Question: "I know someone who says she has fibromyalgia, and I really don't know what to think about it. Sometimes she seems pretty sick, but other times she's just fine. Like last week, we went shopping together and had lunch and it was great, but this week she canceled our plans, saying she's in too much pain. It doesn't make any sense. Is she just faking or trying to get attention? I feel like she's just making up an excuse for being flaky. What's the deal?"
Answer: Fibromyalgia in someone you know can definitely be confusing. We're more accustomed to chronic illnesses that are pretty much the same every day – where someone is functional or they're not.
However, for most people, fibromyalgia isn't like that. It's characterized by different states that are called flares (or flare ups) and remissions.
During a remission, people feel pretty good. They may seem able to do what they want and they may not complain about many symptoms. This is when they're out and about, being social and visible. But then a flare hits and knocks them out of life for a while. You probably won't see them much during this period of heightened symptoms.
During a flare, they may have trouble functioning or they may be utterly unable to function at all. Some cases are severe enough that even taking a shower can be too much exertion. Flares can involve a broad range of symptoms, including intense pain and exhaustion.
Brain fog, also called fibro fog, is common as well. It can make people unable to think clearly to the extreme. They may not be able to follow a conversation, complete a sentence or understand what they read. They may become confused and disoriented and have little or no short-term memory. It can be frustrating and embarrassing.
Flares can come on suddenly, and a lot of different things can trigger them. In your case, it may be that she exerted herself too much on that shopping trip, and that lead to the flare. It may also be a case of hormones, a stressful event or nothing that can even be identified.
A lot of people wonder about faking fibromyalgia, especially because there's no blood test for diagnosing it. However, people do have to meet certain diagnostic criteria to be diagnosed with fibromyalgia. Most "fibromites" would far rather be out having fun or doing something worthwhile than lying in bed or on the couch for days on end. It's common for them to lose friends because they have to cancel frequently, but it's not because they don't want to spend time with people – it's because they can't.
Learn more about fibromyalgia: