The Type-A Personality in Fibromyalgia & Chronic Fatigue Syndrome
Have you ever noticed how many people with fibromyalgia (FMS) or chronic fatigue syndrome (CFS or ME/CFS) have (or at least, used to have) type-A personalities? I've seen it referred to in some literature, and I've certainly seen the pattern in About.com's Fibromyalgia & Chronic Fatigue Syndrome forum. I also know it's true of me.
So what is it that makes those of us who are highly driven, ambitious, competitive and possibly even stress junkies susceptible to these conditions? I don't have a scientific answer for you and from what I can tell, so far there isn't a scientific answer, but I do have some thoughts.
More and more, researchers are looking at the role of the stress hormone cortisol in these conditions. It seems we typically don't have enough of it, which they believe is why stressful situations can ramp up our symptoms.
Last week, I wrote about how chronic pain can essentially wear out the pain centers in our brains. It got me wondering whether we type-As are more likely to put ourselves in stressful situations, and less likely to admit - or possibly even recognize - that we need to slow down. So do we stay in stressful jobs, even thrive in that environment, until the systems designed to handle stress just stop working right?
With my background as, first, a performer and, second, a TV news producer, I know I actively sought out the things that got my adrenaline pumping. I couldn't get enough of that post-performance buzz. Then a switch inside me flipped, and the adrenaline rush would lay me out on the couch for about a day and a half.
What do you think? Does this make sense to you? Am I completely off my rocker? (It's been suggested.) Tell me what you think by posting a comment here or the forum.
- More on cortisol: Marital Bliss & Cortisol Levels, CDC Studies Cortisol & Gender in ME/CFS
- Read Does Pain Wear Out Your Brain?
Comments
There’s a simplier explanation. Only 10-15% of CFS patients are diagnosed. So, likely only those who are type-A or living with a type-A could possiblity get through the fight it takes to get diagnosed with this illness.
There appears to be no connection to stress in general. For instance, I have Holocaust survivors in my family…talk about stress…yet the illness is on the other side of the family and only debilitating in one of us. It does appear to have some relationship to long term, lower levels of stress from dealing with a trauma in some cases. That would be a type of irritant on the body that has nothing to do with type-A personality.
In the end more general studies have not born out the type-A myth and debulked it. I can see you point on stress, but I don’t see it as the likely connection. I know of two people that in retrospect I’m sure had CFS. However, either was so ever diagnosed. They also weren’t the type of person to persist or communicate with demand in a way that would have gotten them diagnosed. I also suspect the African American wouldn’t have had gotten as much from the medical system on her visits (due to system bias.)
Shame on you that is where it got the original name, The Yuppie Disease, back in the 80’s although we have not come very far since then.
Does it make sense. Yes, No, Maybe. I have always been interested in many things, so I always remember striving to establish balance and order. On the other hand, I always loved being physcially active and noticed that I placed a greater value on that and on work, than most others around me. I always knew that there should be limits around how much work a person should be doing, but the workplace for the past 20 years didn’t/doesn’t allow for the limits that I desired. I was/am type “A” in the area of being accountable, and so naturally that is taken advantaged of. I found joy in doing a complex job, well. I found the adrenaline rush through outside activities be it through sports, exercise, or gardening. So I am unsure, is it something more complex than type “A” personality. Certainly I stayed way too long in a job environment that went against my grain politically, I liked the function and complexity of the job, but not the rest. Yes, why do we stay in jobs that don’t suit us all that well? Many people have to do it and don’t suffer from FM/CFS. I will need to read the attached articles you noted.
Without thinking to hard, I tend to agree with Curtis. I often think of the holocust and the documented survivors who live well until a ripe old age. And what of the suffering in Africa and yet the children and mothers keep going. I will say it again and again - there is alot of useless research going on. We have to support a much more advanced and granular level of research to understand this illness.
There is no shame in your thought process. You are making a lot of sense. I absolutely agree that there are some corresponding behaviors of the type ‘A’ that need to be evaluated. I have experienced the episodes of a ’switch’ being turned off, and then days, weeks, or months later being turned on again. I also agree that type “A” personalities do not readily recognize the many flags that say change your pace, slow down or give up some of the responsibilities. I don’t think that this is an affliction exclusive to type ‘A’ individuals, but I believe the type ‘A’ may reap more pain because they are slower to respond to symptons.
A few years back I read an article in a psychology journal that childhood abuse may result in permanent changes to the brain due to prolonged high levels of cortisol. Like most research the study no doubt raises more questions than it answers.
If prolonged stress is the cause then an awful lot of people will be doomed because I see no prospect that life for most will become less stressful. I worked for 25 years as an ICU nurse. Horrible hours, lack of good sleep, combined with single parenthood. Did this somehow cause my fibromyalgia and chronic migraines? Who knows!
