Chronic Fatigue Syndrome, Fibromyalgia and the Stress Spiral

A man rides an arrow to jump over the word stress symbolizing the conquering of stressful anxiety with techniques that achieve inner peace and tranquility

Dr. Purushothaman
January 17, 2014


Stress and anxiety are an unfortunate, but sometimes necessary and inevitable feature of modern life.
As with diet, obesity, alcohol and smoking I am afraid that the news is simple. They have to be addressed.
Learning to deal with stress is something that can be consciously learned and practiced and new techniques have proven very effective.
A higher than average percentage of patients undergoing Fibromyalgia and Chronic Fatigue treatment are, or were, engaged in high stress environments.
This may be or have been at home, as carers of relatives or young children. It may have been in work detail or during a divorce or home move.
Whatever the cause a significant increase in stress is frequently cited at the time of onset of the sufferers Fibromyalgia or Chronic Fatigue Syndrome symptoms.
As well as being implicated pre-onset, stress reactions are involved in the maintenance and exacerbation of the Syndrome post-onset.
Blood pressure, heart rate, the entire endocrine system which controls hormone production are all implicated and involved during stress reactions.
Unfortunately, the system that directly controls all these systems, the Autonomic Nervous System, in particular the Sympathetic Nervous System or "day nerve" remains malfunctional post-onset.
The result, unfortunately, will be an exacerbated negative reaction of your Fatigue and Fibromyalgia symptoms to stress and anxiety producing situations.
To make matters worse there is evidence that once activated the stress reaction lasts abnormally longer in patients afflicted with Fibromyalgia and Chronic Fatigue Syndrome.
Is CFS more common in stressed people?
Let me first give a very broad outline of how general medical advice is presented to Healthcare providers in diagnosing Fibromyalgia and CFS patients:
"frequently seen characteristics of CFS and Fibromyalgia patients
* People who through their own personal attitudes and anxieties tend to make their own lives mores stressful.
* People who are highly ambitious, they appear to be always active physically and mentally.
* People whose lives are fully absorbed coping with the needs and requirements of others.
* People who avoid taking the time they need for themselves to rest, relax and recuperate and build supportive relationships that are entirely their own.
*People who have difficulty finding others to confide in, so bottling up years of emotions and pain at times of bereavement or loss. "
In itself this is not an inaccurate description of frequently seen characteristics of Fibromyalgia and CFS sufferers. However it is so broad that it can describe patients with a multitude of other conditions.
As I have said many times the human body is a remarkably resilient organism, able to accommodate fantastic pressures and stresses, but as with all machines and organisms there comes a breaking point.
Stress appears to be a very large facilitating factor for people who become the unfortunate ones to develop CFS and Fibromyalgia post "trigger" infection or trauma.
A lesser, but still analogous example of stress related conditions is frequently referred to as "burnout", or simply "stress" and I quote.
"A series of personal life circumstances combine to create a "breaking point", for example; death of a close family member, chronic pain, moving house, bullying at work, divorce, separation, financial loss or redundancy have all been linked to detrimental changes in health "
How stress can become a causal factor in Fibromyalgia and CFS
The initial trauma that was the notable "trigger" of your CFS or Fibromyalgia is usually cited as a bacterial/viral or chemically invasive attack of some kind, but it has been noted that in some sufferers extreme acute stress, such as bereavement, divorce, bullying, extremes of overwork may also be a trigger for CFS symptoms in the absence of a notable infection or exposure.
This makes sense in that scientific evidence has shown conclusively that stress lowers our immune defenses against infection as witnessed by white blood cell and lymphocyte counts.
Also, stress has been shown to directly affect the body in the short to medium term causing extreme fatigue and more disabling problems such as migraine, impairment of concentration and memory and interrupted sleep patterns.
Fortunately, as a society we have been woken up to the negative effects of stress.
As is often the case it has taken the negative economic implications of stress to spur employers and healthcare providers into action.
Sufferers no longer have to fight against the labeling that was common with previous generations which took the basic premise that "stress, depression and anxiety are all in the mind and are a sign of weakness"
How stress can maintain and exacerbate CFS and Fibromyalgia
Stress, depression and anxiety are known to slow down and in severe cases prevent recovery from infectious illnesses, and this is partly where the confusion and malpractice surrounding the CFS/depression arena was instigated and fed by general practice and psychologists over the last few decades.
The dividing line between the two conditions can appear very close to the untrained eye, but on closer inspection CFS and Fibromyalgia do in fact have a totally unique subset of features when compared to depression of any type.
To further muddy the waters both CFS and depression cause physical symptoms which can be similar to each other on initial presentation and also there is crossover with the symptoms of various infectious illnesses of the rheumatic and auto-immune spectrum.
As I have mentioned several times in my text, establishment apathy and nonchalance about the true nature of CFS and Fibromyalgia have lead to it being sidelined as a subdivision of psychology and particularly depression.
Historically, when help is sought, sufferers are left feeling isolated and misunderstood to the extent that they will begin to hide their symptoms, live in denial worried about other peoples reactions, and press on regardless while understating their illness.
Unfortunately, these typical reactions only serve to heighten overall stress levels which is precisely the opposite of the reaction needed for recuperation and so leads to a further exacerbation and worsening of symptoms.
A lot of sufferers understandably avoid further professional help.
Some work very hard to find a cure and convince people that CFS/ME/Fibromyalgia is a real illness. This leads to sufferers experiencing a desperate urgency to recover which is met and fed by a cynical and irresponsible health industry full of fake cures, miracle pills and treatments.
All this while sufferers are feeling threatened, scared, angry, stigmatized and generally ill.
The stress cycle goes even higher, and the result, sufferers sink even lower.
There are times in a person life when it may become particularly difficult to actually be ill at all.
For example as a carer of an ill relative, or a baby or young children, during a period of house renovation or construction, the demands of work as primary source of income.
In the absence of people that can help practically and emotionally in these life scenarios it can be very difficult to actually say "STOP".
Traditional medicine understood the importance of recuperation, rest, relaxation and contemplation as an important therapeutical facet of overcoming serious illnesses and infections.
In the presence of a frightening array of diseases which are now largely purged from modern society, and the absence of powerful antibiotics and antivirals, painkillers and analgesics, the body was largely left to its own devices.
In Traditional medicine patients were often treated with herbal tonics and natural cures, a lot of these were incidentally quite effective but have now been largely forgotten, dismissed or dismantled and reproduced in synthetic form to provide the basis of 75% of modern pharmaceuticals.
However the primary strategy of the era involved long periods of rest and recuperation.
By contrast, modern medicine and society place more importance on masking the symptoms, " keeping a stiff upper lip", "knocking it on the head" and "getting back on the job" as quickly as possible.
A "get well quick" protocol which unfortunately is completely at odds with a recuperative strategy for illnesses such as CFS and fibromyalgia.
Learning to control and reduce stress is an important and essential adjunct to any CFS and Fibromyalgia recovery strategy.
You will need to learn how to recognize stress and how to short circuit the sequence of events that leads to a "stress spiral".
Techniques of physical and psychological relaxation are essential and very effective.
Learning when to say NO is essential and avoiding all events and activities that place you under unnecessary stress or anxiety are essential in the short to medium term.
In my next article on this subject I will be talking about techniques that can be used effectively to short circuit and alleviate stress and anxiety at home, in the car and at the workplace.

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