How do you approach patients with fibromyalgia who are reluctant to consider a psychiatric component to their illness but present with clear mood or anxiety symptoms?

Since patients with fibromyalgia (FM) are often stigmatized and worried that clinicians think “it is all in my head,” it is important to discuss FM treatment and mental health referral from a biopsychosocial perspective. This might include introducing concepts such as the pain/depression dyad, centr...

It is important to remind patients that we, as psychiatrists, do not separate the physical and mental aspects when addressing the causes and treatments of suffering. With that in mind, I also emphasize that while some diseases are lesion-based, others are diffuse and system-based. This distinction a...

In these individuals, it is important to recognize that they often experience medical gaslighting, and so it is important to first clarify what their experience has been with the medical system. Staying trauma-informed and developing an alliance are critical first steps to gain any trust in this pop...

This is an interesting question with some very thoughtful answers. The part of this question that concerns me is the author’s sense of “clear mood or anxiety symptoms”. In my experience, this part of patient care is never “clear”. It can be suggested or possible, or raised by a screening questionnai...