Rheumatoid Arthritis and Emotional Health
Have you seen the Pixar film Inside Out? While it may be a cartoon, I love how it shows the interplay among our emotions, and how they all get to have their moment in the sun. When he gets wound up, flames literally shoot out of his head! In my case, the faces of anger look a little different:. Anger is a pretty loaded emotion. Anger is natural, it is useful, and we ALL experience it.
Autoimmune disease like many other things in life, which are also okay to get angry about is frustrating, perplexing, painful, and often unpredictable. We get to learn to navigate it like we do all of our other uncomfortable emotions. The key is to express your anger and move through it, rather than stewing in it.
Admittedly, this can be tough. Unaddressed anger often creates problems in relationships both at home and in the workplace. But beyond that, it can have devastating physical consequences. Both types of anger expression are associated with heart disease, stroke, cancer and even autoimmune disease. It can not only exacerbate autoimmune symptoms but it can also stand in the way of the healing process. In my private practice as a nurse and health coach, I spend a lot of focus with clients working with the connection between the psyche, the nervous system, and the immune system.
Psychoneuroimmunology is a growing field that attempts to understand the interaction between these complex systems of our minds and bodies. We are learning more and more about the profound connection of our thoughts and emotions to and on our immune system.
The Emotional Meanings Behind 10 Autoimmune Conditions
Research has shown that our immune systems and our brains are actually wired together and that they communicate with each other. When anger is driving the bus, our bodies produce a stress response which directly affects the endocrine system think thyroid and adrenals here as well as sex hormones and even the GI tract, to name a few of interest to the autoimmune community. Before you are even aware you are angry, your amygdala in your brainstem is activated.
The amygdala signals the hypothalamus — and we know what happens from here — the hypothalamus releases corticotropin-releasing hormone CRH to the pituitary gland. The pituitary sends a message to the adrenals via adrenocorticotropic-releasing hormones ACTH triggering the release of adrenaline, cortisol and norepinephrine. In chronic doses, these hormones impact microbial diversity, immune function, hormone balance, thyroid functioning, blood flow to digestive system, cardiovascular function and health, and cause inflammation in the body.
Even after the feeling of anger passes, its impact lingers in the body. The more often we experience unaddressed anger, the more these hormones show up in the body and wreak havoc on the environment we are working so hard to heal.At this point you have likely read numerous reports about the COVID Coronavirus and hopefully have started implementing changes to minimize your risk of exposure or transmission of this new strain of virus.
I will start off by saying I am not an infectious disease expert, but what I will seek to share with you below is a general summary of what we know about the current virus, guidance to easily consumable information from experts and expert organizations, and reminders about the fundamentals of supporting your immune system through optimal lifestyle habits.
A virus is most simply an obligate organism that contains genetic material — the script for replicating itself and an interestingly complex capsid or covering. In the case of Coronavirus it is what we call an enveloped virus, acquiring aspects of its outer coating upon budding from an infected human cell. In order to replicate it must enter into a human cell and utilize our own enzymes and organelles to replicate and assemble all viral components before budding from the infected cell.
In general the subclass of Coronaviruses causes illnesses such as the common cold and upper respiratory tract infections, but there have been previous strains such as the SARS and MERS viruses that caused more severe respiratory compromise and patient deaths. The virus is transmitted from person to person in close contact less than 6 feet by droplets created when someone coughs or sneezes or spreads these secretions by touching surfaces. Simply coming into contact with such particles from an infected person, however, does not guarantee you will become infected depending on the nature of your immune response, but appears as the critical event for viral transmission and subsequent infection.
It is still unclear if the virus can be transmitted from other bodily fluids and healthcare workers have been encouraged to take extra precautions with measures to prevent contact and droplet exposures. At this point in time it appears that the main risk factors for having a more severe course of illness are age greater than 60 years old, high blood pressure, diabetes, underlying lung disease, and relative immunodeficiency, which can be present in individuals with the primary immunodeficiency or secondary immunodeficiency from drug treatments or other immune related diseases.
For many with autoimmune disease, immune modulating or immune suppressing medications are used to help balance an overactive or dysregulated immune system. These medications such as TNF inhibitors like Etanercept, Infliximab or Adalimumab and even steroids such as Prednisone can make individuals more susceptible to infectious diseases caused by bacteria and viruses.
Besides being more susceptible to infections, individuals on immunosuppressant medications who become infected may have a more serious illness course than someone not on such a medication. All of this being said, it is very important to weigh the risk and benefits of a medication and in most cases individuals should continue such medications as there is likely a greater risk for complications by acutely stopping the medication than being infected with Coronavirus.
