🧠 When Stress Hurts: How Chronic Distress Rewires the Brain and Fuels Chronic Pain

What if pain, fatigue, and mood swings weren’t just symptoms—but signals of a deeper energy crisis in your body?

A new review by Fülöp and colleagues (2025) in Brain, Behavior, & Immunity - Health explores how chronic psychosocial stress—like unresolved grief, trauma, or persistent pressure—can literally rewire the brain and ignite chronic pain. Their focus? Fibromyalgia (FM), a condition long misunderstood, but increasingly recognized as a disorder of central processing, immune dysfunction, and stress maladaptation.

But here’s the twist: their findings don’t just illuminate the biology of fibromyalgia. They also strongly reinforce the core of the Exposure-Related Malnutrition (ERM) framework—our evolving understanding of how chronic stress depletes metabolic resources, derails adaptive recovery, and creates systemic vulnerability.

🔬 Stress, Inflammation, and the Cost of Coping

The review highlights that chronic psychosocial stress is the only known etiological factor consistently linked to fibromyalgia and other chronic primary pain syndromes. Unlike pain from an injury, these conditions arise without visible damage—but with real, disabling effects.

So what happens inside?

📌 Immune Activation: Chronic stress activates microglia and astrocytes—the brain’s resident immune cells—triggering a flood of inflammatory messengers like IL-1, IL-6, and TNF-α.

📌 Neuroplasticity Changes: Brain networks involved in pain, emotion, and threat detection (like the salience and default mode networks) undergo maladaptive rewiring. This leads to heightened pain perception, anxiety, and difficulty regulating emotions.

📌 Autoimmunity: Even more striking, FM patient antibodies can induce pain when transferred to mice—suggesting the body begins to attack its own neural support systems under sustained stress.

📌 Mood and Pain Co-Morbidity: Depression and anxiety are not mere consequences of pain—they share pathways, inflammatory signatures, and brain regions, indicating a common metabolic and neuroimmune origin.

🔄 ERM Framework: Chronic Pain as a Bioenergetic Trade-Off

According to the ERM model, our body constantly allocates energy to respond, adapt, and recover from challenges. But when stress is chronic and recovery is incomplete, the system gets stuck in a costly state of adaptation.

This paper supports that idea at every level:

• Stress consumes metabolic resources (ATP, antioxidants, nutrients) over time.

• Chronic neuroinflammation is bioenergetically expensive, diverting fuel from brain repair, emotional regulation, and muscular resilience.

• Antibodies and immune dysregulation represent maladaptive defense mechanisms when resolution is delayed.

• Mood disorders and pain syndromes are not isolated conditions—but downstream outcomes of unresolved metabolic strain.

In essence: you’re not broken—you’re exhausted. And your body’s coping systems are running on empty.

💡 Why This Matters

Understanding the metabolic cost of unresolved stress could change how we approach chronic pain and mood disorders. It shifts the narrative from symptoms to systems, from disease to dynamic energy balance, and opens the door for targeted strategies that support resolution—not just suppression.

This includes:

• Nutritional support for immune modulation and neurorepair

• Stress-reduction tools that recalibrate energy use (like CBT, mindfulness, and trauma resolution)

• Therapies that target neuroinflammation and glia-neuron signaling

🌿 Final Thoughts

Chronic pain isn’t just in your body. And it’s definitely not “all in your head.”

It’s in your networks, your immune cells, and your energy budget.

And if we start treating it as a breakdown in adaptive resolution—rather than a static diagnosis—we can begin to restore not just function, but resilience.

#Chronic psychosocial stress, #Neuroinflammation, #Fibromyalgia, #Neuroplasticity, #Exposure-Related Malnutrition (ERM)

Fülöp, B., Borbély, É., & Helyes, Z. (2025). How does chronic psychosocial distress induce pain? Focus on neuroinflammation and neuroplasticity changes. Brain, Behavior, & Immunity - Health, 44, 100964. https://doi.org/10.1016/j.bbih.2025.100964