The main symptoms of fibromyalgia include:
- Muscle pain in many areas of the body.
- Fatigue.
- “Tender points” in specific areas of the body that are painful when pressure is applied to them.

In addition to these symptoms, other common symptoms of fibromyalgia include:
- Sleep problems.
- People with FM often have poor quality
- sleep that is not refreshing.
- Depression or anxiety.
- Stiffness, especially in the morning.
- Problems with thinking and concentrating.
- Headaches, jaw pain, or abdominal pain.
- Digestive problems such as bloating and trouble swallowing.
- Bladder problems such as interstitial cystitis.
- Feelings of numbness or tingling in hands, feet, or other areas.

Other conditions sometimes found in fibromyalgia patients include irritable bowel syndrome (IBS), restless legs syndrome (RLS), periodic limb movement disorder (PLMD), temporomandibular joint (TMJ) pain, and myofascial pain syndrome (MPS)

National Women’s Health Information Center (NWHIC), a service of the Office on Women’s Health in the Department of Health and Human Services. The NWHIC provides a gateway to the vast array of Federal and other women’s health information resources. Our site on the World Wide Web can help you link to, read, and download a wide variety of women’s health-related material developed by the Department of Health and Human Services, other Federal agencies, and private sector resources.
Related Articles
Alcohol : How Badly Can It Affect CFS Sufferers?
Earning Money From Home When You Have Chronic Fatigue Syndrome /Fibromyalgia
Chronic Fatigue Syndrome And Depression Are Not The Same Thing!
Get Free Prescription Medications
How to Select a CFS Support Group
Possible Causes of CFS
The CFS Case Definition

article syndicated from NWHIC

Lisa Angelettie, M.S.W., is a psychotherapist, author, and life coach. She has been helping people make smarter life choices since 1998. Get more free tips like this when you subscribe to the GirlShrink newsletter .

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The cause or causes of Chronic Fatigue Syndrome (CFS) remain unknown, despite a vigorous search. While a single cause for CFS may yet be identified, another possibility is that CFS represents a common endpoint of disease resulting from multiple precipitating causes. As such, it should not be assumed that any of the possible causes listed below has been formally excluded, or that these largely unrelated possible causes are mutually exclusive.

Conditions that have been proposed to trigger the development of CFS include virus infection or other transient traumatic conditions, stress, and toxins. A. Infectious Agents Due in part to its similarity to chronic mononucleosis, CFS was initially thought to be caused by a virus infection, most probably Epstein-Barr virus (EBV).

It now seems clear that CFS cannot be caused exclusively by EBV or by any single recognized infectious disease agent. No firm association between infection with any known human pathogen and CFS has been established. CDC’s four-city surveillance study found no association between CFS and infection by a wide variety of human pathogens, including EBV, human retroviruses, human herpesvirus 6, enteroviruses, rubella, Candida albicans, and more recently bornaviruses and Mycoplasma. Taken together, these studies suggest that among identified human pathogens, there appears to be no causal relationship for CFS. However, the possibility remains that CFS may have multiple causes leading to a common endpoint, in which case some viruses or other infectious agents might have a contributory role for a subset of CFS cases. B. Immunology It has been proposed that CFS may be caused by an immunologic dysfunction, for example inappropriate production of cytokines, such as interleukin-1, or altered capacity of certain immune functions. One thing is certain at this juncture: there are no immune disorders in CFS patients on the scale traditionally associated with disease.

Some investigators have observed anti-self antibodies and immune complexes in many CFS patients, both of which are hallmarks of autoimmune disease. However, no associated tissue damage typical of autoimmune disease has been described in patients with CFS. The opportunistic infections or increased risk for cancer observed in persons with immunodeficiency diseases or in immunosuppressed individuals is also not observed in CFS. Several investigators have reported lower numbers of natural killer cells or decreased natural killer cell activity among CFS patients compared with healthy controls, but others have found no differences between patients and controls.

