Other Adverse Childhood Experiences Increase Risk For Ra/rd
For my grandfather, the loss of his mother to suicide would have qualified as an adverse childhood experience .
Early loss of a parent, often by suicide, was also a finding associated with RA/RD in a study exploring dreams in women with the disease Levitan, H.L., Patterns of hostility revealed in the fantasies and dreams of women with rheumatoid arthritis. Psychother Psychosom, 1981. 35: p. 34-43. . What a remarkable, and specific, finding.
Another study looking at the role of traumatic events in risk for RA/RD found no differences in rates of exposure compared to healthy controls. They noted, however, that responses were different in people who developed rheumatoid disease.
In their study, a higher risk for RA/RD was associated with the way a person was able to process the event in that individuals who developed RA/RD were slower to adapt to adverse life events Carette, S., et al., The role of life events and childhood experiences in the development of rheumatoid arthritis. J Rheumatol, 2000. 27: p. 2123-30. . This suggests that there was an inability to resolve these experiences, which is a common characteristic that determines whether an experience is traumatic rather than merely stressful. It also supports another link between adverse childhood experiences and rheumatoid disease / arthritis.
Dr. Gabor Mate has a hugely informative chapter on the role of adversity in risk for RA/RD in chapter 13 of his book When The Body Says No.
Recovery Of Platelet Parameters In The Condition With And Without Chronic Mental Stress
We performed an additional analysis of platelet function recovery for the condition CS+ and CS- outside the mixed linear model reported above. Observed values were compared by analyzing the difference between T1 and T3 in the condition CS+ and CS-. Platelet CD62P showed impaired recovery i.e. a prolonged activation in the CS+ condition CS+: mean 0.85 CS-: mean 1.52 , T-Test, p=0.023). The recovery of the other platelet activation markers CD63 , PAC-1 and CD45highCD42b+ was not significantly altered in CS+ condition compared to CS-.
Speak To Your Boss About Accommodations If You Feel Comfortable Doing So
There may be times that your condition makes it really hard to work, either because of the physical or mental effects. If you feel comfortable talking to your boss, it may be helpful to explain that having rheumatoid arthritis means you might need to take a quick walk break, come in late for work one morning, or wear sneakers in a formal work setting.
Being able to switch shoes sounds like a very simple thing, but its taken me a very long to even speak up and say that, Leonard says.
Everyones work situation is different, but if your boss is supportive, communicating why you need hourly walk breaks, for instance, may help them understand that youre doing what you need to do to feel your best at work.
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Talking To Your Doctor
Managing stress can play an important role in managing RA. The next time you talk with your doctor, share some of the things in your life that cause you stress. Your doctor may have some advice about how to manage your anxiety and stress.
Your doctor may also be able to refer you to a therapist who has been successful helping people living with chronic conditions, like RA, to manage stress.
Be open with your doctor about your symptoms and the stressors in your life. Be specific when describing your symptoms:
- What brings them on?
- How long do they last?
- What helps relieve your symptoms?
- Where do you feel pain?
You should also talk with your doctor about managing other flare-up triggers, such as overexertion, poor sleep, or an infection, such as the flu.
How Can Having Low Platelets Affect My Pregnancy And Birth Plan
In February, a very pregnant Mandy Moore, star of the popular TV series âThis Is Us,â revealed that she had to alter her birth plan due to a diagnosis of low blood platelets. Though Moore didnât elaborate on what specifically changed, low platelets is a fairly common condition.
Platelets, also called thrombocytes, are the smallest human blood cells and play a crucial role in blood clotting. Released by your bone marrow, the quantity of these specialized cells in your blood is generally reported on a complete blood count .
Pregnancy is generally a pro-clotting state, which makes sense clotting helps protect women from excessive bleeding at delivery. But there is a delicate balance between activities that help your blood clot and those that cause too much clotting.
At their best, platelets combine with other factors in the blood that control bleeding and help plug holes in the walls of blood vessels.
At their worst, platelets can form clots in the blood vessels in areas that have plaque buildup. This can put you at increased risk for heart attacks and strokes. When you have too few platelets, called thrombocytopenia, maternal complications such as excessive bleeding, premature delivery, or inability to get an epidural can arise.
Thrombocytopenia is often a âsilentâ condition, causing few noticeable symptoms. Patients have reported mild symptoms such as bleeding gums while brushing their teeth, easy bruising, or reddish-purple spots caused by bleeding below the skin.
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What Are The Symptoms
The main symptoms of rheumatoid arthritis are pain, stiffness, and swelling in the joints of the hands, wrists, elbows, feet, ankles, knees, or neck. The disease usually affects both sides of the body at the same time. In rare but severe cases, it may affect the eyes, lungs, heart, nerves, or blood vessels.
Sometimes the disease can cause bumps called nodules to form over the elbows, knuckles, spine, and lower leg bones.
