What are the arguments against, and in favor, of fibromyalgia being a “real disease?”

I’m not sure whether this question is trying to get at the difference between “disease” and “syndrome”, or whether it’s an attempt to distinguish between psychogenic and somatogenic illness, or whether it’s about finding arguments in support of the theory that people with fibromyalgia are fakers, hypochondriacs and malingerers.

I’ll deal with the last interpretation first. Is it possible that some people try to fake symptoms of fibromyalgia? Sure, just like some fake spinal pain, migraines, and even cancer. Faking symptoms is not unique to fibromyalgia. Most people who say they have fibro actually do and are not faking anything.

Even if fibromyalgia was psychogenic, that would not make it less “real”. Your body does not distinguish between mental health and physical health. “Mental” illnesses have physical symptoms and “physical” illnesses have psychological ones. People confuse “psychogenic” with imaginary. They are not the same. At all.

However, research conducted over the last several years has essentially disproved the idea that fibromyalgia is primarily a psychogenic condition. There are detectable, measurable differences or anomalies in nerves, brain structure and function, and body chemistry:

• A Peripheral Neurovascular Pathology Associated with Fibromyalgia Patients (S17.006)
• Routine use of punch biopsy to diagnose small fiber neuropathy in fibromyalgia patients
• Fibromyalgia patients have reduced hippocampal volume compared with healthy controls
• Oxidative stress, mitochondrial dysfunction and, inflammation common events in skin of patients with Fibromyalgia

Finally, consider this definition of disease: “a disorder of structure or function”. Diseases tend to have known etiologies and, often, a single cause. A syndrome is a group of symptoms that characterize a disorder. Syndromes tend to have multiple or unknown etiologies. While the distinction has relevance for clinicians and researchers, it does not matter much to those living with the condition.

Whether you refer to it as a disease or a syndrome, fibromyalgia is very real.

It’s time for those who live with it to stop pandering to the idiotic, uninformed notions of those who don’t.  If someone tells you fibro is not real, tell them to prove it.  If someone tells you it’s all in your head, tell them they are only partly right.  Fibro is in our brains, but also in our nerves, and muscles too.  The facts are on our side; let’s end this ridiculous debate.

Parts of this article originally appeared on Quora.