Fibromyalgia and the Exhaustion Nobody Talks About

I don't have fibromyalgia. But someone I love does — Phyllis — and I've watched her live with it for years.

I've also lived with chronic pain most of my life. Six surgeries. Both shoulders rebuilt. My left Achilles reattached. Two mechanical discs placed in my cervical spine. Migraines that started after that neck surgery in 2016 and haven't fully stopped since. So while my experience isn't fibromyalgia, I understand chronic pain in a way that most people don't.

What I've witnessed in Phyllis, and what I've felt in my own body, has a lot of overlap. And the exhaustion — the particular kind of exhaustion that comes with living in a body that hurts — is something I want to talk about honestly.

You look fine. That's what people say.

And so you spend enormous energy — energy you don't have — explaining that you're not fine. That the pain is real even though no scan shows it. That you're not exaggerating. That you're not depressed (or maybe you are, because living with constant pain does that to a person, but that's not the cause of the pain). That you're not just tired — you're a different kind of tired that sleep doesn't fix.

I've watched Phyllis do this. With doctors. With family. With people who couldn't understand why she was struggling on days when she "seemed okay."

I've done it too, in my own way — explaining why I can't do something I could do last week, why a good day yesterday doesn't mean a good day today. That constant low-level battle — the defending, the justifying, the educating — is its own form of exhaustion. And it sits on top of everything else.

Fibromyalgia doesn't give you many days off. So you learn to push through.

You push through the morning stiffness to get to work. You push through the afternoon crash. You push through the flares because life doesn't stop, and the bills don't stop, and the people who need you don't stop.

And pushing through works — until it doesn't. Until your body sends you a bill for all that borrowed energy and you end up in bed for three days wondering how you got here again.

I know that cycle from my own experience with chronic pain. The push, the crash, the guilt about the crash, the push again. It's exhausting in a way that's hard to describe to someone who hasn't lived it. And for fibromyalgia, that cycle can be even more unpredictable — because the triggers aren't always obvious, and the crashes don't always follow a pattern you can plan around.

This one is the hardest to watch.

Over the years, Phyllis tried more treatments than I can count. Medications that helped a little and then stopped. Supplements that promised everything and delivered nothing. Therapies, protocols, diets, devices. Each one came with a small flicker of hope — maybe this is the one — and most of them ended in disappointment.

The hope itself becomes exhausting. Because every time you let yourself believe something might work, you're also setting yourself up for the letdown when it doesn't.

I've felt that too. After six surgeries and years of trying to manage chronic pain, I know what it's like to be tired of trying things. By the time I started seriously exploring breathwork, I almost didn't bother.

I want to be careful here, because I'm not going to tell you that breathing exercises cured Phyllis's fibromyalgia. They didn't. She still has it. She still has hard days.

But breathwork gave her something that years of treatments never managed to give her: a sense of control.

Not control over the fibromyalgia itself. But control over her nervous system's response to it. Control over the moment when a flare starts to spiral and the anxiety kicks in and everything tightens up and the pain amplifies.

In those moments, she has something she can do. Something that works on the actual mechanism — the nervous system dysregulation that sits at the heart of fibromyalgia — rather than just masking the symptoms.

That shift in agency changed something fundamental. Not the pain level on a scale of 1 to 10. Something deeper than that.

I've felt the same shift in my own practice. When a migraine starts building or my pain spikes, having a tool that actually does something — that I can reach for right now, without waiting for a pill to kick in — changes the experience of being in pain. You go from passenger to someone with at least a little bit of the wheel.

Fibromyalgia is increasingly understood as a condition of central sensitization — the nervous system becomes hypersensitive, amplifying pain signals that wouldn't register as painful in a healthy system.

That's not a character flaw. It's not weakness. It's a nervous system that has been under sustained stress for so long that it recalibrated its baseline toward threat.

And here's what I've come to understand: you can't medicate your way out of a nervous system problem. You can manage symptoms. But if the underlying dysregulation stays in place, the symptoms keep coming back.

Breathwork — specifically slow, diaphragmatic breathing — is one of the most direct ways to access the autonomic nervous system and begin shifting it out of that chronic threat state. Not as a one-time fix. As a daily practice that, over time, starts to move the baseline.

Phyllis noticed it in small ways at first. Flares that used to last longer started resolving faster. The anxiety that always accompanied bad pain days started to feel more manageable. Sleep improved slightly. The crashes after pushing through got a little less severe.

None of it was dramatic. But it was real. And after years of trying things that didn't work, real was enough.

If you have fibromyalgia, you already know how to push through hard things. You do it every day.

But breathwork isn't something you push through. It's something you let happen. You sit down, you breathe slowly, you let your nervous system do what it's been trying to do all along — find its way back to calm.

Three minutes. That's all it takes to start.

If you've been exhausted by the explaining, the pushing, the trying — I understand that more than I can say. And I'd gently suggest that the thing worth trying next doesn't require you to push at all.

Start with the Free 5-Minute Rapid Reset — it's the simplest entry point I know, and it's the same thing I reach for on my hardest days.

For the practical side — the specific breathing techniques that work best for fibromyalgia and why — Breathing Exercises for Fibromyalgia is the companion piece to this one. And if you want to understand the nervous system science behind why the body gets stuck in the first place, Your Nervous System Is Not Broken — It's Stuck explains it clearly. The stress-pain feedback loop that makes flares so hard to escape is covered in The Pain Spiral.

You might also find this helpful: Plain-language answers to the exhaustion and symptom questions fibromyalgia sufferers ask most:

• Why Am I So Tired All the Time?
• Why Do I Feel Like I Have the Flu All the Time?
• Why Do I Crash After One Good Day?
• Why Do I Crash After One Good Day?
• Why Do I Feel Worse in the Morning?
• If Your Body Feels Like It's on Fire, What Actually Helps?