Coping with Trauma and Fibromyalgia
- Jul 7, 2023
- 9 min read
Updated: Jul 8, 2023
Episode: 20 Understanding the Connection Between PTSD and Fibromyalgia
Trauma. It's a buzz word right now. I hesitate to use it in relationship to me because of fear that folks may say: "That didn't happen", "Your problems aren't that bad", "Everybody has 'TRAUMA' - so what." I don't know who would say these things, but in my head, this is real. I have been diagnosed with PTSD. Some would call it C-PTSD, or "complex - post traumatic stress disorder". How? Why? Goodness, there is a litany of events that happened in my childhood and into young adulthood that groomed me for terrible abuses that happened well into my adult womanhood. And I believe this is a cause, if not the cause of my fibromyalgia.
In my post "Childhood Trauma: Does it Cause Fibromyalgia?" I concluded after an exhaustive search that: Childhood trauma and childhood sexual assault trigger harmful neurological effects that damage the brain and can lead to fibromyalgia, chronic fatigue and other physiological diseases.
Looking at Trauma Again
So here I am at it again. Looking at trauma again. And I guess, considering the subject matter, I am not sure I can do enough research to fully cover the topic from a laymen's perspective, or from my perspective as a survivor. So PTSD it is. Let's go!
I have been in therapy on and off for most of my adult life starting in my late teens until now where I have a weekly session with my mental health professional. It wasn't until this time around with my current therapist that I got a definitive diagnosis of PTSD, depression and anxiety. And it is just this year that I also finally received a fibromyalgia diagnosis for my lifetime of chronic pain. When I told my therapist that I had recently been diagnosed with fibromyalgia, he said he would have been astonished if I didn't have a chronic pain or illness diagnosis. I didn't understand that response until later as I got further into my research for this blog and I was reminded again that people who have experienced trauma or traumas have higher rates of chronic illnesses including fibromyalgia.
Today, I aim to continue to unravel the confusing connection between fibromyalgia and PTSD, or post traumatic stress disorder, and hopefully be able to share in laymen's terms what I learn and my next steps in self-care.
Fibromyalgia
Let's Start with some Clarifying Definitions: First, fibromyalgia is a central sensitivity disorder characterized by all over body pain, fatigue, brain fog, depression and anxiety. Fibromyalgia is a diagnosis of exclusion. There is no specific test for fibromyalgia, yet. A doctor will review your medical history and perform a series of tests to determine if you have any other underlying conditions or autoimmune disorders such as rheumatoid arthritis, ankylosing spondylitis, Lyme disease, polymyalgia rheumatica, or lupus, all of which can mimic fibromyalgia in that, they too, involve widespread bodily muscle and joint pain. After identifying that you have had the pain for three or more months, a doctor may consider fibromyalgia as the source. It is important to note that it is possible for a person to have an underlying autoimmune condition and fibromyalgia, too.
PTSD and C-PTSD
According to the Mayo Clinic, post traumatic stress disorder, or PTSD, is a psychological condition that occurs after a terrifying, or traumatic event. Not all people who experience a traumatic event develop PTSD, but for those that do, symptoms may include but are not limited to a racing heart, uncontrollable crying, explosive anger, severe anxiety, nervous sweating, flashbacks, nightmares, and widespread bodily pain. I have been diagnosed with complex post traumatic stress disorder, or C-PTSD. This differs from PTSD in that a person has, "experienced multiple and sustained traumas and have greater functional impairment than those with PTSD". According to the Cleveland Clinic, sustained traumas can include: "Long-term child physical or sexual abuse, long-term domestic violence, being a victim of human or sex trafficking, war, frequent community violence". Symptoms of C-PTSD are much the same as PTSD with the addition of hyper-vigilance: super attention to the possibility of danger, and my personal favorite (sarcasm): "A negative sense of self involving persistent feelings of shame, guilt, failure and worthlessness". At one point or another in my life, I have experienced all of these PTSD and C-PTSD symptoms with some lingering for my entire lifetime. Thank God for therapy! Yoga! Meditation... all of it.
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Fibromyalgia and PTSD/C-PTSD: What is the relationship?
Fibromyalgia and PTSD/C-PTSD have been linked in several studies. Though chronic pain is not a defining symptom of PTSD, and not all people living with fibromyalgia have reported PTSD symptoms, in at least one study, fibromyalgia subjects reported higher rates of PTSD symptoms than patients without fibromyalgia:
In this study, 57% of the FM [fibromyalgia] sample had clinically significant levels of PTSD symptoms... The prevalence of PTSD among the FM patients in this study was significantly higher than in the general population.
But does PTSD cause fibromyalgia, or does fibromyalgia cause PTSD. Yes, and no. Both can be true. Fibromyalgia and PTSD are closely linked and frequently occur together. These two disorders have a bidirectional relationship; each condition can act as a likely risk factor for the other. As with depression, which I pointed out in my blog "Complex Connections: Fibromyalgia and Depression", fibromyalgia and PTSD are considered coexisting conditions because they share common triggering traumatic events.
