Does stress induce Autoimmune Disease? Or is stress a cause of Autoimmunity? The precise answer to the question of whether stress is an inducing agent or a causative agent is in the realm of medical minutiae, but there is no doubt that stress has a major impact on your autoimmune disease. This is not new information for most of you. Many of you have experienced worsening of your symptoms soon after some stressful event in your life or you have even tried to blame your significant other for “causing” stress in your life! Though it is true that empathic stress (later blog post) can affect you, it is not stress that is the problem; it is how you deal with it that decides your health! We do need some amount of stress to be alive! Is it eustress (positive stress) or distress (negative stress) that is affecting you?
In my patient intake form I have a section that talks about how you gauge your stress levels. Most of you fill in your health-related stress as an 8 or 10 out of 10. (One lady said it was 11 out of 10!). For many of you this stress comes from the physical pain or the uncertainty of not knowing what happens tomorrow or from being unable to work or from the lack of response to a particular drug or various other factors. In this blogpost I would like to focus more on the solutions to address stress, rather than the problem.
WHAT IS STRESS?
Dr. Hans Selye, who is considered to be one of the pioneers of stress research, in 1936 defined stress as “The non-specific response of the body to any demand for change. Everyone knows what stress is, but nobody really knows.”
YOUR STRESS RESPONSE IS DECIDED BY MANY FACTORS.
Some of the important factors affecting your stress response are:
- Intrauterine influences-your mother’s stress when she was pregnant with you.
- Your childhood experiences (ACE score, explained below)
- Your gender
- Your socioeconomic status
- Your stress management strategies.
Intrauterine influences: Some of the factors that influence your stress response are operative when your mother was pregnant with you! There are many scientific studies that describe how stress experienced by women during pregnancy had adverse influence on the health of the children. The Dutch Winter Hunger Study and the Project Ice Storm study are among some of the often-quoted ones. The effects on the child depended on when during the mother’s pregnancy she had experienced the adversity. For example, children born to mothers who had experienced stress during the last part of their pregnancy were at higher risk for diabetes, heart disease and increased fat mass. The baby in the uterus predicted that it was being born into a world of scarcity and therefore needed to conserve fat! Some of these adverse health effects were trans-generational (affected at least 2 subsequent generations)! This is a truly fascinating field of study called Developmental Origin of Health and Disease (DoHAD).
ADVERSE CHILDHOOD EXPERIENCES (ACE) AND HEALTH
Dr. Vincent Felitti and Dr. Robert Anda’s landmark study of 1998 found a strong relationship between exposure to abuse or household dysfunction during childhood and multiple risk factors for many diseases in adults, including Autoimmune Disease. The higher the ACE score, the higher the incidence of disease. This effect was more pronounced in women and Autoimmune Disease.
We know that factors like sexual or physical abuse have a lot of adverse health effects, but when you check your ACE score you will realize that factors like living with an alcoholic caregiver or someone with mental illness or even being insulted or put down often has many adverse health influences. The point of this study is not to blame your parents but to realize how your health challenges may have an explanation in your childhood experiences and more importantly, these effects are not permanent! You can get better! A recent book Childhood Disrupted: How Your Biography Becomes Your Biology and How You Can Heal by Donna Jackson Nakazawa is a good book to read. Nakazawa is an award winning author who shares her journey through successfully dealing with Guillain Barre Syndrome (GBS).
Do you know your ACE score? Check here to download the form and find out.
IS IT ADRENAL FATIGUE?
During consultation some of you tell me that you have “Adrenal Fatigue” or that your “Adrenals are fired”. Is that true? In medical terms what you mean is that you have a dysregulated stress response or the medical terms HPA Axis (Hypothalamo-Pituitary-Adrenal Axis) dysfunction or Allostatic Load. What does it mean? (I will explain this concept in details on a webinar/series of blog posts later. On this post I’d like to focus on the solutions rather than the problem). Humans have had to deal with stress since time immemorial. What has changed now? Stress for our hunter-gatherer ancestors involved physical stress and was usually short-lived. Our bodies were used to short-lived stress and not the type of ongoing stress that we experience now.
WHAT CAN YOU DO TO TAKE CARE OF YOUR DYSREGULATED STRESS RESPONSE?
- MBSR (Mindfulness Based Stress Reduction)
- Expressive Writing
- Tai Chi,Qigong
- Art Therapy
As a long-term meditator and someone who has read many scientific papers on the neurobiology of meditation, this is my number one go-to when it comes to dealing with your dysregulated stress response. As I always say, the side effects of meditation are all good! What type of meditation should you do? My suggestion is to try several different ones and find out which one you like.
However, there are a few things to keep in mind when we talk about “therapeutic meditation”. • You need to elicit the Relaxation Response (RR) According to Dr. Herbert Benson from Harvard the relaxation response is a state of deep rest that elicits the following changes
- Decreased heart rate
- Decreased blood pressure
- Decreased rate of breathing, and
- Decreased muscle tension.
A Relaxation Response occurs when you meditate for at least 30-45 minutes. If you have never meditated before, start with 5-10 minutes of a guided meditation on an app or CD.
The best results of meditation have been shown in long-term meditators but meditating for as little as 8 weeks have shown many benefits!
- MBSR (Mindfulness Based Stress Reduction):
According to Dr. Jon Kabat Zinn “Mindfulness is awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally”. Dr. Kabat Zinn is Professor of Medicine Emeritus at the University of Massachusetts Medical Centre, where they have done many clinical studies on the health effects of MBSR. In one study of patients with psoriasis, MBSR along with photo therapy (UVB) or photo chemotherapy (PUVA) was found to show faster clearing of skin lesions.
- EXPRESSIVE WRITING:
Professor James Pennebaker PhD, Professor of Psychology at the University of Texas, in a study found that writing about traumatic events was associated with fewer visits to the health center! It also improved immune function. No one has to read your writing and please don’t bother with punctuation or grammar! Check here to read about the guidelines for Expressive Writing.
- TAI CHI
- ART THERAPY
- Schulz, Laura C. “The Dutch Hunger Winter and the developmental origins of health and disease.” Proceedings of the National Academy of Sciences 107.39 (2010): 16757-16758. Cao-Lei, Lei, et al.
- “DNA methylation signatures triggered by prenatal maternal stress exposure to a natural disaster: Project Ice Storm.” PLoS One9.9 (2014): e107653.
- Felitti, Vincent J., et al. “Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study.” American journal of preventive medicine 14.4 (1998): 245-258.
- Benson, Herbert, Martha M. Greenwood, and Helen Klemchuk. “The relaxation response: psychophysiological aspects and clinical applications.”The International Journal of Psychiatry in Medicine 6.1-2 (1975): 87-98.
- Kabat-Zinn, Jon, et al. “Influence of a mindfulness meditation-based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing photo therapy (UVB) and photo chemotherapy (PUVA).” Psychosomatic medicine 60.5 (1998): 625-632.
- Pennebaker, James W. “Writing about emotional experiences as a therapeutic process.” Psychological science 8.3 (1997): 162-166.
- Book: Expressive Writing: Words that Heal by James W Pennebaker.