The Usual Caveats About Observational Studies
Its important to emphasize that a study of this type cannot conclude that stress-related disorders actually cause autoimmune disease. There could be other explanations for the findings. For example, it is often impossible to identify a precise date that an autoimmune disease or a stress-related disorder began. So, despite the researchers requirement that the autoimmune disease be diagnosed well after the stress-related disorder, its possible that the autoimmune condition was already present before the stress-related disorder was diagnosed. If that was the case, the stress-related disorder could not have caused the autoimmune disease.
In addition, its possible that something other than the stress-related disorder was to blame for the higher rate of autoimmune disease. For example, people who have been through severely stressful circumstances may be more likely to smoke, and smoking has been linked to an increased risk of certain autoimmune diseases, including rheumatoid arthritis and multiple sclerosis.
One more point: this study appears to have included type 2 diabetes among the 41 autoimmune diseases it considered. Although this is the most common type of diabetes , it is not considered an autoimmune disease. Different results might have been noted if stricter definitions of autoimmune disease had been applied.
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The Reverse Cause And Effect
People with arthritis must confront the same kinds of stress as everyone else. Additionally, living with chronic arthritis creates another medley of stressful problems. Chronic arthritis adds the stress of pain, fatigue, depression, dependence, altered finances, employment, social life, self-esteem, and self-image.
During stressful times, the body releases chemicals into the bloodstream and physical changes occur. The physical changes give the body added strength and energy and prepare the body to deal with the stressful event. When stress is dealt with positively the body restores itself and repairs any damage caused by the stress. However, when stress builds up without any release, it affects the body negatively.
A vicious cycle occurs in the relationship between arthritis and stress. The difficulties which arise from living with chronic arthritis create stress. The stress causes muscle tension and increased pain along with worsening arthritic symptoms. The worsening symptoms lead back to more stress.
Ways To Manage Rheumatoid Arthritis At Work
Managing rheumatoid arthritis at work can be one of the most challenging aspects of having the chronic condition. The inflammatory disease1 can cause you to have really painful and swollen joints that affect how you dress, use the computer , or even get out of bed some days.
Although finding the right medication may help you alleviate most of your symptoms, making additional lifestyle changes can help you feel more comfortable with managing rheumatoid arthritis at work. Below, we speak with several people with rheumatoid arthritis about how they get through the workday more comfortably. Hopefully, some of their advice can help you at work too.
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Corticosteroid Use And Stress
Many arthritis patients are prescribed a corticosteroid, such as prednisone, as part of their treatment plan. Without some precautionary measures, stress can be dangerous to someone taking corticosteroids. Corticosteroids are closely related to cortisol, which is a hormone produced by the adrenal glands. Cortisol helps regulate salt and water balance and carbohydrate, fat, and protein metabolism. When the body experiences stress the pituitary gland releases a hormone which signals the adrenal glands to produce more cortisol. The extra cortisol allows the body to cope with the stress. When the stress is over, adrenal hormone production reverts to normal.
Prolonged use of corticosteroids results in diminished production of cortisol by the body. With insufficient cortisol production, the body could be left inadequately protected against stress and open to additional problems such as fever or low blood pressure. Physicians often prescribe an increased dose of corticosteroid to compensate for this when there is a known or expected stressful event.
How Are Anxiety And Depression Treated
Some people never experience anxiety and depression related to RA. But if you do, there are treatment options. Talking to your doctor about your mental health may not be easy. Remember, mental health is just as important as physical health. It may take a team of healthcare professionals to make sure you are getting the support you need.
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Autoimmune Disease And Stress: Is There A Link
- By Robert H. Shmerling, MD, Senior Faculty Editor, Harvard Health Publishing
A new study has raised the possibility that stress may cause autoimmune disease, such as lupus or rheumatoid arthritis, because it found a higher incidence of autoimmune diseases among people who were previously diagnosed with stress-related disorders.
I have patients who heard about this research and are saying, “I knew it!”
But before we accept a potential link between stress and autoimmune disease, lets look at some details of the study and consider how we define the terms “autoimmune disease,” “stress,” and “stress-related disorder.”
How Do You Control Joint Pain In Both Conditions
People who have a thyroid disorder and rheumatoid arthritis are likely to have more aggressive disease progression and poorer responses to treatment. What this means is that it can be hard to manage them. So, suppose you do have both conditions. In that case, you will want to stay on top of your routine testing, follow-up consultations, medications, and lifestyle interventions.
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How To Deal With Rheumatoid Arthritis And Anxiety
Anxiety can be a powerful and negative emotion or state of being that you experience when you have rheumatoid arthritis . It may manifest itself in a variety of ways, due to the fact that your RA both makes you more vulnerable in terms of health complications and the fact that in general, the diagnosis of a disease can make one anxious.
This can be especially troubling if you are adjusting to life with RA, the possibility of disability and the uncertainty of the future. However, there are many things you can do to keep your anxiety at a manageable level.
Personally, I struggled with anxiety even before I was in constant pain. Although general anxiety and panic attacks dont necessarily go hand-in-hand with RA, a diagnosis or chronic pain main trigger it for those who are more prone to anxiety in general.
