Is Fibromyalgia Linked to PTSD?

Psychosocial Factors?

The great argument on the subject of fibromyalgia is whether or not there is a psychological or social factor that may lead to a person developing the disease. There are many theories for and against this idea and more work needs to be done to get to the kernel of the truth that is imbedded within all the talk and theory.

The medical community has done well to at least mention psychosocial issues as contributing factors, even if they haven't been proven as primary causal factors for fibromyalgia. It is believed that psychosocial factors affect fibromyalgia in three distinct ways. Psychosocial stressors make one more susceptible to fibromyalgia and can act as a kind of trigger for the onset of fibromyalgia, and may serve to perpetuate the condition. Studies do suggest a greater prevalence of severe emotional, sexual, or physical abuse in fibromyalgia patients as against the general population.

Statistics show that such abuse originated with family members or in relationships. For many in the medical community, this fact carries with it a strong suggestion that long-term stress or post-traumatic stress disorder (PTSD) may be implicated as at least one culprit behind the development of fibromyalgia.

PTSD, an anxiety disorder first classified in 1980, occurs in response to a specific trauma. This disorder can and often does last for many years with varied symptoms such as an exaggerated startle response to auditory stimulus, poor concentration, interrupted sleep or insomnia, mood swings, a feeling of hopelessness, irritability, and apathy. Some diagnostic tests show changes in the brain in PTSD patients which likely occur due to long-term exposure to stress hormones such as cortisol.

Nearly Half

One study of particular interest, performed in the year 2004, concentrated on men with fibromyalgia, a disease that is more common among the female population. This study found a strong correlation between fibromyalgia and PTSD in Israeli soldiers. Fibromyalgia was found in 49% of those men with long-diagnosed PTSD as compared with only 5% of those who suffered from depression as a result of their wartime service. There was no fibromyalgia at all in the control group of healthy male soldiers. Lead investigator of the Hadassah Hebrew University School of Medicine study Howard Amital commented that, "Normal average males have no tender spots on their bodies, so it was very unusual to find such a high number of men showing this level of pain."

Those opposed to the idea that there may be a psychosocial element to fibromyalgia feel that the admission of such causal factors may lend credence to the idea that fibromyalgia is "all in the head." But the nay-sayers would do well to remember that psychosomatic illnesses are real, physical illnesses, brought on by psychosocial issues. Those who wish to argue against the psychosocial causal factors of fibromyalgia would do well, instead, to fight against the stigma attached to mental health issues.


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What I hate is when you go to a doctor that know's you have mental issues and when you C/o of symptoms they immediately correlate what you say to a part of your mental illness. I had severe "month times" couldn't even leave the house cuz nothing was safe against "accidents" I was blown off a ton till I passed out from the pain... then it was like oooo guess what you have endometriosis. I am wondering though if they are barking up the wrong tree. Maybe fibromyalgia is a symptom and not what is causing the symptoms? I used to be so skinny and I climbed rocks and mountains, I was never in my house because of all the adventurous things I wanted to do and now I am stuck hiding at home with a very unhappy husband that accused me of cheating (well he said that is what he keeps thinking) I was like omfg... when and where would I be doing this? I rarely leave the house except to buy groceries.
Fibromyalgia may be linked to PTSD. PTSD may be linked to fibromyalgia. Nobody really knows what fibromyalgia is. It is a Syndrome - a collection of many symptoms, which vary widely from person to person. It probably has several different causes. It seems there is a flaw in simple logic here. Set A = persons with fibromyalgia. Set B = persons with PTSD. There is some overlap between Set A and Set B. That does not mean that Set A = Set B. It does not mean that one causes the other. Let's stick to the facts. Much more research is needed. Let's look at the interesting connection between the invention and heavy marketing of SSRI and SNRI drugs and the sudden recognition of fibromyalgia as a "psychosomatic illness occurring in depressed people." Who funds the research studies on fibromyalgia? "Build it, and they will come!" Well said, abc, there certainly is a stigma about mental health issues, an "Us" and "Them" mentality - when in fact NOBODY is completely "normal." Just as everyone has some weak spot in the physical body, everyone has a weak spot in the emotional make-up too. There is nothing wrong with feeling depressed, it's part of being human, it is a normal response to grief which most people encounter, more than once, in normal life. It does not need to be medicated unless it is severe and life-threatening and unresponsive to good psychological therapy. Just my opinion, but "unhappy" housewives have always been targeted - remember how easy it was to get those "highly recommended" lobotomies back in the 1940s? Probably not. Now we have chemical lobotomies, highly recommended for unhappy women with painful conditions. That bias should be taken into account. Perhaps, as abc notes, men with painful conditions are quickly accepted as having REAL pain, while women are quickly dismissed as having "emotional" pain. Again, let's approach this in a way that has some truth and logical validity.
...."Those who wish to argue against the psychosocial causal factors of fibromyalgia would do well, instead, to fight against the stigma attached to mental health issues." Well, we could start by not differentiating mental health and medical health. Let's work on the stigma... by not putting mental health on a different axis, not treating it like we don't understand any of the medical causes. We understand more about the medical causes, and brain structure differences for psyzophrenia than we do dementia. So why is one a "mental" problem and one a "medical" problem? When health care professionals stop treating us differently, the world will. This same article or report stated "Some diagnostic tests show changes in the brain in PTSD patients which likely occur due to long-term exposure to stress hormones such as cortisol." If you found changes in my brain that caused Alzhiemer's, would you call it a mental illness? The stigma is so severe that if you are admitted to an ER at 88 years old with severe dementia, unable to reason, the law states that you must be given a call light. However, if you are admitted with depression there is nothing in the small room they put you in that is a call light. There is no law to protect you. Can you imagine taking full responsibility for your a "mental illness" and accepting treatment only to have the people you cared about and respected treat you like you've just called yourself a pedophile? "Don't say that. .... You can do anything you put your mind to..... (and my favorite) ...You're so smart, how could you think you have mental illness." Do I sound angry, frustrated, irritated? I am, and there is nothing pathological or dysfunctional about it. If something traumatic enough to fry a circuit in my brain causes the presence of PTSD, I have no problem believing a similar cycle could develop involving the pain receptors. PTSD has the feeling of something being relived, nay, lived again. The pain, real or not, is felt as much and as intensely as a PTSD event is felt and lived when triggered. The study of the Israeli Soldiers could help end platitudes and bias remarks like, "just put your mind to it". These are not your perceived weak housewives whining because they were raped, they are men and as yet don't suffer the same bias and discrimination as women in health care. Discrimination in health care based on gender? Say it isn't so? I have over 23 years experience in this field. A recent reminder of the gender divide was this month when I told my MD of a female pain that required a pelvic exam and he said it could be handled "next month". Really? If I had said I had pain at the base of my penis and can't xyz, do you think I would have had to wait a month? I know I wouldn't have. Fortunately, it is a week I can advocate for myself and I've gotten some medical attention. But I had to fight for it. I've never seen a man wait more than about 15 minutes for a genital concern. This is just a small example of how gender bias we are and that it is important to realize that this article discusses a study done, not only on men, but on Israeli Soldiers who are not exactly known for being weak. Medical professional's, people with mental health diagnosis, family members and loved ones of people with mental health diagnosis, and fibromyalgia sufferers who have comorbid "mental health" diagnosis, start asking the question. WHY? Why is my diagnosis so different from a medical diagnosis? There are, too many to count, medical illnesses, not to mention medications for them, where the rational for or action of are not completely understood. There is zero reason for the isolation of a subset of diagnosis that encourages prejudice.