Fibromyalgia, chronic fatigue and the anxiety-prone brain

” The tenuousness of modern life can make anyone feel overwrought”, Robin Marantz Henig

An article in the NewYork Times Magazine, October 4, 2009 by Robin Marantz Henig, entitled Understanding the Anxious Mind has led me to speculate about the anxious, highly reactive, overly sensitive temperaments of those of us with fibromyalgia and chronic fatigue syndromes. While I am not the first to equate a hyperaroused nervous system with these two conditions, I believe that the new scientific information regarding the brain, remapping and neuroplasticity must also be taken into account if we are ever to reach some kind of understanding of both syndromes.

Reported in Marantz Henig’s article is the research of Jerome Kagan and Nathan Fox, two psychologists, who have explored the realm of anxiety and the physiological brain state, with participants beginning in infancy and followed for 20+ years, searching for highly reactive temperaments. My years of living with fibromyalgia/chronic fatigue and the many intensive interviews with women who also suffer from both chronic fatigue and fibromyalgia has led me to believe that we have highly reactive brains. Anxiety provoking thoughts of the highly anxious person specifically reside in the amygdala, an area found in the midbrain, and which responds to threat. However, whether or not this is a nature or nuture issue might seem irrelevant at this point, although in my view high degrees of anxiety in women (and children and men) is socially constructed. Given the societal expectations of women it is understandable that hypervigilance (a term I use frequently in my book and one which Peter Levine discusses in a very helpful chpater of his book Waking the Tiger)  becomes overwhelming; the brain then cannot distinguish between fear and flight or rest and relaxation. Hence the greater incidence of fibromylalgia/chronic fatigue among women. Fear and anxiety even seem to accelerate as women grow older, rather that diminishing. It is likely that the same is true for men as well if they have not been able to heal the wounds and trauma of earlier times in their lives (read Peter Levine’s work on trauma which I have written about in other blogs).

For those who are extremely anxious the brain cannot differentiate between a real or perceived threat. “ANXIETY IS NOT fear, exactly, because fear is focused on something right in front of you, a real and objective danger. It is instead of kind of fear gone wild, a generalized sense of dread about something out there that seems menacing- but that in truth is not  menacing, and may not even be out there”, writes Marantz Henig.

One of the debates regarding this issue is whether or not chronic fatigue even fits in the category of fibromyalgia. One very recent study (among many older ones) suggests that chronic fatigue is caused by a virus. Whether or not chronic fatigue syndrome is a separate entity is not my concern now, but fibromyaliga does not exist without chronic fatigue. It stands to reason that after the highly anxious/reactive/hyper-aroused brain finally settles for awhile, after an anxiety episode, fatigue sets in. Therefore I equate (perhaps wrongly) both conditions with extreme anxiety.

Marantz Henig’s article and Kagan and Fox’s research leads me further and further into the functioning of the brain and living with this invisible dis-ease. Fibromyalgia is quickly becoming an epidemic and living with the kinds of daily fear we all experience in a fast paced, anxious world it is likely to accelerate even more rapidly. I know anxiety/panic very well and it takes little to bring on a flare-up that I have to deal with along with the chronic pain and fatigue. Feelings of peace are hard for me to come by. Anxiety is my constant companion.

15 thoughts on “Fibromyalgia, chronic fatigue and the anxiety-prone brain

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  2. abot bensussen

    i am sure there are neurological constructs that affect us. however anyone who lives with a chronic illness, and one that is constantly changing it’s course, would feel anxious. not to be able to make an appointment and know whether you can carry it out, or start a project and then leave it unfinished, can cause an anxiety attack. one day the knees don’t work and another it’s the feet, or the arms, or the migraines. what’s astonishing is that we live this way at all, for years at a time, suffering alone and appearing healthy. to be so misunderstood by friends and family, even drs. who think it’s all in “our heads”, is diminishing and exhausting. wish you could know how we feel.

  3. barbara keddy

    Dear Abot: I know exactly how you feel. This is a very bad day for me today (this whole month/year in fact) with pains in my hands, arms and knees. While I know it is an overloaded nervous sytem, I am too overwhlemed not to feel anxious. As long as I have lived with fibromyalgia (most of my lifetime) I still feel anxious when a new symptom appears. I wonder “what now?”. It seems like every new place the pain attacks is arbitrary.The most difficult thing is wondering if it is fibromyalgia or something else. Even going to the Dr makes me anxious. You are right too…we all appear healthy while chronic pain is so exhausting. Thank you for responding to my blog. Your comments are appreciated.

  4. Wellescent Health Blog

    A tie between anxiety and some immune disorders may have been found with research into the womb environment of pregnant women. In a study I recently read, researchers found that when women are stressed during critical stages of pregnancy, the changes in the chemistry of the womb can actually alter the programming of their unborn child’s nervous and immune systems making the child’s system more sensitive than normal and often imparting an immunological disorder.

  5. Ted Zeff, Ph.D.

    This excerpt is from the book “The Highly Sensitive Person’s Survival Guide” by Ted Zeff, Ph.D.

    “Since most medical doctors tend to be non-HSP (highly sensitive person), while many holistic health care practitioners are HSP, you may feel more comfortable working with an HSP health provider. It’s important for you to let your doctor know that you are a highly sensitive person. Tell your doctor that since you tend to feel things more deeply, your body could react to medication and pain more intensely than most people. This is important information for your doctor to know about you. I feel that it’s important to utilize the excellent advances in modern Western medicine such as diagnostic testing, combined with the ancient healing herbs from indigenous cultures with the production of modern supplements and vitamins.”

    In my research of highly sensitive people, I found that most HSPs responded that they had trouble falling or staying asleep frequently, stress at work has affected their emotional and physical health, and reported having a difficult childhood. Having a sensitive nervous system needs to be properly managed to avoid an increase in emotional and physical challenges.

  6. Barbara Keddy Post author

    Thanks for your comments! Your book may indeed help others who define themselves as a HSP. I have not found any herbs to be helpful (and have taken many over the years!) but do take vitamins regularly. Otherwise, I completely agree with you regarding a HSP. In my view, only HSPs have fibromyalgia and although you don’t write about that relationship here I hope that in your practice you will consider this duality! Regards, Barbara

  7. Brant Tutko

    People all over the world in developed, Western nations suffer from panic attacks and naturally want to know the causes. Panic attacks are a tricky thing to have to endure, and sometimes establish, for a number of reasons. It is a hugely complex medical issue involving the person’s psychological state as well as physical condition. There is a good deal of resemblance and cross-influence happening within the mind and body. Those states only tend to make everything more troublesome to endure, form a variety of viewpoints.,

  8. Moses Buxbaum

    The entirety of the connected indicators of the panic disorder spring from the stimulation of distressed nerve signals that are created by the brain. The signs of panic attacks are rather regular and also without any type of damages. These signs are not poisonous, however they are not good. As we react in a different way in a response to the same stimulus, so the signs of the panic disorder vary from person to person. The signs of an anxiety attack can be connected with breast pain, light headiness, too much sweating, quick heart beat, abdominal restlessness and lack of breath. –

  9. Barbara Keddy Post author

    Dear Joanne: I just found your message of long ago after neglecting my site for many, many months.
    The answer for fibromyalgia is within us: we alone can have a better, though not perfect quality of life once we recognize the source of our anxiety and acknowledge there isn’t really a ‘cure’. Exercise moderately, avoid as much stress as possible, do relaxation, mindfulness meditation, avoid foods that are bad for you etc. All of this is not easy but there doesn’t seem like any alternative.
    Kind regards,

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