Right now, I think if they could find an effective treatment if not an outright cure then there will be more information regarding cause and prevention. I certainly would be thrilled to have something that worked.
I believe the issue here is not who survived a holocost or other stressful event and did not end up with fibro or cfs. But, may there were some who survived, had low cortisol levels, and did end up with one of the two illnessess. I am one who does believe there is a relationship between stress, Type A’s, and fibro or cfs. Not long-term, low-level stress…long-term, but high-level stress is, what I feel, the factor here. If we started out with low level stress cortisol and have had long-term, high stress throughout our lives…yes, I can see where it could certainly play an important role.
Yes, there has been evidence of Type A’s being afflicted the most and I think Type A’s tend to want to please others and don’t protect personal boundaries (see the book Boundaries by Henry Cloud and John Townsend). Type A’s please everyone (work, family, friends) at the expense of their own health.
I’ve heard this theory many times, but I don’t buy it. I have always been the kind of person who enjoyed relaxing, was criticized for being “lazy” in my teens and early 20s, and only wound up becoming “Type A” because of factors beyond my control.
Those factors included jobs from which I did not want to be fired while working for bullying, overbearing, demanding, highly critical employers who insisted I put in as many hours as possible. While interviewing for each position, I certainly didn’t think it was appropriate to ask a future supervisor whether he or she intended to work me until I dropped or perhaps was seeking a robot who could put in 24 hours rather than a human who could put in eight to 16.
Naturally, advice from friends and relatives was to seek other positions, which I did, finding myself working for the same type of personality. Not only did I change jobs, I attempted several times to change my career by returning to college or vocational school time and time again despite already having two B.A.s. Although I am now trained in five fields, one is extremely competitive, another is unnecessary (thanks to the computer), one requires that I obtain several years of experience in order to get the job for which every company with which I interviewed said I was sufficiently educated (but would not hire me due to lack of experience), one is impossible for me to work at now due to my pain, and another is feasible if I return to college for a master’s and a Ph.D. However, that field is also extremely competitive. These days, I advise anyone who asks to go into a field that will pay relatively well and not be outsourced whether they like it or not.
I have experienced more than your average trauma, tragedy and stress during my life, including non-stop bullying in childhood, but again, that too was out of my control. I had no luck convincing my parents to move for my benefit. My two sisters were popular and doing well, so I was to just “ignore it”.
Currently, despite being on disability, my home, my car and my appliances have been experiencing constant problems, requiring that I either repair them or live without, for example, light and/or water and/or transportation. Did I want this? No, of course not. Many of the lesser repairs I put off while I was working or working and attending school simultaneously until they got to a point where I could no longer put them off, for instance, when a leak under the kitchen sink became an outpour, flooding the area beneath my cabinet and out onto my kitchen floor. Each of my toilets has overflowed for no apparent reason, spilling water not only all over the bathroom floors but out onto the carpeting in the house. I also had a leak in the roof that drenched all the clothes in my master bedroom closet and a crack in a skylight that resulted in a torrent of insects into the kitchen. For years, I had been searching for a handyman who was competent. When I finally found one whose expertise knew no bounds, within the first two months of working for me he was diagnosed with a terminal illness and died shortly thereafter. He had several months to go before he would have celebrated his 45th birthday.
I am certain that none of these things would have occurred if I replaced everything I own every few years, and I can see now why people do buy a new car every five years or buy a new home every seven years.
Another factor is my dog, a 3-year-old I adopted from a rescue group not anticipating she would have a slew of health problems including one that typically occurs in older dogs. This is especially ironic when you consider that prior to my adopting this dog, I had just put one down who, at 12, had been very ill for the previous three months. Dealing with a dog vomiting, being unable to keep anything down, falling and being unable to stand up on her own, cooking for her, driving to the vet every day for different medications and types of food, going to different veterinarians for treatment and driving 25 miles each way to and from a vet hospital where your beloved dog is spending her final days is extremely stressful.
The final factor is the disability paperwork and not knowing what to expect, from whom and when. This is stress I can do without.
So did I seek out stress? No, it found me apparently at birth and has lived with me since. I have tried to avoid it, and have found small ways; for example, relationships with men have always been very stressful for me because every man I have ever known has been extremely critical of me, so by avoiding dating and men, I avoid that stress. I also am trying to declutter my home to an extreme.
I do think that stress contributes to these conditions, and while I have heard so-called experts say they believe women are more predisposed because of hormones, I believe they are more so because, as a rule, women have more responsibility. What feminism did for women was to get them “out of the house” to be like men and then leave the house and children without anyone to care for it except the woman. Working a 40 hour job, caring for one child and maintaining a home is the equivalent of at least three jobs. In most relationships I see, the man’s role is to add much more to a woman’s workload than he subtracts. So most women who have a male partner have yet another job: Taking care of a man.
