The Link Between Abuse, Chronic Fatigue and Fibromyalgia

Domestic violence has long been linked to mental health conditions such as depression and post-traumatic stress disorder (PTSD). But the stress of trauma can contribute to physical ailments, one of which is the difficult-to-diagnose chronic fatigue syndrome (CFS), which can mask itself as a multitude of other health issues.

CFS is particularly prominent in adults who experienced childhood domestic abuse. Reports the Centers for Disease Control, “Childhood trauma, defined as abuse, neglect, or loss, is a stressor that affects the physical and mental well-being of humans from infancy throughout the lifespan … Of note, markedly elevated levels of pain and fatigue have been reported in studies of survivors of childhood abuse.”

CFS is More Than Exhaustion

People with CFS are exhausted, but they can’t sleep. This, often debilitating, combination of exhaustion and sleeplessness can last for three months or more. Other symptoms of CFS include foggy thinking, sore throat, enlarged lymph nodes, unexplained muscle pain and unfamiliar feeling headaches. People with fibromyalgia, a related condition, have the symptoms of CFS, plus widespread pain.

There is no definitive test to confirm CFS, so doctors often first rule out other conditions. A diagnosis of CFS may take some time, and doctors often wait to see if the extreme fatigue lasts for more than six months in order to name it CFS.

How Trauma Can Pave the Way to CFS

Jacob Teitelbaum, MD, a board-certified internist who specializes in chronic fatigue syndrome, fibromyalgia, sleep and pain, compares CFS and fibromyalgia to an electrical system. “When your body is under stress it’s like you trip a circuit breaker or blow a fuse,” he explains.

There are many possible causes for this excess stress—infections, autoimmune conditions, nutritional deficiencies and the trauma of abuse are all linked to CFS and fibromyalgia. “Your body doesn’t differentiate between different types of stress,” he points out.

When stress levels get too high, your body doesn’t have enough energy to manage them. These high stress levels appear to affect the hypothalamus, an almond-sized region of the brain that helps control sleep and certain hormones. Teitelbaum reports that people who have been through abuse, including being abused as children, are twice as likely to develop fibromyalgia as others.

Treating This Tricky Disorder

To get symptoms under control, the doctor recommends what he calls the SHINE protocol for treating CFS and fibromyalgia, and research has found it to be effective. The protocol focuses on:

Sleep. Aim to get eight to nine hours of sleep per night, since sleep can help you heal. Talk to your doctor about melatonin or other sleep aids if you aren’t able to sleep.

Hormonal support. Get tested for any hormonal deficiencies that might contribute to CFS or fibromyalgia.

Immunity. Lack of sleep can compromise your immune system and make you more prone to infections, most commonly bowel, sinus and yeast infections. Seek treatment right away when infections occur.

Nutrition. CFS and fibromyalgia can trigger nutritional deficiencies, so talk to your doctor about your food choices and any supplements.

Exercise. Start small—too much exercise can be overwhelming. After about 10 weeks of following the first four steps, you might find you can slowly build your exercise levels.

Teitelbaum says it’s important for people to know that CFS and fibromyalgia are very real diseases. He notes that historically, for certain diseases—especially those like CFS and fibromyalgia that are difficult to diagnose—patients have been told they are “crazy” or that their symptoms stem from psychological conditions. If you run into a doctor who claims that these aren’t real conditions, Teitelbaum recommends finding another doctor. Patients might also consider looking into seeing a rheumatologist or a doctor of osteopathic medicine (a DO instead of an MD).