For those on such medications please contact your prescribing physician to ensure your optimal treatment and if you develop symptoms such as cough, fever or difficulty breathing. These individuals should also take additional precautions to prevent exposure in larger public and social gatherings.
Like nearly everything related to our current understanding of COVID, the increased precautions we are taking for those with diabetes including Type 1 diabetes and on immunosuppressant medications are based mostly on our theoretical understanding of how these medications and conditions affect the immune system and not from large amounts of data from the current COVID pandemic. Mortality in infected younger and healthy individuals appears to be between 0.
The primary symptoms typically appear in the first week after transmission and include fever, cough, shortness of breath or difficulty breathing. The current goals and strategies for preventing further spread of the virus specifically to higher risk individuals involves social distancing and self quarantine.
By social distancing we hope to minimize contact between individuals thus preventing transmission from infected or nearly asymptomatic individuals with the ultimate goal of allowing our current healthcare force with its ceiling for providing care in hospital or intensive care settings to be able to handle those who become severely ill.
While it is recommended for infected individuals to wear certain types of masks in an attempt to prevent transmission of infected droplets, sadly much of the personal protective equipment needed by healthcare personnel is in shortage because it is being stored by individuals who do not necessarily need such equipment.
The most important strategies for you to prevent transmission or to prevent infection are to continue with rigorous handwashing and current social distancing recommendations and do not necessarily include wearing a mask in every public setting in which you find yourself.
It is important to realize that the strategies for prevention will be different than the strategies for active treatment. As a foundation we should ensure we maintain as optimal of lifestyle habits as possible including optimal nutrient density, movement, adequate rest, and most importantly adequate stress management in this extremely anxiety and fear provoking time. Being in a heightened state of stress or a sleep-deprived state will impair immune function and this is exactly what we do not want in this current environment.It is my belief that a physical showing of symptoms is actually the last stage of the disease process.
This obviously contradicts the modern medical system, which holds that symptoms are the first indications of a disease formation. However, in many Eastern traditions, the physical body the one closest to us only begins showing symptoms once a disturbance has moved through many different aspects of ourselves, including our emotional and mental bodies, and other subtle bodies that surround us see below for a depiction of this.
When we understand disease in this way, physical pain or discomfort can mean that the disturbance has already progressed quite a ways, and it is now showing up right in front of us, in need of our immediate attention. This is why I believe understanding the emotional meanings behind illness or really any physical symptom is important, as it provides us with a clue about what may really be going on within us. In that way, disease can become our greatest teacher.
I have found that in my own experience, a physical problem will often persist until I am able to learn from what it has come to teach me. Otherwise, it may stick around or even change form until I am finally ready to listen and make changes accordingly, or heal whatever truly needs to be healed.
These meanings are a combination of interpretation from the book, Messages From the Body by Dr. Michael Lincolnand my own thoughts and insights that have been formed over years of study of Ayurveda, Yoga, and autoimmunity in general. Parts of these may resonate with you, while parts of them may not, and all of these are just possibilities of what they often mean to the general population.
So, I encourage you to read them with open-mindedness. Additionally, these meanings do not discount the fact that your body may have real physical healing that needs to take place!Inflammatory / autoimmune diseases of the skin
Ideally though, reading these suggestions will help you gain a general understanding of what the disease could mean, which you can then use as a jumping off point for your own inner exploration. I hope this can be a valuable first step on the path of deep healing for you!
They may also feel unimportant or overlooked, particularly when growing up. Rheumatoid Arthritis There may be a struggle with deep self-dislike, shame and guilt; an extreme form of self-rejection attacking oneself. Oftentimes these individuals feel a sense of worthlessness and have a high propensity toward self-criticism.
Unable to release pent-up emotions. As a result, individuals may feel unsupported, resentful and frustrated. As a result, individuals may have a subconscious feeling of self-disgust and lack of self-confidence. Distrust in the Universe, people, and even new ideas may occur as a result. The individual may have turned off all feelings and emotions in response to hurts they have experienced throughout the years. There may be considerable grief and sorrow beneath everything, which is unable or unwilling to be accessed and resolved.
This ties in with a perpetual feeling that they may not deserve support from others as a result of not being good enough. Psoriasis Psoriasis, or red, itchy patches on the skin, can represent the individual feeling a constant nagging, irritation or annoyance.
They may feel as if they have to settle for putting up with incompleteness.It has been my observation that many patients describe a stressful event preceding the onset of their autoimmune disease. The stress could be the death of a loved one, marital conflict, or job loss. It is known that the accumulation of multiple stressors may lead to disease onset. In fact, an article published in The Lancet in found that the risk correlation of smoking and heart attack 2.