T-cell activation markers have also been reported to have differential expression in groups of CFS patients compared with controls, but again, not all investigators have consistently observed these differences. One intriguing hypothesis is that various triggering events, such as stress or a viral infection, may lead to the chronic expression of cytokines and then to CFS. Administration of some cytokines in therapeutic doses is known to cause fatigue, but no characteristic pattern of chronic cytokine secretion has ever been identified in CFS patients. In addition, some investigators have noted clinical improvement in patients with continued high levels of circulating cytokines; if a causal relationship exists between cytokines and CFS, it is likely to be complex.

Finally, several studies have shown that CFS patients are more likely to have a history of allergies than are healthy controls. Allergy could be one predisposing factor for CFS, but it cannot be the only one, since not all CFS patients have it. C. Hypothalamic-Pituitary Adrenal (HPA) Axis Multiple laboratory studies have suggested that the central nervous system may have an important role in CFS. Physical or emotional stress, which is commonly reported as a pre-onset condition in CFS patients, activates the hypothalamic-pituitary-adrenal axis, or HPA axis, leading to increased release of cortisol and other hormones. Cortisol and corticotrophin-releasing hormone (CRH), which are also produced during the activation of the HPA axis, influence the immune system and many other body systems. They may also affect several aspects of behavior. Recent studies revealed that CFS patients often produce lower levels of cortisol than do healthy controls.

Similar hormonal abnormalities have been observed by others in CFS patients and in persons with related disorders like fibromyalgia. Cortisol suppresses inflammation and cellular immune activation, and reduced levels might relax constraints on inflammatory processes and immune cell activation. As with the immunologic data, the altered cortisol levels noted in CFS cases fall within the accepted range of normal, and only the average between cases and controls allows the distinction to be made. Therefore, cortisol levels cannot be used as a diagnostic marker for an individual with CFS. A placebo-controlled trial, in which 70 CFS patients were randomized to receive either just enough hydrocortisone each day to restore their cortisol levels to normal or placebo pills for 12 weeks, concluded that low levels of cortisol itself are not directly responsible for symptoms of CFS, and that hormonal replacement is not an effective treatment.

However, additional research into other aspects of neuroendocrine correlates of CFS is necessary to fully define this important, and largely unexplored, field. D. Neurally Mediated Hypotension Rowe and coworkers conducted studies to determine whether disturbances in the autonomic regulation of blood pressure and pulse (neurally mediated hypotension, or NMH) were common in CFS patients. The investigators were alerted to this possibility when they noticed an overlap between their patients with CFS and those who had NMH. NMH can be induced by using tilt table testing, which involves laying the patient horizontally on a table and then tilting the table upright to 70 degrees for 45 minutes while monitoring blood pressure and heart rate.

Persons with NMH will develop lowered blood pressure under these conditions, as well as other characteristic symptoms, such as lightheadedness, visual dimming, or a slow response to verbal stimuli. Many CFS patients experience lightheadedness or worsened fatigue when they stand for prolonged periods or when in warm places, such as in a hot shower. These conditions are also known to trigger NMH. One study observed that 96% of adults with a clinical diagnosis of CFS developed hypotension during tilt table testing, compared with 29% of healthy controls. Tilt table testing also provoked characteristic CFS symptoms in the patients. A study (not placebo-controlled) was conducted to determine whether medications effective for the treatment of NMH would benefit CFS patients. A subset of CFS patients reported a striking improvement in symptoms, but not all patients improved. A placebo-controlled trial of NMH medications for CFS patients is now in progress. F. Nutritional Deficiency There is no published scientific evidence that CFS is caused by a nutritional deficiency. Many patients do report intolerances for certain substances that may be found in foods or over-the-counter medications, such as alcohol or the artificial sweetener aspartame.

While evidence is currently lacking for nutritional defects in CFS patients, it should also be added that a balanced diet can be conducive to better health in general and would be expected to have beneficial effects in any chronic illness. Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, U.S.A Tel: (404) 639-3311 / Public Inquiries: (404) 639-3534 / (800) 311-3435 This article was contributed by: www.fibromyalgia-support.org

Related Articles:
Alcohol : How Badly Can It Affect CFS Sufferers?
Earning Money From Home When You Have Chronic Fatigue Syndrome /Fibromyalgia
Chronic Fatigue Syndrome And Depression Are Not The Same Thing!
Get Free Prescription Medications
How to Select a CFS Support Group
What are the symptoms of fibromyalgia?
The CFS Case Definition

Lisa Angelettie, M.S.W., is a psychotherapist, author, and life coach. She has been helping people make smarter life choices since 1998. Get more free tips like this when you subscribe to the GirlShrink newsletter .