If you find you are suddenly beginning to have panic attacks or are having frequent racing thoughts, it is important to discuss this with your doctor, as he or she may be able to prescribe medication to help bring you to a calmer state.
Many people I have spoken to worry that anti-anxiety medication will make it so they can no longer feel, but this is simply not the case. Instead, the anti-anxiety medication will help you relax and cut down on panic attacks.
If your panic attacks are especially bad, you may also be prescribed something to help stop them while they are happening, which is extremely useful for getting over the hump of the most difficult parts.
The Consequences Of Stress Go Beyond Ra
Experiencing exceptional stress when you have RA may increase the risk for other serious health concerns. For instance, theres evidence that RA patients with higher levels of stress and anxiety are more likely to have atherosclerosis, a buildup of fatty acids in the arteries and precursor to cardiovascular disease. Its also likely that stress ups the chance of depression, anxiety, and gastrointestinal conditions among RA patients, says Dr. Askanase. Obviously, stress is bad for the body in general. Exactly how stress increases vulnerabilitydoes it lead to the production of more inflammatory molecules?is still being investigated.
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Can Rheumatoid Arthritis Be Caused By Stress
Rheumatoid arthritis is a chronic inflammatory joint condition and an autoimmune disease. It has no definite cure and only the symptoms can be managed. At times, treatment can make rheumatoid arthritis symptoms disappear for a while. This symptom-free period is referred to as remission. A remission is followed by the reappearance of symptoms and this period is known as a flare-up.
Research says that rheumatoid arthritis can be caused by stress. Stress triggers rheumatoid arthritis by setting off the immune systems inflammatory response in which cytokines are released. Cytokines are chemicals that play an important role in inflammation and can increase the severity of rheumatoid arthritis in some patients. The greater the exposure to stress, the greater the inflammation becomes. This triggers a rheumatoid arthritis flare.
Take Care Of Your Teeth And Gums
People who have rheumatoid arthritis tend to get gum disease. Some experts think that infection that enters the body through the mouth may make rheumatoid arthritis worse, although this has not been proved. You can help prevent gum disease through good basic dental care. For more information on taking care of your teeth and gums, see:
Stress May Disrupt Immune Function Inflammatory Response
Song does have a hypothesis about the correlation. Previous animal models and human data supports the theory that psychological stress can modulate the immune system, probably through disruption of the hypothalamic-pituitary-adrenal axis and the autonomic nervous system. The activated autonomic nervous system might cause the disruption of immune function and inflammatory response via the inflammatory reflex. Moreover, patients with PTSD have been reported to have excessively low cortisol levels, which can consequently lead to amplified production of pro-inflammatory cytokines with accelerated immune cell aging, and overactivated immune system, she says.
Song notes that although much more research needs to be done, patients should still be proactive about managing stress disorders: Individuals suffering from severe emotional reactions after trauma or other life stressors should definitely seek treatment due to the risk of chronicity of these symptoms and thereby further health decline and the increased risk of autoimmune disease. There are now several treatments, both medications and cognitive behavioral approaches, with documented effectiveness of core symptoms of stress-related disorders and their comorbidities.
Cognitive Function And Cytokines
Cognitive impairment may occur in RA patients because of the direct effect of inflammation on the brain, the impact on cerebral blood vessels in the same way as cardiovascular complications or adverse effects from glucocorticoids and immunosuppressants . Pain, fatigue, anxiety and depression are also responsible for cognitive dysfunction. Cytokines released in RA cause systemic inflammation and can interfere with mood, cognition and sleep . Bartolini et al. reported in their cohort study that 3870% of RA patients have cognitive impairment . A study performed by Shin et al. used the American College of Rheumatology neuropsychological battery modified for RA to assess cognitive function scores in 144 RA patients, and the results showed cognitive impairment in executive function, visuo-spatial learning and verbal memory as> 20%, 29% and 18% respectively . A cross-sectional study assessed cognitive function using the Montreal Cognitive Assessment on 60 female RA patients taking MTX or bDMARDs, and the results showed> 60% RA patients scored MOCA< 26 compared to 49% in the control group . Another study that measured the Mini Mental State Examination score, level of depression, VAS and DAS28 reported the correlation between a low level of MMSE and VAS but not between depression and cumulative steroid dose .
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Inflammation And Stress: Theyre Closely Connected
Research shows that stress may play a role in the cascading process that leads to inflammation and causes RA pain. Inflammation in RA is partly caused by molecules called cytokines. While cytokines can be released for a variety of reasons, stress also releases them. If youre stressed and are producing more cytokines, you will most likely develop more inflammation, which may result in more pain.
Whether we consider rheumatoid arthritis, osteoarthritis, systemic lupus, or any other rheumatic disease, the presence of emotional stress may well exacerbate the condition, says Richard Roseff, MD, a rheumatologist at Danbury Hospital and a private practitioner in Danbury and Ridgefield, Connecticut.