Kind of like which comes first, the chicken or the egg?  Does it really matter?  They are both there like ugly mean enemies, trying to steal from me my daily joy, energy, and activities.  One time I wrote that Fibromyalgia was my Dictator...it runs my life, I can only plan any activity depending on its cycle of abuse and control.  It rules my every movement, from dawn til dusk and even oversees my nights.  It can rob me in the most incidious ways...sometimes I am not even aware how the theft comes until hours or days later.  It is a robber of my friends. They have given up on inviting me places because I never know from one hour to the next just how I will be feeling or if I will have the energy to do any of the fun things I used to do. I fight every day to overcome the agony, and sometimes I am able to accomplish some pretty amazing tasks, but that evening, or night or the next day I pay dearly for that accomplishment.  It scolds me for working too much, or it beats me at times with viscous attacks of pain over every inch of my body.  I feel like Pavlov's dog.  I think, "Oh, I will do such and such," and then I am reminded of the pain that has come with it before and I shy away from it in fear of the after effects, like aftershocks from an electric prod."  Again the Dictator of fibro has won again, ruling every aspect of my life...this is one of those days...