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Scientific studies on EBV sparked new interest in the syndrome among medical researchers. They realized they needed a standard way to describe Chronic Fatigue Syndrome (CFS) so they could more easily compare research results. In the late 1980s, CDC brought together a group of CFS experts to tackle this problem. Based on the best information available at the time, this group published in the March 1988 issue of the scientific journal, Annals of Internal Medicine, symptom and physical criteria “the first case definition” with which scientists could evaluate CFS study patients.

Not knowing the cause or a specific sign for the disease, the group agreed to call the illness chronic fatigue syndrome after its primary symptom. Syndrome means a group of symptoms that occur together but can result from different causes. (Today, CFS also is known as myalgic encephalomyelitis, postviral fatigue syndrome, and chronic fatigue and immune dysfunction syndrome.) After using this definition for several years, CFS researchers realized some criteria were unclear or unnecessary. An international group of CFS experts reviewed the criteria for CDC, which led to the first changes in the case definition.

This new definition was published in the same journal in December 1994. In addition to revising the CFS case criteria which reduced the required minimum number of symptoms to four out of a list of eight possible symptoms the newer report also proposed a conceptual outline for studying the syndrome. This outline recognizes CFS as part of a range of illnesses that have fatigue as a major symptom. Although primarily intended for researchers, these guidelines should help health care providers better diagnose CFS. Despite the existence of case definitions, the causes of CFS remain essentially unknown, and the only way to make the diagnosis is to rule out other causes of the same symptoms. This can be particularly difficult because many patients with CFS also have major psychiatric illnesses such as depression, and some of these conditions and the medicines used to treat them can cause some of the CFS symptoms.

NIAID is a component of the National Institutes of Health (NIH), which is an agency of the Department of Health and Human Services. NIAID supports basic and applied research to prevent, diagnose, and treat infectious and immune-mediated illnesses, including HIV/AIDS and other sexually transmitted diseases, illness from potential agents of bioterrorism, tuberculosis, malaria, autoimmune disorders, asthma and allergies.

This article was contributed by: www.fibromyalgia-support.org

Lisa Angelettie, M.S.W., is a psychotherapist, author, and life coach. She has been helping people make smarter life choices since 1998. Get more free tips like this when you subscribe to the GirlShrink newsletter .

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The wonders of alcohol. The achilles heel for many people. The ‘norm’ for some others. And poison if you have CFS/PVFS/M.E…. I remember when I first got Post Viral Fatigue Syndrome/CFS back in 1995, I thought that having a drink or two wouldn’t affect me any differently to my PRE-CFS days. Unfortunately I didn’t realise what I was doing to myself.I didn’t know how badly alcohol can affect the severity of CFS… Nowadays I don’t touch alcohol at all, and haven’t done so for a few years now. I’d rather see at least a few hours in the day instead of being bedridden for weeks on end because of one alcoholic drink! Because when you have CFS/M.E., you might as well be pouring arsenic down your throat…

——SIDE NOTE——- Okay – so that comparison might be a little ‘dramatic’, but you get what I mean right?

——SIDE NOTE——- You see when you have CFS/M.E., you are likely to develop **alcohol intolerance**…

The smallest alcoholic drink – even a tiny bit, can send you into a relapse – as I learnt the hard way many years ago. Having an alcoholic drink now and again was enough to tip the severity of my CFS over the edge and put me in bed indefinitely.

When a **normal** person gets drunk they may feel a bit bad for a day or so, after which, they’re back to ‘normal’, bouncing back and raring to go. But when a person with M.E./CFS gets drunk – or even has just one drink, they’re likely to feel like ‘death warmed up’ for what seems like an eternity!!!

Personally, I don’t actually like alcohol much so I don’t miss it. But even if I did, I have realised that alcohol no longer makes me feel the way it used to before I had CFS… Drinking alcohol now feels like I’m feeding myself poison, and my body reacts accordingly – i.e. a relapse – and I suffer the consequences for a long, long time afterwards.