Considering the evidence, the answer is as clear as mud. Fibromyalgia does necessarily cause PTSD; PTSD does not necessarily cause fibromyalgia; fibromyalgia is not a definative symptom of PTSD and PTSD is not a defining symptom of fibromyalgia. However, more people with fibromyalgia report PTSD symptoms than the general population. From a layman's perspective, if you have fibromyalgia, your are more likely to have symptoms of PTSD than a person without fibromyalgia.
Self-Care
If you have fibromyalgia and PTSD, what can you do about it? Since the start of the COVID pandemic, as tiresome as it is, "Self-Care" has been the term of the century. I would say that this applies to us. It is often difficult for others to understand what fibromyalgia does to our bodies and our minds. As a matter of fact, just a day ago, I had a dear friend say to me, "But you don't look sick. How can you have fibromyalgia?" I told her I have fibromyalgia because I have an overactive central nervous system that doesn't read the room right and sends pain signals when there is nothing that should hurt. I told her that the abuses I have suffered and the trauma(S) I have endured changed the way my brain perceives stressful situations and throws my sympathetic nervous system into overdrive causing me pain. And PTSD shifts my brain into a place that, when triggered with sight, sound, or smell, makes me feel either physical sensations and/or flashbacks, and in the snap of a finger, I feel like back in the situations that caused me harm. Yes, that was too much technical information for a non-sufferer to comprehend; neither are visible diseases. So, it stands to reason that we are tasked with caring for ourselves.
Having said all of that, self-care has so many options and components that it is actually a-whole-nother blog. But, I will provide an introductory listicle with the things I do to avoid a "fibro-flare" or, if I am in a flare, how I nurture myself until my central nervous system has calmed down.
Quality, restful sleep: First and foremost, quality restful sleep in a MUST. According to the Mayo Clinic, "getting a full night’s sleep and more restorative sleep can lessen pain and fatigue". Restful sleep not only helps me avoid a flare, it is the number one thing I can do to calm a flare.
Nutritious diet: Many of the components of a "nutritious diet" remain controversial including the use of supplements, but with a diet: "rich in plant foods, antioxidants or fiber... people have experienced an improvement in symptoms ... [this] suggests that ... diet could play a crucial role in the management of FM". Expanding your diet to include mostly minimally processed foods, may reduce fibromyalgia pain and improve overall health.
Movement: As I stated in my blog "Movement is Medicine", low impact aerobic exercise, strength training, and stretching can reduce pain and help manage Fibromyalgia. But, according to the Harvard Health Publishing blog, as with any exercise program, start slow. The last thing we want is to jump in, get excited and do too much. The Mayo Clinic advises, "People with fibromyalgia should gradually build up their exercise tolerance to avoid an increase in symptoms". Recovering from a "Fibro-Crash" is just as bad if not worse than recovery from a "fibro-flare"!
Manual therapies: Massage therapy, water therapy, and chiropractics are all things I do to work with my body and help myself become and stay relaxed, rejuvenated, and aligned. These therapies along with others like acupuncture can be helpful in relieving pain and stress. The National Institute of Health Center for Biotechnology Information invites people to try alternative therapies but they recommend a healthy dose of skepticism because alternative therapies (believe it or not) can have side effects too. I can attest to this when it comes to massage. In my blog post "Is Massage the Poison" I tell the story of the time my massage therapist actually injured me. Read about that here. My advise - try manual therapies but with caution.
Stress Management: In today's society, this is almost laughable. Managing stress includes all of the above strategies, and this means paying attention to what your body needs. Do you need rest? How is your diet? Are you moving your body? These are the good strategies for managing your stress along with choosing supportive relationships, environments, and distancing yourself from toxic situations: people, places, experiences.
What did I Learn?
Fibromyalgia and post-traumatic stress disorder/complex-post-traumatic stress disorder (PTSD/C-PTSD) are two distinct conditions that have been linked in various studies. Fibromyalgia is characterized by widespread body pain, fatigue, brain fog, depression, and anxiety, while PTSD is a psychological condition that arises following a traumatic event, or in the case of C-PTSD, multiple and sustained traumatic events. Although chronic pain is not a defining symptom of PTSD, and not all individuals with fibromyalgia experience PTSD, there is evidence suggesting a connection between the two. Because others may not fully understand what effects these two invisible disorders have on our minds and bodies, it stands to reason that we are tasked with caring for ourselves. It is important that we use self-care strategies, such as diet, exercise, quality restful sleep, and stress management to help us through difficult times and with our overall well-being in daily life.
If you enjoyed this post, share it with your friends and colleagues, and consider becoming a subscriber. If you have any tips or suggestions about how to better cope with chronic pain, leave a comment. I would love to hear from you!
Karen Palmen, EdD is a veteran educator in Saint Paul, Mn. She teaches Dance and English at Saint Paul Central High School. She has an active TikTok page that features humorous, political, mental health, and educational content (kickin it with karen). And a a dormant YOUTUBE channel with the same name, featuring fermented foods and other cooking oddities.
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