Yes, I am positive stress plays a huge role in these conditions. But I don’t think there is a Type A personality so much as we live in a Type A world or perhaps we, in America, live in a Type A country. I must admit that the only time I was ever able to become my “true self” was when I traveled south of the border, to Mexico or the Caribbean.
I wanted to make one more comment in response to what Soleil said about Type A’s not protecting their personal boundaries. As someone who spoke out when my boundaries were being violated by employers, relatives, friends and so on, I must let you know that losing jobs, alienating relatives and hurting friends’ feelings is another type of stress that I think contributes to many, many conditions. This was the result when I protected my boundaries by being assertive as I had learned in quite a few courses. So whether protecting boundaries or not, both are stressful.
I maintain that we live in a Type A country. This is what needs to change.
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I completely agree with this. Our country, from elementary school on, encourages and rewards Type A behavior. Americans are told the only way to make anything out of their life is to go to college, and the only way to afford college is scholarships and financial aid, which only go to the students who are active in community activities, extracircular activities, sports, and still manage to keep up a 4.0
As someone who was diagnosed in high school but told there was nothing to be done, I can say that the failure to be a type A personality made school so miserable that I homeschooled my first year. The pressure was on me especially because I was in honors classes and considered “bright” or “genius” level intelligence.
There certainly is some evidence that physical and emotional stress can contribute to these syndromes. OTOH, there is a very great danger in overemphasizing the role stress plays. Stress to doctors equals psych problem. Stress (both physical like an injury or illness, or emotional like severe financial stress or a death) is one role. Genetics is another.
I don’t know a lot about the research. I can only confess that I AM a type-A personality, HAVE been under a tremendous amount of stress, especially in the last five years, and my fibromyalgia pain was diagnosed 17 years ago. Being a neuromuscular therapist at the time, I really only believed that my doctor ‘assigned’ me that particular diagnosis because it was the ‘catch-phrase-diagnosis’ of the 90’s. After spending two years going to every kind of doctor and health practitioner I could find, an inordinate amount of time, and a gazillion bucks, I was no closer to debunking that diagnosis. I finally accepted that my doctor knew what she was doing when she diagnosed me two years earlier, and I have learned to live with the painful symptoms ever since. Add to that pain the fact that I have herniated discs and severe osteoarthritis in my neck and low back, and I would say I live with STRESS in my life……..can’t really pin this on anything else but the stress. So, with or without the studies, I fit the type-A, stressful-life, on-the-edge profile. I’ll accept that until someone studies fibromyalgia long enough to give me some better facts. I’m with KAT…….we need to change the type-A country ‘mentality’. Any ideas?
I totally agree. I have it and so does another person at work. We both knocked ourselves out at our job for years and are still under a lot of stress. As soon as we can retire we will.
CFS FM:
At last great scientists have now understood the probable cause of the above.
I have been repeating and repeating for the last 10 years that Multiple type of stressors happening at the just right period of time in an individual that can take as much as what life can give has consequenses like FM CFS
Before having fibro, I WAS a Type-A. At age 50, I was enrolling in a Ph.D. program. I had suffered the symptoms of fibro for 5 years before that, but my Type-A personality refused to slow down. However, the rigors of the program, often sent me to the doctor’s office complaining of exhaustion.
Now, I’m a teacher and I’ve had to learn to leave my Type-A behind a little more. I have had to learn to pace myself or I will be wiped out for a few days.
After trying prescription medicines and massage, I decided to try acupuncture. Today was my first visit, so time will tell if it provides me with long-term benefit. I certainly do feel good right now!
Although I do consider myself “type A” if indeed I must label myself, your conclusion does not account for the fact that more women are diagnosed than men. Certainly there are many “type A” men out there. I think the fact that women are “wired” differently than men should be looked at. (note that posts here are from women). Women tend to let things get to us more. I would catagorize that as “worry”. Perhaps it would make sense to look into what makes a human being “worry”. Is worry equivalent to stress? I was diagnosed in 1989. I don’t buy it. I am sick of the whole damn thing. This country needs to protect it’s citizens from all those out there that are trying to jump on the band wagon and capitalize at the expense of those diagnosed or believed to have fibromyalgia. Including but not limited to the big drug companies. What is this country coming to advertising drugs on TV???!!! It’s all about money. It’s big in the news now because there is money to be made. Lyrica is a horrible drug for type A personalities. Weight gain, swelling, blurred vision, head rushes, confusion???? Sounds like the makings for a real productive day. Also, what’s with all these doctors and fibromyalgia centers that insurance won’t pay for??? MONEY that’s what. This country is succeeding and worsening the symptoms in us by exploiting us and increasing 10fold our frustration and irritation…..all for the sake of a buck.
