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The Twins: Fibromyalgia / PTSD

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Reprinted with the kind permission
of Barbara Keddy

“After a traumatic experience,
the human system of self-preservation seems to go onto permanent alert,
as if the danger might return at any moment.”

~~~ Judith Lewis Herman ~~~

In my book almost a decade ago, I wrote about Gulf War syndrome and the similarities between this condition and fibromyalgia. From the terms ‘shell shock’ and ‘Gulf War syndrome’ has emerged the contemporary ‘Post Traumatic Stress Disorder’ label.  We have now landed firmly on the relationship between these three conditions and fibromyalgia. Years and years of studying and researching on the topic of fibromyalgia has convinced me that PTSD and fibromyalgia are the same thing. There I’ve said it! And, finally others are saying it too. What do all those terms share in common? How is it that PTSD and fibromyalgia are twined? Wars, abuse, crises, trauma of many sorts take their toll on us all, but it is the highly sensitive person whose psyche becomes over-burdened. Here are the ways in which the two conditions match:
Insomnia is insidious, silent and invisible. Worse still are night terrors and dreams that rob peace of mind and wear one down. Not only do physical ailments develop from unrestful sleep, but also emotional problems develop. Things that seem bearable somewhat during the day become unbearable in the dark. Sleep deprivation and other disturbances are common.
Often gripped with the feeling of dread but cannot tell why. There is a constant merry-go-round of fearful thoughts in the brain. Looking constantly for anticipated trouble. A neurotic terror of the unknown is a frequent companion. The world is seen in black and white. The anxiety levels rise to panic. Change is not well tolerated.
Lack of contentment
Achieving even little contentment and peace is a struggle. Living in the moment is difficult as there is anticipation of the possibility that danger lurks around the corner. Living with tension and fear of the future while remembering the past is common.
Lack of resilience
Easily startled, frightened even when not in a dangerous situation. Flashbacks in terms of smells, sights and sounds from shocking, scary or crises once experienced. Negative thoughts about oneself result in being hard on self, mired in depressive thoughts.
Along with these emotional reactions, there are the physical ailments that accompany the emotional ones. Pain, fatigue, abdominal upsets, lack of energy, sensitivity to sounds, smells and frightening sights, uncontrollable itching, tingling of limbs and a myriad of other symptoms are what PTSD and fibromyalgia have in common to a lesser or higher degree. 

Each person is unique and may or may not share all of these emotional and physical symptoms, but the similarities can no longer go unheeded.

About the AuthorBarbara Keddy, BSc.N., M.A., Ph.D., Professor Emerita, School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada, has lived with fibromyalgia for more than 40 years. Barbara has been interested in social justice issues throughout her professional career, with particular focus on women’s health, resulting in her book Women and Fibromyalgia:  Living with an Invisible Dis-ease

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7 thoughts on “The Twins: Fibromyalgia / PTSD”

  1. Perpetua says:

    I’ve always believed there must be a connection between my fibro and PTSD; the worst of my fibro pain, after all, began the day I was diagnosed with PTSD.

    But here’s the thing: I don’t think I have PTSD anymore. I went through 2+ years of EMDR a decade ago, and it was very effective. I’ve done really well, emotionally speaking, for a lot of years now. But I still have fibro pain every day.

    I wonder if the trouble is that maybe we know how to treat PTSD on an emotional level, but not in a physical level. Maybe my body still has PTSD even though the rest of me doesn’t? What do you make of that?

  2. IanH says:

    Yes the symptoms of PTSD and fibromyalgia can be similar but is not possible to equate illnesses by symptoms. Both illnesses clearly involve neuro-immune dysfunction but the neuro-immune interface is vast and little understood. Children with fibromyalgia often look like children with Ehlers Danlos syndrome and some people equate them. Some people also equate ME/CFS and Fibromyalgia.

    Until we understand the underlying mechanisms we cannot equate these “conditions”. Of course we are only separating these conditions by symptoms and labelling. I know of cases where the diagnosing physician has placed people into “illness-boxes” which another physician later placed in a completely different box. Perspective? Bias? Whenever we rely on symptoms the box we end up in is “tentative”.

    Recently there have been some good early studies on the miRNA discrepancies in these neuro-immune conditions. I cannot see any similarity at this stage between PTSD and Fibromyalgia because the studies on PTSD have not been done as well as those for fibromyalgia. But what has been done shows some possible differences. Additionally, I don’t see any trauma precedent events in many people with FM whereas I always see trauma precedents in PTSD.

    1. IanH says:

      While the cytokine profiles in PTSD can be similar to those of FM depending on which cell types you investigate, this can also be misleading. Cytokine and Chemokine disruption and alterations in their receptors is common to many diseases and mapping these to illuminate similarities or differences between illnesses has not been successful. We must look below this level into the genetic transcriptions. This is where miRNA analysis is more revealing but still in its infancy.

      In a recent study, 7 miRNA were up-regulated in PTSD patients and as many as 64 miRNA were down-regulated 2.5 fold or more in PTSD patients. The most significant are miR-125a and miR-181c which are consistently and significantly down-regulated in PTSD.Such dysregulation can explain increase IFN-gamma production and a possible persistent neuro-inflammatory state.

