The concept of our body, our most reliable shield, turning against itself, is haunting for many individuals. Autoimmune disorders are one example of that contradiction; they occur when our bodies produce an immune response to an invader in the body, typically created by a physical ailment, but this type of response occurs for an internal reason (the immune system “sees” a tissue as an invader).
Fears, traumas, and unresolved conflicts within us, often linked to stress, can, in some cases, cause these emotions to manifest as physical conditions. Scientists are now discovering, through the study of Psychoneuroimmunology (PNI), that there is a lot of overlap between the minds of people and their bodies themselves. In other words, chronic stress may affect the immune system by creating reactions that may trigger or compound already present autoimmune disorders.
The Immune System: A Delicate Balance
The immune system functions as an elaborate surveillance network that distinguishes between “self” and “nonself” cells and eliminates harmful invader cells while protecting its own cells from harm. In autoimmune diseases, this differentiation fails, and the body’s immune system attacks its healthy cells, resulting in inflammation, pain, and damage to the cells of organs.
Historically, autoimmune disease has been characterised primarily by genetic influence (i.e., familial history) and environmental influences (i.e., exposure to toxins). Although both types of influences continue to be important, their inability to explain why certain individuals have developed an autoimmune disease while others have not has led scientists to investigate the influence of psychological factors, specifically, the effects of chronic stress on the pathogenesis of autoimmune disease.
Read More: How your body responds to Trauma
Stress: More Than a Mental Experience
Stress is not simply a mental symptom of experience; there are strong physiological links between stress and an individual’s physical state. When an individual feels threatened by something, the brain triggers the release of stress hormones such as cortisol and adrenaline through activation of the hypothalamic-pituitary/adrenal (HPA) axis. The short-term activation of this system is adaptive in that it enables the body to become able to respond quickly to a perceived threat in order to preserve life.
However, when stress remains a constant in one’s environment (chronic stress), the workings of the HPA axis become dysfunctional. The body becomes unable to regulate its own levels of cortisol and/or keep them elevated over long periods of time, which inhibits or disrupts immune function. The immune system can either be overactive or dysfunctional, and both conditions can lead to the development of autoimmune responses (McEwen, 1998). Chronic stress essentially causes a person to remain in a prolonged state of “alert” because they have chronic inflammatory responses instead of just the temporary inflammatory responses that are associated with acute stress. Chronic inflammatory responses are associated with autoimmune diseases.
Read More: How Chronic Stress Disrupts Working Memory: The Role of Cortisol Awakening Response
Trauma and the Body’s Memory
Trauma can affect the mind as well as the body, so it can change how a person’s body reacts to things long after the event has passed. This is called hyper-vigilance and occurs when the body is continuously trying to protect itself. Hypervigilance affects the communication between the body’s nervous system and the immune system and has been shown to affect these systems through changes in the autonomic and endocrine systems, both of which are involved in regulating inflammation and responding to stress.
Research has shown that people who have experienced physical or emotional trauma during childhood (including neglect) or lives filled with adversity have increased (and disproportionate) chances of developing autoimmune disease (Dube et al., 2009). Trauma may have “sensitised” a person’s immune system and increased its ability to respond to threats, even harmless threats, or recognised their own tissues as being “attacking” when they are trying to protect themself from an attack.
Therefore, autoimmune disease can reflect a biological breakdown in the immune system, and it may also reflect a body system that has continued to remain fully responsive to threats and to prior experiences of attacks.
Read More: Trauma on Repeat: Why the Past Keeps Showing Up in the Present
Emotional Dysregulation and Inflammation
Emotions are not just a temporary experience; they are an experience that is embodied. When individuals have their emotions, for instance, anger, sadness, and fear (negative emotions), regularly repressed or poorly regulated over a long period of time, this can lead to physiological stress.
However, Emotional Dysregulation (the extent to which you can manage and respond appropriately to your emotional experience) has been correlated with an increase in markers of inflammation within the human body. This is particularly pertinent to Autoimmune Diseases, in which inflammation is at the heart of what are considered clinical symptoms.
From a psychological perspective, some theories suggest that unprocessed emotions can affect the body. This can happen when we experience emotions but cannot express or resolve them. In such cases, these emotions may manifest physically. For example, frequent anger or chronic stress can build up internally. This may lead to ongoing muscle tension in the body. It can also affect the individual’s immune regulation.
Psychoneuroimmunology: Bridging Mind and Body
The framework provided by psychoneuroimmunology (PNI) into the mechanisms in which the psychological, the nervous, and the immune systems interact with one another through PNI’s exploration of how the psychology, nervous systems, and immune systems interact with one another. PNI explains that the brain has constant communication with the immune system via the use of messengers through chemicals such as cytokines, neurotransmitters, and hormones. Through experiences of stress and/or emotion, the functioning of this communication can be altered, ultimately impacting the functioning of the immune system.
