family members to cook.

Or they might go to the event but stay for less time than when they were healthy or change their level of involvement based on symptoms. For example, they might opt out of some activities on a trip to take additional rest.

Fibromyalgia and emotions

Fibromyalgia and emotions can be a challenging mix! Most people with fibromyalgia find their emotions more intense and harder to control than before they became ill. The technical term is labile. As someone with fibromyalgia once said, “My emotions are much more sensitive than ever before. I cry more easily, and I have less emotional reserve.”

One example of intense emotions among people with fibromyalgia is irritability. People with fibromyalgia can quickly feel frustrated, often leading to unfortunate outbursts of anger directed at those around them.

Experts advise patients to take help take responsibility for the problems their illness may create for others. If fibromyalgia affects their moods, they should use a time when they are feeling well to make a plan of things to do to help them feel better when their mood is low.

For example, they might plan to respond to feeling irritable by taking a rest (irritation is frequently triggered by overexertion), taking a walk, or listening to music.

Read more: Nurturing sexual connections with Fibromyalgia

Making fibromyalgia dietary changes

One way to help someone with fibromyalgia is to be aware of the frequent dietary changes they will experience. Most people with fibromyalgia are intolerant of alcohol, and many are sensitive to caffeine and other stimulants, sweeteners such as sugar and corn syrup; food additives; and tobacco.

Food sensitivities or food allergies are yet another example of how fibromyalgia affects day-to-day living. About a third of fibromyalgia patients report food sensitivities or food allergies. Negative reactions include gastrointestinal symptoms such as heartburn, gas, nausea, diarrhea, constipation, and an increase in their symptoms such as headaches, muscle pain, changes in pulse, and fatigue.

Some familiar sources of food allergy include dairy products, eggs, soy, wheat, and corn. Often the solution is to eliminate a food or food group from the diet. Sometimes the patient’s diet is restricted to a limited number of foods, calling for family accommodation.

Identifying those allergies and shopping for healthy anti-inflammatory cookbooks, healthy food, and supplements is part of adapting to life with fibromyalgia.

Fibromyalgia support groups

Many people with fibromyalgia find that a fibromyalgia support group can help them manage their symptoms. If you are on Facebook, there are plenty of fibromyalgia support groups; just take the time to find one that is well moderated and meets your support needs. There are also numerous fibromyalgia blogs written by either people with fibromyalgia or their family.

Read more: How to explain fibromyalgia to my boss

Helping someone with fibromyalgia requires adaptation

Adaptation is central to helping someone with fibromyalgia and knowing how to support someone with fibromyalgia. How people with fibromyalgia live their lives significantly affects their symptoms and quality of life.

So the best way for family and friends to help someone with fibromyalgia is to know how fibromyalgia affects day-to-day living and how they can adapt to support their loved ones.

How to help someone with fibromyalgia? is adapted from an article by Bruce Campbell, PhD