The Impact of Stress on Autoimmune Disease

Authored by Emma Robinson

Art by Ngoc Truong

American society has evolved to consider stress as a normal part of everyday life. However, stress can have detrimental consequences. Specifically, the triggering or worsening of autoimmune diseases is a repercussion worth inspecting. Diseases such as Crohn’s disease, psoriasis, arthritis, and lupus, can impact many body systems, ranging from the gastrointestinal tract to the skin. Immune mediated diseases have become a widespread issue in the United States, with 5-8% of Americans currently affected. It has even become the fourth largest cause of disability among American women [1]. Over the past 30 years, the prevalence of antinuclear antibodies, a marker of autoimmune diseases, has increased in prevalence from 11% of Americans to 15% in 2012 [2]. Doctors and researchers aim to discover the origin of these autoimmune disorders, but there is not one clear-cut answer. Some argue that the cause of such disorders is solely genetic or that they are linked to environmental factors, while most agree it is likely a combination of both. 

When the immune system is working properly, it effectively fights off viral, fungal, bacterial, and parasitic infections that the body may face. However, when a person develops an autoimmune disease, the immune system begins to attack tissues that are a part of a person’s own body, leading to adverse health issues [3]. Stress is a possible environmental factor that contributes to these abnormal immune responses. Biological stress responses occur when the body prepares itself for a fight or flight response by secreting hormones, such as adrenaline and cortisol, from the brain and into the body. These hormones increase vital signs and lead the body to prioritize life-sustaining mechanisms [4]. Stress responses in and of themselves are not necessarily harmful. However, long-term stress or continued exposure to stress is known to damage health. The exact mechanisms of such injury remain unclear [5].

Recent studies have shown that autoimmune diseases are more common among those who suffer from stress-related disorders [6]. These disorders, such as post-traumatic stress disorder (PTSD), are more severe and long-lasting than the stress most people face in their daily lives. One study compared over 100,000 individuals with stress-related disorders to over 1 million other individuals without such disorders. These 100,000 individuals were found to be more likely to develop an autoimmune disorder, develop multiple autoimmune disorders, and develop them at a younger age than their non-affected counterparts [6]. This study therefore provides evidence for a link between stress and autoimmune disorders on a more extreme scale. 

A more comprehensive meta-analysis, which synthesized findings from hundreds of studies, demonstrated that stressful events consistently trigger alterations in the human immune system [7]. When addressing the impact of long-term stressors on autoimmune disorders, one study analyzed the link between childhood trauma and autoimmune diseases. This was carried out by assigning a score to each participant based on the severity of the trauma they faced. The study found that as the severity of traumatic experiences and situations increased, so did the likelihood of hospitalization from autoimmune diseases. This relationship was especially prevalent among young adults [8].

With over 50% of autoimmune diseases having unknown triggers and numerous studies linking significant emotional distress to disease onset, the emotional well-being and autoimmune disorders link cannot be disregarded. [9]. Stress studies using mice and other animals have shown similar results, further confirming the argument that genetics is not the only determinant of autoimmune disease [9]. However, despite this strong evidence, the biological link between stress and autoimmune diseases has not been pinpointed. Evidence on epigenetic changes in immune and inflammation genes point to a potential link between stress and autoimmune diseases, but more research is necessary [10].

When managing autoimmune diseases, doctors aim to take a dual approach with both medicine and lifestyle changes. Most medications to treat these diseases are either immunosuppressants or symptom-specific treatments targeting disease manifestation. Such medications often have a multitude of side effects, with immunosuppressants putting patients at risk of cancer and infection [11]. For these reasons, a more holistic approach is beneficial. Reducing stressors is an obvious change that those with autoimmune disorders can make, but this is not always possible for students or those with demanding jobs or family situations. Practices such as meditation, journaling, and spending time in nature can help to reduce stress. Those with autoimmune disorders also benefit from sticking to a regular exercise and sleep schedule and eating a healthy diet with minimal additives and preservatives [10].

Treating autoimmune diseases is not a one-size-fits-all solution, and patients may find some approaches work better for them than others. Autoimmune diseases are just one of many medical issues that can be addressed with both medicine and lifestyle changes. While American culture often normalizes stress, it continually proves to be detrimental to our health. The link between the body and mind has just recently been explored. However, the importance of taking care of both needs to be prioritized to live a healthy and balanced life.

Works Cited

1. Autoimmune Disease. (n.d.). National Stem Cell Foundation. Retrieved September 28, 2023, from https://nationalstemcellfoundation.org/glossary/autoimmune-disease/

2. Autoimmunity May be Rising in the United States. (2020, April 8). National Institutes of Health. Retrieved September 28, 2023, from https://www.nih.gov/news-events/news-releases/autoimmunity-may-be-rising-united-states

3. Orbai, A.-M. (n.d.). Autoimmune Disease: Why Is My Immune System Attacking Itself? Johns Hopkins Medicine. Retrieved September 28, 2023, from https://www.hopkinsmedicine.org/health/wellness-and-prevention/autoimmune-disease-why-is-my-immune-system-attacking-itself

4. Biology of Stress. (n.d.). Florida State University College of Medicine. Retrieved September 28, 2023, from https://med.fsu.edu/childStress/biology#:~:text=Research1%20has%20shown%20when%20an,blood%20pressure%2C%20and%20breathing%20rates

5. Schneiderman, N., Ironson, G., & Siegel, S. D. (2005). Stress and Health: Psychological, Behavioral, and Biological Determinants. Annual Review of Clinical Psychology, 1, 607-628. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2568977/

6. Shmerling, R. H. (2020, October 27). Autoimmune Disease and Stress: Is there a Link? Harvard Health Publishing. Retrieved September 28, 2023, from https://www.health.harvard.edu/blog/autoimmune-disease-and-stress-is-there-a-link-2018071114230

7. Segerstrom, S. E., & Miller, G. E. (2004). Psychological Stress and the Human Immune System: A Meta-Analytic Study of 30 Years of Inquiry. Psychological Bulletin, 130(4), 601-630. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361287/

8. Dube, S. R., Fairweather, D., Pearson, W. S., Felitti, V. J., Anda, R. F., & Croft, J. B. (2009). Cumulative Childhood Stress and Autoimmune Diseases in Adults. Psychosomatic Medicine, 71(2), 243-250. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3318917/#:~:text=Conclusions,autoimmune%20disease%20decades%20into%20adulthood.

9. Ilchmann-Diounou, H., & Menard, S. (2020). Psychological Stress, Intestinal Barrier Dysfunctions, and Autoimmune Disorders: An Overview. Frontiers Immunology, 11. https://www.frontiersin.org/articles/10.3389/fimmu.2020.01823/full

10. The Role of Nutrition and Lifestyle in Fighting Autoimmune Disease. (n.d.). Denver Health Medical Plan. Retrieved September 28, 2023, from https://www.denverhealthmedicalplan.org/blog/role-nutrition-and-lifestyle-fighting-autoimmune-disease

11. Rosenblum, M. D., Gratz, I. K., Paw, J. S., & Abbas, A. K. (2012). Treating Human Autoimmunity: Current Practice and Future Prospects. Science Translational Medicine, 4(125). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4061980/