For example, it has been discovered that chronic stress influences the increase of pro-inflammatory cytokines; that depression and anxiety influence the immune systems of individuals; and that the positive emotions of being socially connected and relaxed influence an individual’s immune regulatory function. The interconnectedness of these systems suggests that the immune system is not a separate entity but is subject to the influences of the psychological experiences that individuals are exposed to.
The Role of Chronic Stress in Autoimmune Disorders
One mechanism of chronic stress may be through a combination of mechanisms that trigger an autoimmune disease via dysregulation of the immune system, aggravate current symptoms such as pain, fatigue and/or inflammation, as well as prevent recovery from exacerbation of a current autoimmune disease through impairing the body’s ability to normalise immune function.
For example, persons with diseases like rheumatoid arthritis frequently experience flares following a significant period of stress or with significant stressors, as has also been found in conditions such as systemic lupus erythematosus (lupus) or multiple sclerosis (MS), where there is an association between the level of stress experienced by the individual and the amount of disease activity they experience.
On an emotional basis, continual activation of the body’s stress response system reduces the capacity for the body to return to its baseline state following the activation of this system, resulting in a prolonged state of immunological imbalance in the body, since the immune system is never deactivated.
The Body as a Reflection of Experience
In recent times, there has been a shift in how we understand the body in health psychology. We now see the body as an embodiment of our life experiences rather than simply as a biological entity. In this conceptualisation of the immune system, there is an acknowledgement that, in addition to genetic predispositions, the immune system also reflects the cumulative effects of stress, trauma and patterns of emotional expression (McEwen, 1998; Kiecolt-Glaser et al., 2002). The psychoneuroimmunological (PNI) literature supports this idea through an emphasis on the ongoing interaction between psychological processes and physiological systems (Ader, 2007).
This perspective does not assign blame or responsibility for the development of an illness to an individual. However, it supports the view that human health is highly complex and that the relationship between psychological systems and biological systems exists in deep interdependence (Segerstrom & Miller, 2004). Numerous studies show a link between chronic stress and adversity in childhood. These experiences can affect how the immune system works over time. This may increase vulnerability to disease(Dube et al., 2009), highlighting this connection. Consequently, we can view autoimmune diseases as multi-faceted conditions. Biological vulnerability interacts with environmental exposures. It also interacts with psychological factors. These include emotional regulation and past experiences of stress. Researchers such as Kiecolt-Glaser et al. (2002) and McEwen (1998) have highlighted this.
Healing Beyond Medication
Managing autoimmune disorders requires proper medical treatment. However, we can also explore other ways to support recovery. This includes understanding the psychological side of these disorders. We can offer help to deal with stress and emotions, such as:
- Using mindfulness and meditation to reduce stress and inflammation in the bodies of people with disorders.
- Providing therapy, such as special approaches that consider the past traumatic experiences of people with autoimmune disorders.
- Teaching people with autoimmune disorders techniques to manage stress, such as relaxation training or changing the way they think about things.
- Giving people with autoimmune disorders support from others, which can help protect them from stress and its effects on the immune system of people with autoimmune disorders.
These approaches do not replace treatment for autoimmune disorders. However, they can work alongside medical treatment. They may also help address the underlying psychological factors related to autoimmune disorders.
A New Perspective on Illness
The body can attack itself. That is a pretty big deal for our understanding of health and disease. It makes us compassionately think about things. We should not just think that autoimmune disorders are because something is wrong with our bodies. They are actually the result of the mind, body, and the world around us working together. All these factors connect and influence one another. Researchers like Engel and McEwen have explained this idea.
The field of psychoneuroimmunology is very interesting. It shows that our thoughts and emotions are connected to what happens in our bodies. For example, they influence how our immune system functions. People like Ader and Kiecolt-Glaser have researched this. They found that prolonged stress or emotional distress can affect how our body fights off illness. This shows that what is happening in our mind can influence what is happening in our body. Segerstrom and Miller demonstrated this connection.
Knowing about this connection does not give us answers. It does give us a better way to think about being sick. We need to pay attention to what our bodies are telling us. Also, we need to think about how stress and bad things that happen to us can affect us over time. We also need to think about how to get better. This should include both our mind and our body. McEwen and van der Kolk have emphasised this approach.
References +
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- Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196(4286), 129–136. https://doi.org/10.1126/science.847460
- Kiecolt-Glaser, J. K., McGuire, L., Robles, T. F., & Glaser, R. (2002). Emotions, morbidity, and mortality: New perspectives from psychoneuroimmunology. Annual Review of Psychology, 53, 83–107. https://doi.org/10.1146/annurev.psych.53.100901.135217
- Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer Publishing Company.
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- Segerstrom, S. C., & Miller, G. E. (2004). Psychological stress and the human immune system: A meta-analytic study. Psychological Bulletin, 130(4), 601–630. https://doi.org/10.1037/0033-2909.130.4.601
- van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.