Unfortunately, us CFS sufferers are just not strong enough to resist the poisons of alcohol. So it’s unfortunately a case of accepting it, or getting much, much worse. As Dr Shepherd writes in his book ‘Living With M.E.’: “Some people who previously enjoyed and tolerated regular consumption of alcohol without any adverse effects, now find that even small amounts make them extremely unwell.” — p214, Dr Shepherd, ‘Living With M.E.’ — So if you have M.E./CFS, it is likely that you may have developed an intolerance to alcohol.

And that’s not forgetting that alcohol also affects the effects of antidepressants (often prescribed to CFS sufferers to treat their fatigue and to help sufferers sleep)! So if you’re taking antidepressants, it’s definitely something to bear in mind. Having CFS/FM can be a very lonely and devastating experience and depression can be a very real and serious symptom for many CFS/FM sufferers. So the last thing you need is to take substances that make you feel worse. And guess what? Yep, you’ve guess it, alcohol is also a depressant. So it’s not a great thing to drink if you’re depressed! And according to Dr Shepherd, many sufferers sadly do turn to alcohol… But alcohol is no answer. Apart from probably making you feel depressed, you could also develop an alcohol dependency! What’s more, if you **are** alcohol intolerant, then it would make it much harder for yourself to recover from M.E./CFS (pretty much impossible even), while you keep putting alcohol in your body. And here’s some more ‘food for thought’…

When you think about how badly a CFS sufferer can be affected by **one** alcoholic drink, then how badly could alcohol be affecting you if you’re drinking more??? So there you go – a whole list of reasons why you might think twice about drinking anything remotely alcoholic while you have CFS/M.E. While you may no longer be alcohol intolerant once you have recovered from CFS/M.E., it may well be a major culprit for preventing you from **recovering** from your CFS/M.E while you still have it. I didn’t know about the possible effects of alcohol when I first had CFS/M.E… … and I suffered the consequences. My M.E./CFS got worse. A lot worse. And I was only having a couple of drinks now and again!

So I hope this article arms you with enough info for you to make an educated decision about alcohol either way. You never know – it may well make the difference… ===========================================================

** Reprinting of the article above is welcome! ** The article above may be freely reproduced provided that: (1) you include the following resource box; and (2) you only mail to a 100% opt-in list. Here’s the resource box to use if reprinting the article above: —— Claire Williams is editor of sleepydust.net … Helping You To Deal With Post Viral Fatigue Syndrome, Chronic Fatigue Syndrome, M.E. and Fibromyalgia “From Solving Your Money Worries To Recovering From Your Condition” http://www.sleepydust.net To subscribe to the newsletter in which this article was published, please go to: http://www.sleepydust.net/ezine.com

Recommended resource: How To Give Up Alcohol

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Chronic Fatigue Syndrome /Fibromyalgia makes you extremely tired, exhausted and weak. It means you only have a fraction of the waking hours that most people enjoy – and even those waking hours are often spent feeling exhausted and with brain fog. But you **can** do something in your day – it just may not be much… … so all you have to do is ‘focus your light’ – focus your energy!

Most healthy people have oodles of energy – but many don’t focus on anything in particular and so they don’t feel that they get anything done. In essence, many people – healthy or otherwise – sadly lack direction. They lack focus… Even the tiniest amount of energy – directed every day (or every other day or basically, when you feel well enough) towards a goal – in the end, and after time, forms a huge result. No matter how much energy you have – if you focus that little amount of the energy on working from home – setting up your own project – you will get there. After all… … the snail wins the race! It’s not a question of: “But how can I make money? I have nothing to sell!” – that’s the one objection pretty much every CFS or FM sufferer that I have talked to, initially comes up with. I say ‘initially’ because after I’ve explained to them the different ways in which they can make money online, something ‘clicks’…

