Is Fibromyalgia Fake?

Fibromyalgia Fakes Are Fewer Than You Think

Fibromyalgia. Credit: Gwen Shockey / Getty Images

Question: Is fibromyalgia fake? 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 acts just fine. 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: A lot of people have asked questions about whether fibromyalgia is real or fake, so you're not alone. You're correct that it can be confusing when someone is sick one day, seems fine the next, and feels bad again the day after. You might feel like screaming, "When people are sick, they should be consistently sick!"

But here the thing—that's not how fibromyalgia works. It is a real medical condition, it just happens to be one with unpredictable ups and downs that are hard to cope with for the person who has it, and often perplexing to their family, friends, and co-workers.

The ups and downs are called symptom flare-ups (periods of more and more severe symptoms) and symptom remissions (periods when symptoms lessen and/or disappear).

How Can We Know Fibromyalgia Is Real?

One reason for the “fake or real” issue may be that fibromyalgia doesn’t have a single, easily identifiable cause, such as an infection.

Instead, the symptoms (widespread musculoskeletal pain, fatigue, and problems with mood, memory, and sleep) may begin after a single triggering event. For example, a physical injury or an emotional disturbance might lead to symptoms that just don't get better over time like they should. Or, the symptoms may gradually appear.

It’s probably this uncertainty about why someone has developed fibromyalgia that keeps the “fake or real” issue going.

Another reason may be because there's no blood test for diagnosing fibromyalgia—again, eliminating a way for doctors to identify it with certainty. However, people do have to meet certain diagnostic criteria to be diagnosed with fibromyalgia. Yes, there's misdiagnosis, but that's true of any illness, whether it's diagnosed via a blood test, some kind of imaging, or based on symptoms.

What Happens During Fibromyalgia Flares and Remissions?

When a flare hits, it usually knocks the person out of life for a while. You probably won't see her or him much during this period of heightened symptoms. (By the way, fibromyalgia affects many more women than men.) Some people can get around and socialize even though they're in pain, while others may be unable to function at all. Even taking a shower may hurt too much or be too exhausting.

Brain fog, also called fibro fog, is also common during flare-ups. It can make people seriously unable to think clearly. They may not be able to follow conversations, complete sentences, or understand what they read. They may become confused and disoriented and have little or no short-term memory.

Needless to say, this can be frustrating and embarrassing, adding to everyone's discomfort.

But then comes a remission, and the person feels pretty good, gets out and about, and starts being social again. She or he seems able to handle any situation and doesn't complain about symptoms much if at all. This is when friends and family may think, "Oh, good, she's over it," only to become irritated all over again when the next flare hits.

What Can You Do to Help?

Now that you understand why your friend acts in such contradictory ways, hopefully you can "let her be" and continue to offer your friendship and support through her good and bad times.

Keep in mind that most people with fibromyalgia would far rather be out having fun or doing something worthwhile than lying in bed or on the couch for days on end. Think of how sad it makes them to annoy or even lose friends because they have to cancel frequently. Besides the pleasure of your continued friendship, the assurance of your understanding may give your friend the confidence to believe that others, too, will understand.

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