Also, it was determined that stress as a risk factor for heart attack was actually greater than the risk for high blood pressure 2. So what about stress as a risk fac tor for autoimmune disease?
However, because of the nature of stress, proving that it actually causes autoimmune disease or describing the mechanism of causation is a challenging task. We would have to sort out diet and medications and a multitude of other factors to make this link. There is also evidence that stress induced hormones, especially on a chronic basis, may lead to alterations in the immune system. However, our understanding of this process is still limited and treatments are still evolving.
So have I convinced you that stress is important? Stress is defined as the application of pressure, strain or tension. That sounds simple enough, but how we react or respond to our emotions can make a big difference in how we are able to manage a situation. Emotion is an automatic, powerful bias, in our way of thinking.
It has evolved to help us survive by interpreting what is pleasurable and what is not. However, it may be so powerful that it is destructive—so destructive that it may trigger autoimmune disease or a heart attack. It is amazing to me that we have made such enormous technological progress that we can put a powerful computer in the palm of our hands or catheterize a heart blood vessel, yet we still understand so little about our emotions and how to regulate them to avoid potentially destructive results.
Perhaps this is because of the social stigma associated with mental health issues and a corresponding lack of funding. Perhaps if we had a better understanding of our emotions and better access to mental health care, we would be able to prevent, or at least better manage, certain stress-related diseases. Unfortunately, not only does stress cause disease, but the disease itself also may cause significant stress, resulting in a vicious cycle that magnifies the problem.
Stress by itself also may aggravate or cause pain. We know that the areas for emotion and physical pain sit very close to each other in the brain and both areas may be triggered simultaneously during stress, resulting in a mutually enforcing cycle that leads to chronic pain. Furthermore, there is clinical data showing that drugs acting as anti-depressants can be effective pain medications because they can modulate the connection between emotions and pain in the brain.
There are simple things we can do to help manage stress every day, especially major stress, which may lead to disease. Get plenty of sleep. Lack of sleep may increase the risk for depression, diabetes, obesity, and a host of other health issues. It may be the most important thing we do to help manage our health. Eat a proper diet. The Dietary Guidelines Advisory Committee identifies that a healthy dietary pattern is higher in vegetables, fruits, whole grains, low- or non-fat dairy, seafood, legumes, and nuts.
Drink plenty of water. Water flushes toxins out of vital organs, carries nutrients to your cells, and provides a moist environment for ear, nose and throat tissues. The general rule is to drink eight 8-ounce glasses of fluid a day, which is equivalent to about 1.
There are numerous benefits to exercise such as controlling weight obesity is a cause of inflammationimproving cholesterol, strengthening your immune system, improving your mood, increasing energy by improving oxygen delivery to tissues, and improving sleep. Try to exercise at least 30 minutes, three times a week.The etiology of autoimmune diseases is multifactorial: genetic, environmental, hormonal, and immunological factors are all considered important in their development.
Physical and psychological stress has been implicated in the development of autoimmune disease, since numerous animal and human studies demonstrated the effect of sundry stressors on immune function.
Unfortunately, not only does stress cause disease, but the disease itself also causes significant stress in the patients, creating a vicious cycle. Recent reviews discuss the possible role of psychological stress, and of the major stress-related hormones, in the pathogenesis of autoimmune disease.
It is presumed that the stress-triggered neuroendocrine hormones lead to immune dysregulation, which ultimately results in autoimmune disease, by altering or amplifying cytokine production.
The treatment of autoimmune disease should thus include stress management and behavioral intervention to prevent stress-related immune imbalance. Different stress reactions should be discussed with autoimmune patients, and obligatory questionnaires about trigger factors should include psychological stress in addition to infection, trauma, and other common triggers.You can help by doing this survey and sharing this link : Click here for the short survey.
According to the US National Institutes of Health, 24 million Americans have an autoimmune disease, plus at least 8 million carry antibodies showing that such a disease will likely develop in the future like the ACPA antibodies that indicate RA.
However having a malfunctioning immune system and being immune suppressed by our medications could likely make us more vulnerable to contracting the virus or becoming seriously ill.
Certain autoimmune disease medications may help people fight coronavirus. While this is one of dozens of drugs being investigated for the coronavirus, many with autoimmune disease already take this or another medicine that results in inhibition of IL-6 signaling Actemra, Kevzara, and JAK inhibitors like Rinvoq and Xeljanz.
The newly formed COVID Global Rheumatology Alliance is creating a secure international case reporting registry that will eventually be able to help guide doctors in assessing and treating patients with rheumatologic disease and evaluating risk of infection in patients who are immune suppressed.