All you need is a computer, the Internet, and a passion about something. ANYTHING! We live in a world where knowledge is KING. People are hungry for knowledge – and everyone – EVERYONE – knows something about SOMETHING. It might be about how to manage 3 kids during the holidays. It might be about your faith in a religion or about spirituality. It might be about your interest in history, pets, makeup, knitting, fishing, model planes, sport, massage, quilting, sewing, gardening, computers, chess, cooking, travelling, cars… You might know about ways to entertain toddlers and young kids (for baby-sitters and young mothers). You might know about how to be super organised – or maybe you’re good with numbers? You may know a lot about your local area – its history – or great places to go out to – or beautiful nature trails in your area. You may know about an area you visit often on holiday…

What matters is that you know about something that you can write about – that you can either sell in the form of an e-book (easier than you think), or that you can put on your own website (also easier than you think), to attract visitors. Having your own website on a topic you are passionate about is the BEST way to generate long-term income – if you do it properly.

The point is that YOU know SOMETHING about SOMETHING that SOMEONE ELSE wants to learn about! YOU have knowledge – that someone else is looking for! The point is that the only thing you need to bring to the table is passion and the motivation to work……which won’t actually feel like **work** when you’re doing something you love anyway! And the great thing about working on your own project is that you can work WHEN you want, for HOW LONG you want, and on WHAT you want. If you can only manage 25 minutes one day, then that’s 25 minutes more than you would have done if you had done nothing! If you can manage 2 hours on another day – even better! If you can’t manage to do anything another day, then so be it! It doesn’t matter because you have no-one to answer to but yourself! Because it’s YOUR project! YOU set the pace… … focus your energy and you can have your own income-earning web project in months.

This is so important that I’m going to repeat it!!! Focus your energy and you can have your own income-earning web project in months!!!

I’ll leave you with a little quote: “We act as though comfort and luxury were the chief requirements of life, when all that we need to make us happy is something to be enthusiastic about.” — Albert Einstein (1879-1955)

– And good luck! This is the beginning of a fantastic journey! ===========================================================

** Reprinting of the article above is welcome! ** The article above may be freely reproduced provided that: (1) you include the following resource box; and (2) you only mail to a 100% opt-in list. Here’s the resource box to use if reprinting the article above: —— Claire Williams is editor of sleepydust.net … Helping You To Deal With Post Viral Fatigue Syndrome, Chronic Fatigue Syndrome, M.E. and Fibromyalgia “From Solving Your Money Worries To Recovering From Your Condition” http://www.sleepydust.net To subscribe to the newsletter in which this article was published, please go to: http://www.sleepydust.net/ezine

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Chronic Fatigue Syndrome is a very misunderstood illness and this is perhaps why there are so many myths about it. Perhaps the most common myth about Chronic Fatigue Syndrome is that it is effectively a mental condition, and another name for depression. But these two conditions are very different! And when you label a condition incorrectly it can cause no end of problems when trying to diagnose and treat it. So it’s extremely important to make the distinction between Chronic Fatigue Syndrome and depression – because they are completely different illnesses.

For one, depression can be a symptom of Chronic Fatigue Syndrome, but there are many Chronic Fatigue Syndrome sufferers out there who do not suffer from depression at all. Second, research has shown that Chronic Fatigue Syndrome sufferers have an abnormality in their ‘deep sleep’ brainwave patterns. In contrast, depression sufferers do not have this abnormality. In addition, depression sufferers tend to feel tired all the time, whereas Chronic Fatigue Syndrome sufferers’ exhaustion increases notably after mental or physical exertion. There are also symptoms of Chronic Fatigue Syndrome that are not shared by depression sufferers. Nasty flu-like symptoms, headaches, reversal of sleeping patterns, painful muscles and joints, Restless Legs Syndrome, and an increase in colds and viruses all are just a few symptoms that can play a part in Chronic Fatigue Syndrome. These are just a few of the differences between Chronic Fatigue Syndrome and depression!

Another myth about Chronic Fatigue Syndrome is that all Chronic Fatigue Syndrome sufferers need to do is to ‘pull themselves together’ – and they’d be cured… … if only it were that simple! Chronic Fatigue Syndrome is actually a bio-physical condition and was (finally) accepted as such by the UK government in 2001. But no cure has yet been found.

