“After a traumatic experience, the human system of self-preservation seems to go into permanent alert, as if the danger might return at any moment” , Judith Lewis Herman
There has been a great deal of public awareness of late regarding the concept of Post Traumatic Stress Disorder. It seems as though the syndrome has become somewhat commonplace and many are quick to self diagnose. But, even more are recognizing that the condition is one caused by great stress and chronic anxiety and there are commonalities among us in our responses to traumatic experiences. What was once associated with abuse, now is believed to be the result of many occurrences that bring about dramatic memories, which in turn trigger danger to an overly stimulated nervous system. With the relatively recent wars in the Middle East whereby PTSD among veterans became all too common, public awareness has been heightened. In my book I discussed fibromyalgia in relation to what was then becoming known as Gulf War Syndrome, now it is more specifically known as PTSD that is capturing the attention of the experts. In the first world war it was known as shell shock. In the second world war it became known as battle fatigue, finally it is now more appropriately labelled as PTSD. Many of these veterans with PTSD have fibromyalgia, in fact I speculated then (and do so now) that they are one and the same thing. I will acknowledge there is the possibility that they are somewhat separate but akin to identical twins. The symptoms are identical.
It is chronic stress and subsequent chronic anxiety that precipitates PTSD (and fibromyalgia) since many (maybe all) people with PTSD develop fibromyalgia. What actually happens in the body is related to: the interaction between the hypothalamus , which is a portion of the brain responsible for activities of the central nervous system, to the pituitary gland ( the master gland at the base of the brain) which causes other glands to produce hormones, and the adrenal glands (situated on top of the kidneys) which secrete hormones that act as “chemical messengers”. These three (HPA) regulate our response to stress. The hypothalamus gives off hormones that cause the pituitary to give off another hormone and causes the adrenal to produce cortisol. This all equals BALANCE. When out of balance then fibromyalgia and PTSD and chronic fatigue occur.
But, what of the veterans who do not have PTSD or the people who have experienced a traumatic event like an accident who do not have fibromyalgia or PTSD? What is it about those of us whose psycho-social make-up affects our predisposition to these conditions? As I have repeatedly written I believe that these “psychosomatic” ( I hesitate to use this word as it conjures up bad images) syndromes are related to highly sensitive personalities. It can be due to nature or nurture, or both, and it cannot be proven which as it is all rather obscure at this point. It is not necessary to speculate about whether or not a person has the predisposition to be a highly sensitive person (HSP) because of their genetically inherited qualities or because of life experiences. Nonetheless, a HSP is more likely to develop PTSD and FM because of their personality type (HSP). Psycho-social factors contribute to the predisposition for fibromyalgia and a person becomes more susceptible when emotional, sexual or physical abuse occurs. This is my analysis and again while it cannot be proven it seems to me this is the most logical explanation to date.
In short, PTSDs are triggers from bad experiences which brings on: pain-fibromyalgia-clenching- sleep disorders- hyper-vigilance-anxiety- feelings of lack of safety- hyper-ventilating- nightmares and night terrors- catastrophizing- startled easily-flashbacks-depression, and a host of other symptoms.
So, while we can relate to these symptoms what can be done? This is the big question that arises repeatedly. Among the many suggestions are : talk and body therapy that does not include repeatedly inciting the brain to relive the trauma, relaxation techniques such as Mindfulness Meditation, undertaking a creative, repetitive, new-to- you hobby to change the neural pathways of the brain, movement strategies such as Qi Gong or Tai Chi, and strategies for better sleep, are among the most important. It is a long and tedious process, one which requires an understanding of the ability of the brain to change itself (neuroplasticity). In short, it must be a mind-body approach that is undertaken.
Do we ever change our personalities? It isn’t easy, but what choice do we have but to understand that we are not crippled or doomed forever by stressful events in our lives? We are like the psychologist Elaine Aron who is the world wide expert on highly sensitive persons (HSPs) who suggests we are like canaries in a coal mine. We are extremely sensitive to the increasingly stressful world in which we live and our experiences of it are worthy of admiration, rather than scorn. In the meantime we are floundering as we face the daily challenges in a world which does not understand our struggles. What is necessary at this point is self compassion, not self blame.