Fibromyalgia, chronic fatigue and the anxiety-prone brain

” The tenuousness of modern life can make anyone feel overwrought”, Robin Marantz Henig

An article in the NewYork Times Magazine, October 4, 2009 by Robin Marantz Henig, entitled Understanding the Anxious Mind has led me to speculate about the anxious, highly reactive, overly sensitive temperaments of those of us with fibromyalgia and chronic fatigue syndromes. While I am not the first to equate a hyperaroused nervous system with these two conditions, I believe that the new scientific information regarding the brain, remapping and neuroplasticity must also be taken into account if we are ever to reach some kind of understanding of both syndromes.

Reported in Marantz Henig’s article is the research of Jerome Kagan and Nathan Fox, two psychologists, who have explored the realm of anxiety and the physiological brain state, with participants beginning in infancy and followed for 20+ years, searching for highly reactive temperaments. My years of living with fibromyalgia/chronic fatigue and the many intensive interviews with women who also suffer from both chronic fatigue and fibromyalgia has led me to believe that we have highly reactive brains. Anxiety provoking thoughts of the highly anxious person specifically reside in the amygdala, an area found in the midbrain, and which responds to threat. However, whether or not this is a nature or nuture issue might seem irrelevant at this point, although in my view high degrees of anxiety in women (and children and men) is socially constructed. Given the societal expectations of women it is understandable that hypervigilance (a term I use frequently in my book and one which Peter Levine discusses in a very helpful chpater of his book Waking the Tiger)  becomes overwhelming; the brain then cannot distinguish between fear and flight or rest and relaxation. Hence the greater incidence of fibromylalgia/chronic fatigue among women. Fear and anxiety even seem to accelerate as women grow older, rather that diminishing. It is likely that the same is true for men as well if they have not been able to heal the wounds and trauma of earlier times in their lives (read Peter Levine’s work on trauma which I have written about in other blogs).

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For those who are extremely anxious the brain cannot differentiate between a real or perceived threat. “ANXIETY IS NOT fear, exactly, because fear is focused on something right in front of you, a real and objective danger. It is instead of kind of fear gone wild, a generalized sense of dread about something out there that seems menacing- but that in truth is not menacing, and may not even be out there”, writes Marantz Henig.

One of the debates regarding this issue is whether or not chronic fatigue even fits in the category of fibromyalgia. One very recent study (among many older ones) suggests that chronic fatigue is caused by a virus. Whether or not chronic fatigue syndrome is a separate entity is not my concern now, but fibromyaliga does not exist without chronic fatigue. It stands to reason that after the highly anxious/reactive/hyper-aroused brain finally settles for awhile, after an anxiety episode, fatigue sets in. Therefore I equate (perhaps wrongly) both conditions with extreme anxiety.

Marantz Henig’s article and Kagan and Fox’s research leads me further and further into the functioning of the brain and living with this invisible dis-ease. Fibromyalgia is quickly becoming an epidemic and living with the kinds of daily fear we all experience in a fast paced, anxious world it is likely to accelerate even more rapidly. I know anxiety/panic very well and it takes little to bring on a flare-up that I have to deal with along with the chronic pain and fatigue. Feelings of peace are hard for me to come by. Anxiety is my constant companion.

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