Unfortunately there are still many people out there (including some medical professionals) who still think that the condition is ‘all in the sufferer’s head’. It is because of this misunderstanding that the Chronic Fatigue Syndrome community has fought so hard against Chronic Fatigue Syndrome being wrongly labelled as a mental illness. And it is perhaps because of this battle that depression amongst Chronic Fatigue Syndrome sufferers has often sadly been overlooked… Yet for many, depression can be a very real symptom of Chronic Fatigue Syndrome.

If you suffer from depression as a Chronic Fatigue Syndrome sufferer, then it’s vital that you take it very seriously and that you try to address it as soon as possible. If you don’t deal with your depression, you are unlikely to be able to recover from any chronic illness… …and recovering from Chronic Fatigue Syndrome is no exception. It is possible to recover from Chronic Fatigue Syndrome. So if you do experience depression as a symptom of your Chronic Fatigue Syndrome, make it a priority to deal with it. Only that way can you get yourself on the road to recovery.

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** Reprinting of the article above is welcome! ** The article above may be freely reproduced provided that: (1) you include the following resource box; and (2) you only mail to a 100% opt-in list. Here’s the resource box to use if reprinting the article above: —— Claire Williams is editor of sleepydust.net and has suffered from Post Viral Fatigue Syndrome/ Chronic Fatigue Syndrome since 1995. She created ‘sleepydust.net’ to help Chronic Fatigue Syndrome and Fibromyalgia sufferers to deal with the condition – from handling their money worries, to recovering from their illness…. http://www.sleepydust.net To subscribe to the newsletter in which this article was published, please go to: http://www.sleepydust.net/ezine

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Did you know that in 2003, over 6.2 million Free Medicines were given away through US Pharmaceutical Patient Assistance Programs?

And not just to the elderly. If you qualify, you and your family can get free medications for a variety of conditions. Qualifications are usually need and income based.

Organizations such as medicinebridge.comcan assist you with finding a company that has the medicines you are looking for. Some qualifications that medicinebridge.com states as required include:

General Income Guidelines:

- A Single individual’s income must be at or below $1,300 per month (Gross).

- A Married couple’s income must be at or below $2,100 per month (Gross).

- Your Income may be higher if you have dependents (add $250/month for each dependent or $3000/year).

Your Income levels are higher for individuals that take drugs for Cancer, HIV, and MS.  If you are outside the income guidelines and you take a specific drug for Cancer, HIV, or MS please e-mail us the name of the drugs and we will e-mail you back within 24-48 hours to see if we can help you get them for free.

There are over 1,200 name brand medications available on the Medicine Bridge Program. For more information visit: http://www.medicinebridge.com

Lisa Angelettie, M.S.W., is a psychotherapist, author, and life coach. She has been helping people make smarter life choices since 1998. Get more free tips like this when you subscribe to the GirlShrink newsletter .

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Support groups are not appropriate for everyone, and some CFS patients may find that a support group actually adds to their stress rather than relieving it. Most support groups are free, collect voluntary donations, or charge modest membership dues to cover basic expenses (e.g. refreshments at meetings or photocopying costs).

A useful support group should include: Both newcomers and patients who have had CFS for longer periods of time to provide a balance of perspectives for the group. People with whom the CFS patient feels comfortable. Leaders who empathize, gently draw out shy members, and keep others from dominating, and who distill discussion into useful information. A history indicating the group is stable and meeting the needs of its members. Some support groups may put their own interests before those of the individual patient. Groups that engage in any of the following activities should be avoided: Promise sure cures and quick solutions. Conduct meetings that are mainly “gripe” sessions. Urge patients to stop prescribed treatment and recommend a single solution to their problem. Insist that patients reveal private or sensitive information. Demand allegiance to a cult-like, charismatic leader. Charge high fees. Require patients to purchase products.

Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30333, U.S.A Tel: (404) 639-3311 / Public Inquiries: (404) 639-3534 / (800) 311-3435 This article was contributed by:www.fibromyalgia-support.org

Lisa Angelettie, M.S.W., is a psychotherapist, author, and life coach. She has been helping people make smarter life choices since 1998. Get more free tips like this when you subscribe to the GirlShrink newsletter .

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