Pre-disposition seems to be the main factor. Not personality. But perhaps a type A with a pre-disposition can get it after stress. Major changes or griefs have caused plummeting/relapses and I use to feel I could not turn off the adrenaline after a shock even thou my mind was dealing with it my body wasn’t. Yet recently when I did a play (during a well period) I felt better as the adrenaline rush seemed to energise me. When the play was over I got a severe flu and have taken months to get balanced again!Many of my fore bears with the same condition were quiet house wives…intelligent and perhaps never fully fulfilled but that was because they had CFS which restricts despite the desire to expand into new horizons.One of my children has the condition and although they had a mum with CFS they didn’t have the stressful childhood I had.
I am not sure what I believe. Unfortunately I am a type A workaholic/ problem with boundaries / childhood abuse with FMS. While I can see that I may have just “worn myself out” as an adult it does not explain why I began experiencing symptoms as a child. My now 11-year-old daughter has been experiencing back and neck pain, sleep problems, and with headaches and nausea for the last couple of years. She has not had an abusive childhood but I would say that she tends to be perfectionistic at times. I am more inclined to think that the genetic link is more valid than those other theories
I can only speak for myself and I see a possibility. I started having symptoms of fibromyalgia in 2005.
In 2001, I moved in with my (now ex) boyfriend’s family. I didn’t know they were recreational drug-users (marijuana definitely, but I suspect cocaine and harder drugs as well). My ex’s mother was bipolar, his father was distant and deeply angry. I lived in a very turbulent “home-world” until I moved out in 2006.
My job situation was also very high-tension. The business-owner would often scream at her employees if she had a bad day being overwhelmed by caring for her children, which was sadly all too often. She told us that none of her patients ever said anything good about us. When my office chair broke, she told me it was because I was fat, and I shouldn’t drink milk because milk is for baby cows. I stayed with that job for four years.
So, in short, during that time, my home-life and work-life was extremely stressful, with no relief other than my long weekend shopping trips and my joy at exploring new parts of the city.
I prided myself in my ability to stay cool, know when to fight and when to listen quietly and take the abuse. I said these people weren’t going to get to me and the part of me that would react sincerely and emotionally really shut itself down. Did it cause my fibromyalgia? Don’t know… but it’s interesting that I started getting mystery symptoms then. (Gut pain, fatigue… during that time, they thought I had gallstones, but never found any. They said I had IBS, but that, too, passed on its own. I was diagnosed with “mild arthritic change” at that time, also - and insisted that the pain was more than just “mild”). I was diagnosed with fibromyalgia , finally, at the end of 2007 after a car accident and am now receiving treatment.
I would like to subscribe to your blog, but don’t know how. Is there a way I can be added? Thank you!
I believe that I’m a type A personality as well. I went back to school in my early 30’s an obtained an A.A.S. Degree in Accounting. I’ve always been smart but been physically ill since 12. Have had probably 8 surgeries, uncountable treatments, 6 laproscopies, went through Hep C treatment and more. I am a recoverying alcoholic/addict of 4 years now at the age of 47. I believe that the stress plays a BIG part in all this. Childhood molestation…rape and all the dangerous situations I’d put myself into when Drinking, Abusing Prescription and Street Drugs. I’m on way too many meds now for more than FMS/CFS…Bi-Polar for one.
Anyway, I have to agree. And I know that in the past…young years…I THRIVED ON STRESS~~I WORRIED ABOUT WHAT I’D WORRY ABOUT!! Insanity is what it was with the drugs and such. I believe that I’ve had FMS/CFS and all this other damn crap for years…cuz was too drunk or drugged to know until I got clean and sober. I’ve been rediagnosed for Bi-Polar and FMS since early sobriety. Still have it. I really do believe it’a a trauma created syndrome.
First time I’ve posted so I hope I didn’t do anything wrong or say anything wrong… lol … you never know. Plus I am a very honest and outgoing person..well I used to be outgoing when I was drunk and not so mentally and physically ill. But I trust way too many ppl!! I would say that 80% ++ of the folks I meet aren’t the same as me. They are liars, manipulators, abusers and so on. Why do I allow myself to keep getting into these situations? Self-Esteem? Who knows…all I really want is PEACE AND PERHAPS, FINALLY A GOOD MAN FOR COMPANIONSHIP AND SO ON TO LIVE THE REST OF MY LIFE WITH. Is that too much to ask for? I can’t work. I have soooooooooo much going on for no one that works I’d rather be working. Tough world but we gotta keep getting our selfs up and trudging on.
Marge