What are fibromyalgia and chronic fatigue syndrome?

If you or someone close to you suffers from either fibromyalgia syndrome (FMS) or chronic fatigue syndrome (CFS), you’ll know the significant impact it can have on quality of life and the ability to carry out everyday activities.

While fibromyalgia causes widespread pain, chronic fatigue causes severe exhaustion. Both conditions can also cause difficulties with memory, digestive challenges, insomnia, anxiety, depression and more. What makes these conditions more distressing is that the collection of symptoms cannot be medically explained – doctors cannot find a precise cause for fibromyalgia syndrome or chronic fatigue syndrome (also known as myalgic encephalomyelitis).

Both conditions are thought to be triggered by either an injury, acute episode of stress, or infections like Covid or Epstein Barr Virus. But most people would recover from these within a few days to weeks. So, why do some go on to develop long-term conditions like fibromyalgia or chronic fatigue?

Emerging scientific research shows an undeniable link between your mind and body. The chronic debilitating symptoms you’re experiencing are real – they’re not ‘in your head’, which some may have you believe. Instead, they’re in your brain, triggered by nervous system activation which stimulates your sympathetic nervous system into a state of fight or flight.

Pain is felt in the brain, rather than your bodily tissues – which send the message to your brain that they’re experiencing pain.

Fibromyalgia and chronic fatigue are psychophysiological disorders (PPD)

Psychophysiological Disorders (PPD) is the clinical term for mind-body symptoms. Our entire brain is connected and communicates through neural pathways (like highways between cities). These pathways form the basis of our habits of thinking, feeling, and behaving. They create every sensation we feel in our body. One of these neural pathways is called the danger-alarm system, which alerts us to potential danger. It’s designed to keep us safe, to keep us alive. It serves an important purpose.

But, when a child grows up afraid, in a highly stressful environment, the body and brain’s system become more sensitised to threat, real or perceived. Later, when the child or adult is exposed to even ordinary levels of stress, these systems may respond automatically – as though the person is under extreme stress. They may experience the heart pounding, rapid breathing, or shut down completely.

While other responses include fatigue (chronic fatigue syndrome), difficulty managing emotions, explosive anger, anxiety, depression and insomnia, and irritable bowel syndrome, pain is the brain’s most common response to threat.

When danger signals disappear, your body should ideally return to a state of relaxation and calm. But, if your danger alarm mechanism is being activated longer than it should or in response to perceived threats, your brain can generate chronic pain and other symptoms, keeping you stuck in a constant state of alarm.

The symptoms of fibromyalgia and chronic fatigue don’t appear due to tissue damage, rather due to overactivation of your danger-alarm system. Unfortunately, the more we focus on our symptoms, such as fatigue or pain, the more our brain receives a signal that there is something wrong with us. It directly activates the danger response and the vicious cycle continues until it becomes a learnt and engraved pathway in the brain that is triggered more and more frequently.

Know this: all tissues heal and scars don’t hurt. If you’re experiencing pain or other debilitating symptoms that persist more than three months after an acute injury, it is almost always linked to mind-body symptoms. Chronic pain, migraine, fibromyalgia, chronic fatigue and pelvic pain syndromes are just a few of the very real chronic conditions that can be diagnosed as PPD.