Living with Invisible Pain: Understanding the Mental Health Effects of Fibromyalgia By Elisha

Every year, May 12th marks National Fibromyalgia Awareness Day – a day to recognize and uplift the voices of those living with a chronic illness that often goes unseen and misunderstood. But for those who live with fibromyalgia everyday, awareness isn’t just an Instagram post or movement, it’s a daily, profoundly personal reality. As a therapist, I have had the privilege of sitting with clients who carry not just the burden of chronic pain, but the emotional weight that comes with it. And not only professionally – I also know and love someone who lives with fibromyalgia. I’ve witnessed the invisible toll it can take, such as the unpredictability, emotional exhaustion, and moments of isolation that come from not feeling seen or understood. Fibromyalgia is not only about aching muscles or fatigue, it’s also about relationship changes, shifting identities, and a quiet need to feel acknowledged and supported.

In this post, I want to explore the mind-body connection in fibromyalgia, the emotional toll of invisible pain, and how we can support healing through empathy and somatic therapy.

What is Fibromyalgia?

Fibromyalgia is a chronic condition identified through pervasive musculoskeletal pain, and often accompanied by fatigue, insomnia, cognitive fog, digestive issues, and heightened sensitivity to sensory input (such as light, temperature, and sound). It affects approximately 2-4% of the population, primarily women, and often coexists with other conditions like irritable bowel syndrome, migraines, PTSD, or rheumatoid arthritis.

What sets fibromyalgia apart is that it is not caused by inflammation or tissue damage the same way as other illnesses are. Instead, research shows it is tied to the central nervous system becoming overly sensitive and amplifying pain signals. This is essentially the body’s ‘alarm system’ going off at a higher rate and frequency, even in the absence of a real threat. This makes fibromyalgia very hard to detect using traditional medical tools. And that invisibility often contributes to its emotional burden.

The Mind-Body Connection: Why Emotional Wellness Matters

One of the most important things to understand about fibromyalgia is that it doesn’t exist only in the body, but it’s also connected to mental health, the nervous system, and how we process stress. Many people living with fibromyalgia report having a history of chronic stress, emotional neglect, physical, emotional, and mental trauma, or over-responsibility in childhood or adolescence. Others notice their symptoms intensify during period of emotional difficulty, like grief, major life transitions, or relational stress. This is not simply someone being ‘in their own head’ about something, it is in their nervous system. When our bodies stay in a prolonged state of fight, flight, or freeze, the nervous system can become hypersensitized, identifying even neutral sensations, such as the wind or a gentle shoulder tap as danger.

Over time, this constant state of arousal takes a toll, contributing to both physical pain and mental exhaustion. For this reason, mental health, emotional regulation, and somatic experiences are vital in any supportive approach to fibromyalgia. We can’t disentangle the pain without looking at the full picture.

The Emotional Toll of Living with Invisible Pain

Imagine waking up each day with pain in your body that you can’t predict, explain, or always manage. You look fine on the outside with no visible disadvantage, so people assume you’re fine. But inside, you’re carrying an aching body, a foggy brain, and a nervous system that feels like its stuck in overdrive.

Imaging being told:

 “It’s probably just stress”

 “You’re too young to feel like this”

 “Have you tried yoga? Or drinking more electrolytes?”

This is a reality for many people living with fibromyalgia. In addition to the physical symptoms, people also face:

 Being misdiagnosed or dismissed

 Guilt about not being productive or energetic

 Grief for the life they once had

 Loneliness from not being able to keep up with social expectations

 Anxiety about how bad the next day or next hour might feel

When pain is invisible, the burden of proving it becomes part of the condition. That is why empathy is not just helpful – it’s invigorating.

Why Empathy Makes a Difference

So many people with fibromyalgia are not looking for others to fix them. They are looking to be heard, believed, understood, and supported without judgement.

Empathy can sound like this:

 “That sounds exhausting – I’m here with you”

 “I don’t fully understand what you’re going through, but I want to”

 “You’re not making this up. I believe that your pain is real”

For therapists, family members, partners, and friends, this type of compassion can be a turning point. It doesn’t always take away the pain, but it eases burden of carrying the loneliness.

Somatic Therapy: Reconnecting With the Body

Because fibromyalgia affects both the body and the mind, talk therapy alone isn’t always enough. Many people living with chronic pain benefit from somatic therapy, which works with the nervous system, breath, and body awareness to support healing from the inside out.

Here are a few somatic techniques that I often use or recommend:

1. 5-4-3-2-1 Grounding Technique

 Bring attention to something tangible – what you see, hear, feel, smell, or taste

 Helps pull the mind out of anxious spirals into the safety of the present moment

2. Body scanning

 A gentle way to check in with the body from head to toe, without judgement

 Helps build body awareness and emotional unity, especially when the body has become a source of distress

3. Progressive Muscle Relaxation (PMR)

 Involves slowly tensing and the releasing different muscle groups throughout the body

 This practice helps reduce physical tension and brings awareness to where stress is being held

 It can also gently reconnect a person with their body in a safe and structured way

4. Gentle movement

 Light stretching, breath-based movement (restorative yoga), or guided somatic exercises

 The focus is not on “fixing” but on reconnecting with safety and compassion

These techniques can help reduce stress, improve nervous system regulation, and empower clients to feel less helpless in the face of unpredictable symptoms

Final Thoughts

Fibromyalgia doesn’t just live in the muscles or nerves – it lives in the stories, the relationships, and the self-structure of those who carry it. To support someone with fibromyalgia is to believe them, to walk with them, and to acknowledge the depth of their experience.

As a therapist, I believe that healing starts with being seen. Whether that is through talk therapy, somatic work, or simply being held in a space of understanding and empathy, those with fibromyalgia deserve care that honors the full complexity of their pain – and the resilience it takes to live with it.

If you or someone you love is living with fibromyalgia, you are not alone. Your pain is real. Your experience matters. And there is hope in reconnecting with your body and your story – one moment at a time.