Stay tuned for more information and to learn how you can help. Respiratory viral infections like COVID 19 can increase the risk of developing rheumatoid arthritis in those who are genetically susceptible to autoimmune disease. People with autoimmune disease are more vulnerable in a health crisis for other reasons. They often suffer financial strain from high medical costs my meds cost more than food.
Lower incomes often result from disability. They have increased risk by greater contact with medical systems infusions, medical appointments, lab visits, and so-called elective surgery—like joint replacements. Despite progress, there is still a great need to improve awareness that rheumatoid disease is not a type of arthritis and that arthritis is just one symptom of RD.
Of course this disease is more than hands and does not usually start in the hands. Cell Discov 6, 16 Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus nCoV in vitro. Cell Res 30, — Business Insider. Elon Musk and Trump are touting a s malaria pill as a potential coronavirus treatment. But supplies are already running short as prescriptions spike. Hospital for Special Surgery Mar Teva and Mylan to jumpstart production of old malaria drug to fight the novel coronavirus.
Stat News ,3 Respiratory viral infections and the risk of rheumatoid arthritis. Arthritis Res Ther 21, Kelly O'Neill formerly Kelly Young has worked over 10 years as an advocate helping patients to be better informed and have a greater voice in their healthcare. She is the president of the Rheumatoid Patient Foundation. Through her writing and speaking, she builds a more accurate awareness of rheumatoid disease RD aka rheumatoid arthritis RA geared toward the public and medical community; creates ways to empower patients to advocate for improved diagnosis and treatment; and brings recognition and visibility to the RA patient journey.
In addition to RA Warrior, she writes periodically for newsletters, magazines, and websites. There are over 60, connections of her highly interactive Facebook page. She created the hashtag: rheum. She has lived over thirteen years with unrelenting RD. Your email address will not be published. Thank you Kelly for this article.
Rheumatoid Arthritis and Emotional Health
I have been concerned about the covid since my immune system is as one Dr.In a nutshell, your system gets confused and starts to attack itself. I wrote a bit about the emotional conditions that set us up for susceptibility to autoimmune conditions in a co-authored book on soul fragments, I'll give you that excerpt of the chapter below, as well as unpack some other ideas in this post. The correlation between early childhood trauma and autoimmune disease is astounding, especially for women.
In dealing with people in my day-to-day life, I noticed this link myself, and after hearing from others in different healing modalities who had also seen the correlation, I went digging for the proof. I found a study supporting my findings published by the American Psychosomatic Society Dube.
This study researched the possible link between the scores of each of 15, participants with Adverse Childhood Experiences ACE and their medical records. The results were staggering. The link between childhood trauma and later developing an autoimmune condition is comparable to the link between a fast-food diet and obesity or between alcoholism and liver failure.
For every ACE a person has, the likelihood of a first hospitalization with any autoimmune disease increased 20 percent for women and 10 percent for men. In other words, a woman with three adverse childhood experiences is 60 percent more likely to be hospitalized with an autoimmune condition than a woman with no adverse childhood experiences. Should you want to know your ACE score you can take the test here. Keep in mind, the ACE test does not cover every circumstance that may have been traumatizing to you.
If there were things in your childhood that felt major to you, that didn't get scored, you can adjust the score as you see fit. You are a person, not a scientific research project, and while such a concrete test is helpful for seeing patterns with cross-sections of people, it ceases to be as helpful when it's your individual life.
I've heard it said that autoimmune disease is rooted in self-hatred. You're attacking yourself. That might be true in some people, but even when it is, I don't think it goes back far enough.
Self-rejection often tracks back to early childhood again, with an emotionally abusive whether they intended or realized it or not parent or other close figure that you didn't get approval from.
With self-hatred, you never quite live up to your own expectations, but were they really your expectations in the first place? In a way, if you boil it down, it's just shame. Who taught you you were only worthy of your own distain? That critical internal voice is well meaning, believing that if it can get you performing right, looking right, then you'll have right relationships.
It's not truth, it's a false strategy from a wounded younger you. Self-hate also isn't always so extreme. It doesn't come across as "hate" to constantly being seeing your flaws and trying to work on them. Sometimes there is a fine line between self-improvement and self-nitpicking. It can be a perception of how you think you should be an a rejection of your true design.
I spoke with a doctor in South Africa briefly about it, and she remembered a case where the person was a mixed race. She believed that the two sides of their DNA were fighting each other.
The hate was coming generationally through epigenetics. This doesn't have to only apply to racism, but anywhere hatred reigned. If Romeo and Juliet had lived long enough to procreate, their child may have had a greater risk of developing an autoimmune disorder. We are more resilient than that. I mean that the array of autoimmune diseases we see in developed countries are not as much a third world problem excluding AIDS of course.