If you have fibromyalgia, you may want your doctor to examine you for attention deficit hyperactivity disorder (ADHD).
This is the message of a study presented at the annual meeting of the American Academy of Pain Management in April 2018. It found a high and surprising rate of co-investment of these conditions.
Fibromyalgia: chronic pain and more
Fibromyalgia syndrome (FMS) is a chronic pain disorder. In addition to musculoskeletal pain, it is associated with many other symptoms, such as chronic fatigue, difficulty sleeping, dizziness, sensitivity to light and others.
Many people also experience problems thinking or remembering, a symptom known as “fibro haze”.
Other diseases may appear on the trip
Fibromyalgia is not well understood, but something researchers know is that it is often accompanied by other medical conditions. Those that are known include depression, anxiety, interstitial cystitis (a condition of the bladder) and irritable bowel syndrome.
This is where this study comes into play. Researchers at the University of Pretoria in South Africa began to notice that some adults with fibromyalgia suffered from extreme forms of cognitive decline and inattention. They wondered if this could also indicate a coexisting condition instead of a symptom of the disease.
Roland van Rensburg, a doctor at the university, asked if people with fibromyalgia who had more extreme symptoms of myoma fogging could actually have undiagnosed ADHD.
“In both conditions, patients have problems thinking, remembering, concentrating or maintaining attention, which is usually called ignorance or cognitive commitment,” he says.
What the Fibro-ADHD study found
In this study, more than 100 people with fibromyalgia were examined to detect ADHD in adults through a selection questionnaire developed by the World Health Organization (WHO).
The elements of this 18-question selection tool include these queries:
- How often do you make careless mistakes when you need to work on a boring or difficult project?
- How often do you lose or have trouble finding things at home or at work?
- When you have a task that requires a lot of reflection, how often do you avoid or delay the start?
The participants also had their cognition evaluated.
Almost half of the participants had both conditions
What the researchers discovered is that 45% of people with fibromyalgia tested positive for ADHD in adults.
Most people with ADHD at some level knew they had a problem: they had a cognitive compromise reported in greater numbers than those without the condition that accompanied it.
The results of this study have also been published in the journal Pain Medicine in November 2017.
Dopamine is the probable link
The connection between the two diseases can probably be found in the underlying dysfunction in the brain that seems to cause each condition.
“SFM seems to be caused by the deregulation of neurotransmitters, mainly dopamine and serotonin, and the abnormalities of these neurotransmitters are also involved in the development of ADHD,” explains Dr. van Rensburg. “The connection between the two seems to be in the problems underlying the neurotransmitters.”
A very boring symptom
The researchers point out that the problems of concentration and attention experienced by people with these two conditions can be very important for patients. These problems are sometimes more disabling than chronic pain, they observe in the study.
However, many doctors and researchers tend to ignore these symptoms, they say.
Ask your doctor for a screening test
The researchers recommend that if you have fibromyalgia, you should have an ADHD test in adults. “The significant impact of ADHD in adults probably … indicates that all patients with MFS should be subjected to a test of ADHD in adults with conorbid,” concludes the study.
Your primary care provider can administer the WHO follow-up questionnaire. If your result is positive, a neurologist or a psychiatrist will evaluate you before receiving a formal diagnosis.
Strategies and treatments can help
According to the nonprofit organization Children and adults with attention deficit / hyperactivity disorder, there are strategies that people with ADHD can use to compensate for some of their cognitive problems.
Some of them include the systematic organization of your work space to reduce distractions or divide each task into smaller stages and reward yourself at the conclusion of each one.
Adults with ADHD generally benefit from cognitive-behavioral therapy or hire a personal trainer to help define manageable goals.
Medications such as stimulants or antidepressants can help with ADHD. Van Rensburg notes that some case studies suggest that psychostimulant Ritalin (methylphenidate) not only improves cognitive symptoms, but also seems to benefit from fibromyalgia pain. Clinical trials are necessary to confirm this, but you may want to talk to your doctor about this medication.