The central nervous system is rapidly developing during childhood and being conditioned to respond to various stimuli and stressors that are encountered in life. As an assortment of environmental stimuli are encountered, new pathways are created between the cells of the brain in response to each stimulus. For example, a pleasurable experience such as a hug from a parent or a sweet food creates pathways that teach the brain to respond pleasurably to those stimuli. Likewise, a frightening experience will create and exercise pathways that respond in fear. This process of creating new pathways in response to stimuli is referred to as neuroplasticity.
As we age, neuroplasticity decreases, meaning it is more difficult to develop new pathways and adjust our brain's responses to stimuli. Children are at a distinct advantage in possessing a high degree of neuroplasticity. However, this also highlights the importance of delivering meaningful stimuli to the developing brain, to ensure the development of positive pathways.
In the presence of a strong support system and normal, short-lived stressors, a child's stress responses are appropriately activated and buffered through supportive relationships. In this way, positive pathways are developing in the brain and training the nervous system how to appropriately respond to the normal stressors of life. As the brain encounters various stressors, a healthy resilience is built so that increasingly stressful circumstances are able to be experienced with normal biological responses.
In the absence of supportive relationships or in the presence of extreme and/or long-standing stressors, the stress response is inappropriately activated and may negatively impact the development of the brain and neurological system. As regions of the brain that are responsible for fear, anxiety and impulsive responses are activated, neural pathways are developed to favor these regions of the brain. Subsequently, regions of the brain that are responsible for reasoning, planning and behavioral control may lack appropriate pathways, leading to a propensity toward negative emotions such as fear, anxiety, panic attacks, and depression.
The human stress response elicits a cascade of events that impact the brain, neurological system, and various endocrine glands and hormones, explaining its broad influence over health. The stress response begins with neurons experiencing environmental stressors or stimuli, translating the stimuli into messages, and sending those messages along pathways to various regions of the brain for interpretation and response. During these activities, the production of brain chemicals, known as neurotransmitters, are triggered. Neurotransmitters deliver messages to other regions of the brain and other organs. These chemicals communicate with the adrenal glands (of the endocrine system), which then produce hormones such as cortisol and epinephrine (adrenaline). These hormones are responsible for the traditional "fight-and-flight" response to traumatic or dangerous stressors. While these are helpful if we need to dodge a ball or car accident, chronic activation of these hormones can weaken the health of the immune system, the gut, energy systems, and pain perception, contributing to various health issues such as irritable bowel syndrome, chronic fatigue syndrome, and fibromyalgia. When the stress response is over activated during childhood, it becomes hypervigilant and has difficulty maintaining balance in adulthood.
According to the National Child Traumatic Stress Network, the most common traumatic stressors affecting children include, accidents, physical trauma, abuse, neglect, and exposure to domestic and community violence. Other impactful stressors include death of a family member, divorce, drug or alcohol abuse, and natural disasters. When encountered during childhood, these traumatic stressors precondition the neurological system and the stress response system to produce exaggerated responses to normal stimuli. Fibromyalgia and irritable bowel syndrome are two examples of hypervigilant neurological responses. Normal stimuli such as wind blowing in the face or clothing rubbing against the skin can produce painful sensations in those with fibromyalgia, illustrating an exaggerated pain response. Normal stressors triggering the neurological system to inappropriately stimulate the muscles of the intestine, leading to alternating constipation and spastic diarrhea, is a classic sign of irritable bowel syndrome. The pain response is also heightened in those with irritable bowel syndrome, causing abdominal pain.
Currently, specific causes of conditions associated with chronic pain and fatigue, such as fibromyalgia and chronic fatigue syndrome, are unknown; however, nearly two decades of research has strongly pointed to early childhood stressors as significant risk factors for initiating these conditions. While not every child who has been exposed to traumatic stressors will experience emotional and physical health calamities, research shows that children exposed to traumatic events or long-standing stressors are 2.7 times more likely to experience functional somatic conditions (functionally debilitating conditions for which no distinct cause can be determined), such as fibromyalgia, chronic fatigue syndrome, chronic pain, irritable bowel syndrome and others. Additionally, these conditions commonly exist with psychiatric conditions such as anxiety and depression. The age at which trauma or stress is experienced, its duration, and even the type of trauma does not appear to shift this alarming statistic.
Considering the increasing prevalence of functional somatic conditions, emotional and psychiatric problems, it is important to consider the influence of childhood experiences in the development of these conditions. Dwelling upon past trauma is not always helpful in supporting health and healing, and may actually be counterproductive; however, understanding its influence upon health is helpful in being able to appropriately identify elusive health conditions such as fibromyalgia. It is also important to understand for the purpose of protecting future generations from the debilitating effects of childhood trauma and stressors. Finally, it serves as a good illustration of the success of a functional medicine approach, which relies on a thorough health and lifestyle history to put together the "story" of an individual's health and gain insight into the root causes of health problems.
