FIBROMYALGIA syndrome (FMS) can cause profound changes in the life of the person diagnosed, and the lives of family and friends. The changes may include loss of income, independence, good health, and future plans. Those affected by fibromyalgia often feel their hopes, dreams, and expectations have been broken.

When faced with significant change and loss, the normal and natural reaction is grief ¹. According to John W. James and Russell Friedman, "Grief is the conflicting feelings caused by the end of or change in a familiar pattern of behavior." ² For example, when a loved one is diagnosed with fibromyalgia, you may feel a sense of relief knowing the cause of the symptoms. This positive feeling can be coupled with the painful realization that the peaceful life you both once shared has been permanently altered. These conflicting feelings, relief and pain, are normal responses to fibromyalgia.

Regardless of whether grief is caused by illness, divorce, death, or another loss, incomplete recovery can have a lifelong negative impact on a person's capacity for happiness. Families affected by fibromyalgia need to recognize when loved ones are grieving, know how to support one another, and find a way to heal from grief. If families are unable to regain a sense of well–being, then over time, the pain of unresolved grief will cumulate ³.

In her book On Death and Dying ⁴, Dr. Elisabeth Kubler–Ross identified five emotional stages people go through after being diagnosed with a terminal illness. The stages she identified are shock, denial, anger, bargaining, and acceptance.

While Kubler–Ross' work highlighted awareness about the process of dying, people, both professionals and the general public have inappropriately attempted to apply Dr. Kubler–Ross' stages to the emotions that arise after loss. James and Friedman write, "There are no absolutes in grief. There are no reactions so universal that all, or even most, people will experience them." 5 Circumstances and culture are factors that affect how people grieve 6. When reacting to loss caused by FMS, it is possible for family and friends to share the same emotions, or not. For example, a person diagnosed with FMS may feel depressed from the loss of good health. On the other hand, the well spouse may experience anger and the extended family members may deny their loved one has a chronic illness. People simply do not experience grief in the same way 7.

Although grief does not occur in stages, James and Friedman acknowledge that many grievers do share common responses, such as:

• a sense of numbness,
• inability to concentrate,
• disrupted sleep patterns,
• changes in eating habits, and
• feeling emotionally and physically drained.

These are normal, natural responses to the loss FMS causes. The duration of these emotional responses differs from person to person and individuals may not experience all these responses.

While recovering from their losses, it is important for family, friends, and the person diagnosed with fibromyalgia to grieve without following an expected timeline or stages. Recognizing that each individual emotionally reacts to loss in a unique way will make recovering from grief easier.

On average, we are not socialized to know how to properly recover from grief or help others who are grieving. When in the midst of grief, James and Friedman say people are mistakenly advised to:

• grieve alone,
• give grief time to heal,
• be strong for others,
• don't cry,
• replace the loss with food, alcohol/drugs, shopping sprees, workaholism and other short-term fixes, and
• keep busy.

But these pieces of misinformation will not help the person diagnosed with fibromyalgia or family and friends recover from their losses.

It is important to remember that grief doesn't produce the same emotions in everyone. Furthermore, its impact on our lives cannot be predicted or fully controlled. But recovery is possible from any significant emotional loss. We can actively influence the texture of our lives during this period. Here are some suggestions:

• express your feelings,
• ask for help,
• medicate with caution,
• stay involved, and
• if indicated, get evaluated for depression ⁸.

Sometimes people have difficulty recovering from their losses. An outsider's involvement—a professional counselor, clergy, or wise and trusted friend—can help family members recover. It is wonderful when families can work through their grief recovery together. But if your family or you are having difficulty, it's not a failure. You should be respected for admitting you need help.

If you are interested in seeking help for your family or yourself, there are many helpful resources available.

Counselors and support groups provide an opportunity for grievers to meet others with similar experiences. Contact your local health clinic, social services office, and religious organizations to find out about grief counselors and support groups in your community.

There are many books covering the topic of grief available at your local library and bookstores. One such book is The Grief Recovery Handbook, written by John W. James and Russell Friedman. This book illustrates what grief is and how it is possible to recover from grief. It offers activities to help people working through grief issues of all kinds complete their grieving process.

The Internet is another resource where you can get information about grief and communicate with others with similar experiences. For example, GriefNet is a site developed to provide support to people working through loss and grief issues of all kinds. All support groups offered at GriefNet are operated through e–mail. The WebMD website hosts chat room discussions for members with FMS. If you are a well spouse seeking online support, refer to Well Spouse Foundation's website.

"Grief is, first, the raw awareness of change, but then it becomes a terrific struggle: a violent disputing of the facts, a striving for life again, a revising of the terms by which we know ourselves, a sometimes surrender to despair, and finally a conscious acceptance of the change—in which we change. This is a labor, burdensome, aching, and painful. But it can accomplish a blessed rebirth in the griever." ⁹

2. James and Friedman, Grief,3.

3. James and Friedman, Grief,8.

4. E Kubler–Ross, On Death and Dying, (New York: Collier Books, 1997).

5. James and Friedman, Grief, 14.

6. "Dimensions of Grief: Coping with Sudden Loss," Mayo Clinic Health Oasis, 11 November 1996, <http://mayohealth.org/mayo/9611/htm/grief.htm> (19 April 1999), Response to Loss Varies Greatly.

7. "Dimensions of Grief," Response to Loss Varies Greatly.

8. "Coping with Loss: Practical Suggestions," Mayo Clinic Health Oasis, 11 November 1996, <http://mayohealth.org/mayo/9611/htm/grief_sb.htm> (19 April 1999).

9. W Wagerin, Mourning Into Dancing, (Grand Rapids, MI: Zondervan Publishing House, 1998).