      In FM there is a marked downregulation of hsa-miR223-3p, hsa-miR451a, hsa-miR338-3p, hsa-miR143-3p, hsa-miR145-5p and hsa-miR-21-5p (4-fold or more). These miRNA are only slightly affected or not at all in PTSD in the same cell type (PBMC).

      In FM the only upregulated miRNA with higher expression levels (hsa-miR3687) presented important inter-individual differences but this miRNA change was not reported in PTSD.

      Much more work needs to be done but at this level and at this stage I see differences not similarities.

    2. Canuckshutin says:

      I have to admit that I find it insulting that those who suffer from fibromyalgia are now further victimized to be labelled as “highly sensitive” people. Before getting fibromyalgia I was capable of working full time in an executive position, as well as volunteering in my spare time. Painting us all with a broad brush is insensitive and damaging. I am surprised that ProHealth felt that this was an acceptable article to publish.

    3. GeminiMoon says:

      I like this article. I have been diagnosed with PTSD and Fibro & no one before has ever linked it with Fibro. And I seem to be hyper-sensitive to my environment and to people as well. I really have to protect myself physiologically by setting firm boundaries, getting rest & taking supplements daily.

      What I do not know is: what came first; the chicken or the egg?

      I’d love to see some research or articles on that.

    4. KDJplus3 says:

      I had saved this article early, and this week seeing my Dr. who deals with the physical aspects of my fibermyalgia. Then my psychiatrist who deals with my psychological overlay, which is what the 2 Doctors who have been treating me for since 2003. This article is becoming more present in my life almost everyday. All you publish is so clinically true, as I am living proof.
      Would also like to say thank you from myself and my family. Without articles that you provide to people who suffer from these conditions and others. My family, especially one day my 2 younger son’s who don’t understand their Moms illness, and will be able to start reading all the information I have collected over the years. They are 15 & 14 now where my oldest son is 23, and Mom’s protector and continues to learn more about what his Mom deal’s with everyday and always here for me. I was always scared that he would have to take care and protect his Mom, for the rest of his life. I always told him and his younger brother’s the I would be fine, and them growing up and living their dreams and being happy in their future’s is all that mattered to me. I never wanted them, especially my oldest son, that I would be a burden to them. At last I have found an amazing man, who accepts me for who I am and wants to take any thoughts out of my kids lives, that their Mom would be loved and he will take care of what ever comes, as we are planning to be married and have an amazing future, and my 3 amazing son’s will know this and become whatever they wish to be and have nothing to hold them back. Not sure why I chose today after all this time, to thank you for the amazing work you do, to provide new information and hope for others.
      I don’t know if you ever answer questions, but the only question I have is that, due to my illness’s my relationship with my 2 younger son’s is not what I would like it to be. They have both left living with me, to live with their Dad, and don’t want to talk or hear about their Mom being sick, again because they don’t understand. My Doctor’s have their opinion’s, but I admire your work and would like to know if them being 15&14 yrs old, if they would be able to comprehend information I could give them to read or are they not really going to be able to comprehend the full aspects of their Mom, who loves them, but don’t want to overwhelm them either?
      Thank you for reading my story, and again thank you now and in advance for the work you do.
      Kelly Johnson (kdjventures@live.ca)

    5. CarolBuck says:

      If I just simply had fibromyalgia and did not wish to tackle all the other related disorders, then I might consider PTSD as an alternate diagnosis. However, I’m a person who tends to tackle each disorder as it occurs, and I still remain active, thanks to looking at things positively and doing something about all the problems. True, fibromyalgia is not all in the head, as doctors once claimed. But, a lot of the disease’s side effects can be lessened by doing positive things. I have been volunteering at a local library for more than 20 years. Yes, that type of work can cause pain, but I take my D3 vitamins every day, just as my doctor said to do, and that helps lessen a lot of the pain. When I’m in a flareup situation, I go back to using the Symbiotics pure colostrum, although the cherry-flavored chewables seem to work better, usually starting out with 6 per day, then cutting back slightly as the flareup subsides a little. (Colostrum must be used following the guidelines that the CDC set up perhaps 17 years ago, when they were experimenting with it. No food or medication 2 hours before taking or 1/2 hour afterwards, to prevent digestive problems and headaches; colostrum must be taken from cows only, no longer than 12-16 hours after the birth of the calf; no additives of any kind, except in the cherry-flavored kind.) I also have massage therapy twice a week in the late afternoon, after I’m done with most activities. My youngest has massage therapy every 3 weeks, which works fine for her fibro problems. I watch my diet, go to sleep about the same time every night, and pace my daytime activities. I now have plenty of energy when not dealing with side disorders, and I love my volunteer job and fellow volunteers and staff, despite all the difficult physical requirements. (Books weigh a lot.) I’m 75, have a number of health issues I’ve had for decades, but I take care of myself and am doing fairly well. A good psychological outlook really helps, and it actually lessens most of the pain. No pain drugs, either. They tend to backfire after a few months.

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