The fight-or-flight response (also called the fight, flight, freeze, or fawn response [in PTSD], hyperarousal, or the acute stress response) is a physiological reaction that occurs in response to a perceived harmful event, attack, or threat to survival. It was first described by Walter Bradford Cannon. His theory states that animals react to threats with a general discharge of the sympathetic nervous system, priming the animal for fighting or fleeing. More specifically, the adrenal medulla produces a hormonal cascade that results in the secretion of catecholamines, especially norepinephrine and epinephrine. Amit Sood, Professor of Medicine at Mayo Clinic College of Medicine discusses the classic fight or flight response and states that estrogen and testosterone are also hormones that affect how we react to stress, as are the neurotransmitters dopamine and serotonin.

As I was cleaning my kitchen this morning, I happened to glance to my left and saw a huge bug. Okay, maybe it wasn’t huge, but because I hate bugs (especially inside my apartment), it looked to be the size of a mouse.  I did what most women do:  I screamed, jumped, and bid a hasty retreat.  This is the fight-or-flight response in action.

Pain is also an example of fight-or-flight, as it describes a threat.  But when the pain is constant, like in many chronic pain conditions, this fight-or-flight response is also constant.  This means your brain is producing the chemicals associated with fear, but there’s no imminent threat. And these brain chemicals are damaging to your body when they are on constant replay, often making the pain even worse.

We know that increased activation of the sympathetic nervous (fight or flight) system is present in fibromyalgia but is it contributing to the pain there? Martinez-Lavin (“When Stress Causes Distress”) has been hypothesizing that it’s been a key pain driver in FM for years.

He’s shown that levels of norepinephrine – the neurotransmitter that turns the SNS on – are positively correlated with pain in FM. The higher the NE levels – the higher the pain level. He’s also shown that FM patients in severe pain tend to have alterations in some genes that control sympathetic nervous system functioning. The authors of this paper suggest that these findings suggest fibromyalgia may be similar to several to types of chronic regional pain syndrome (CRPS).

Other studies have associated increased SNS activity with poor sleep and reduced cognitive functioning in chronic fatigue syndrome (ME/CFS). Increased SNS activity has also been associated with increased fatigue in cancer survivors…

Unfortunately, you can’t escape from chronic pain, so the battle is in how to manage it. Regarding the huge bug that dared to invade my home — since I live alone, I was forced to grab a shoe and smash that bugger as quickly as possible before it got away.  But even after the threat was disposed of in the toilet, my heart was still racing a little and now I keep anxiously scanning the floor looking for this bug’s friends and relatives.  My anxiety also makes me wonder how I’m going to sleep and scan the floor at the same time, along with fearing what my dreams (nightmares) may bring.  Considering I took pictures of some humongous anthills yesterday, I’m also wondering if I’ll dream about ants or roaches.

Of course, if I wasn’t in constant pain and had the energy, I would be doing some heavy-duty cleaning right about now instead of blogging about it, which could help me get rid of some of this anxiety. The additional exercise might help me sleep better too.  It also helps to laugh about it, because compared to bugs, I’m a really big giant.

Chronic pain conditions throw many obstacles in our paths, including anxiety and fear.  I mean, who wants to wake up to more pain or a pain storm?  But understanding how our brain works may help to ease some of that anxiety and allow us to focus on accepting and managing the pain instead of fearing it.

Sweet dreams. 🙂

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