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In some shocking studies, researchers have found that abuse during childhood is associated with higher rates for chronic fatigue syndrome, chemical sensitivities, and fibromyalgia. Studies have shown that women (and a few men) who have reported childhood abuse (sexual or physical) are 65 percent as likely to have fibromyalgia and twice as likely to have chronic fatigue syndrome (which some scientists believe is linked closely to fibromyalgia).
According to one 2011 study from the University of Toronto, "These findings persisted even after controlling for potentially confounding factors such as other adverse childhood experiences, age, race, mental health and adult socioeconomic status." However, although studies show that abuse and fibromyalgia are linked, there is still some debate in the medical community about the importance of the findings.
According to studies, about 30-40 percent of adults have suffered physical, emotional, or sexual abuse at some point in their childhoods. Other studies suggest that the actual statistics may be much higher and under-reported. Several studies have looked at the role of sexual abuse and fibromyalgia specifically, and the results are shocking.
In several studies, about 65 percent of women with fibromyalgia reported sexual abuse. Although researchers do not quite know how or why childhood abuse is linked to fibromyalgia, it is important to consider abuse's role in the steps taken to heal and control fibromyalgia symptoms.
Individuals with fibromyalgia should examine their personal history to uncover any past abuse that could have contributed to the sensitivity.
Other Possible Causes
Although abuse is one common contributing factor for fibromyalgia, it is not the only factor. Genetics and infections can also be triggers. Current research has looked at the role of infections in fibromyalgia, and the results there are also somewhat surprising. Latent infections, particularly infections in the nervous system, may contribute to fibromyalgia symptoms and pain sensitivity.
Genetically, studies have shown that individuals who have family members with fibromyalgia or other pain sensitivity disorders are more likely to have fibromyalgia themselves.
How Is Abuse Linked to Fibromyalgia?
Much of the research about abuse and fibromyalgia has emerged within the past 5-10 years. This means that there is little hard evidence that pins down how abuse can influence fibromyalgia symptoms in the future. However, there are currently two different theories about how fibromyalgia and abuse are linked:
Extended Stress Theory
Research published in "Scientific American" in 1995 looked at the brain changes in patients who were sexually abused. The researchers found that the hippocampus was significantly altered in abused patients. The hippocampus is the part of the brain responsible for short-term and long-term memories.
During stressful events, the hippocampus is flooded with the stress hormone cortisol. This altered the brain and the way memories were stored in abused patients. Some researchers theorize that extended stress could also alter the area of the brain dealing with pain reception. Studies have shown that individuals with fibromyalgia are more sensitive to pain even at a chemical level, so this theory is not completely unfounded.
Sensitization
The second theory about fibromyalgia and abuse is called sensitization. This theory states that individuals with fibromyalgia have a reduced threshold of pain because their brains have an increased sensitivity to pain signals. This theory is similar to the stress theory, but looks at the same conclusion from a different angle.
The researchers believe that extended nerve stimulation (as occurs during abuse) can cause brain changes in individuals with fibromyalgia. Basically, all sensations are reported to the brain as pain.
Click here to see the studies cited.
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References:
- National Scientific Council on the Developing Child. (2005/2014). Excessive Stress Disrupts the Architecture of the Developing Brain: Working Paper 3. Updated Edition. http://www.developingchild.harvard.edu
- The National Child Traumatic Stress Network (2010.) Early Childhood Trauma. Retrieved from http://www.nctsn.org/content/scope-problem
- Burke, N.N., Finn, D.P., McGuire, B.E., & Roche, M. (2016). Psychological stress in early life as a predisposing factor for the development of chronic pain: Clinical and preclinical evidence and neurobiological mechanisms. Journal of Neuroscience Research. doi: 10.1002/jnr.23802.
- Zouikr, I., Bartholomeusz, M. D., & Hodgson, D. M. (2016). Early life programming of pain: focus on neuroimmune to endocrine communication. Journal of Translational Medicine, 14, 123. http://doi.org/10.1186/s12967-016-0879-8
- Afari, N., Ahumada, S. M., Wright, L. J., Mostoufi, S., Golnari, G., Reis, V., & Cuneo, J. G. (2014). Psychological Trauma and Functional Somatic Syndromes: A Systematic Review and Meta-Analysis. Psychosomatic Medicine, 76(1), 2-11. http://doi.org/10.1097/PSY.0000000000000010
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