published by nonprofit Johns Hopkins Press
posted in Triggers Of Lupus Disease Activity on January 8, 2022 by
Updated December 29, 2023
ANSWER: “There have now been several studies showing that significant stress, such as post-traumatic stress disorder, natural disasters, sexual abuse, physical abuse, exposure to racism, etc have been associated with higher rates of developing SLE. Studies have also associated stress with flares of lupus, and I know many patients who state that they flare during times of stress. One of the first studies to associate stress with the immune system was by Dr. Janice Kiecolt-Glaser, PhD in the 1980s when she measured natural killer cells in Ohio State University Medical students. She showed there were significant abnormalities in students who were stressed. Then during examination week (a time of high stress for everyone), these abnormalities also occurred in students who were fine before “test week.” This is why I recommend that SLE patients learn to decrease stress as a way to potentially decrease flares. For example, consider practicing mindfulness every day. Just 5 minutes of breathing exercises daily may help make a difference.” Learn more about managing lupus and stress management.
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As the questioner points out, a group of Harvard researchers published this study in 2019. It showed that women with lupus were more likely to have suffered from significant abuse and trauma as children.
In addition, another study showed that children exposed to 2 or more traumatic events were twice as likely to have been hospitalized with rheumatic disease. This also suggested that childhood stress increases the risk of developing systemic autoimmune diseases. Again, suggesting a link between stress and lupus.
Several studies have shown that people who have had PTSD are more likely to develop lupus.
For example, one study evaluated veterans.
The Harvard group showed in a previous 2017 study that women who had suffered trauma or “probable PTSD” were three times more likely to develop lupus.
Hearing about and observing acts of racism and discrimination are causes of significant stress. Just think about it. When you witness acts of discrimination against someone similar to you (race, gender, religion, sexual orientation, age, etc.), you realize that this could happen to you. We call this type of racism “vicarious” or “indirect” racism.
Auburn University (Alabama) conducted the Black Women’s Experiences Living with Lupus (BeWELL) Study. Doctors from the University of California, The University of North Texas Health Sciences Center, and Emory University (Georgia) participated in this.
This is just another example showing the results of racism. There is no room for racism, bias, and prejudice. We must all work at ridding this virus from society.
Studies have also shown a link between lupus flares and stress. I would not be surprised if most lupus patients reading this have noted lupus flares occurring during periods of increased stress.
A European study showed that women with lupus who had daily hassles with social relationships had more lupus flares and required increased doses of steroids compared to others. Other studies have shown similar results, which shows the importance of lupus and stress management.
Some studies suggest that people with lupus who learn to lessen stress do better and have a better quality of life. This is important because most lupus patients have decreased quality of life due to their disease and all the problems that come with it.
The good thing is that everyone can learn to deal with lupus and stress management. A few recommendations include:
Read chapters 3, 38, and 39 of The Lupus Encyclopedia, edition 2
Look up your symptoms, conditions, and medications in the Index of The Lupus Encyclopedia
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If you have stress reducing advice, what has your experience been? What do you recommend for other patients?
Do you have any questions to ask Dr. Thomas?
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I don’t know if stress caused my lupus, although it wouldn’t surprise me, given that at one point, I was working full-time, raising a family, was in law school, and commuted two hours a day. The stress certainly didn’t help the situation.
Definitely noticed increased flare activity related to periods of increased stress, and, once I retired, lupus symptoms decreased significantly.
I grew up in a house where physical and mental abuse occurred on a daily basis until my early teens when my parents divorced. I joined the Police Force when I was 19 and was exsposed to tradgedies that caused PTSD. I started to have SLE sympoms in my late teens but was only diagnosed at the age of 47. Still working. Have regular flare-ups. Thankfully I have a supportive family.
Lourika: thanks for your comments. I’ve seen too many cases like yours. Sharing your story can help others realize that they are not alone in their experiences, and hopefully, the cycle of abuse will hopefully stop in many families. Some of my lupus patients had horrible pasts, and now I see them being the wonderful parent that they never had. I wish you all the best in the future. Donald Thomas, MD
I grew up in a house with physical and mental abuse as well. My father was an abuser and I ended up marrying a man exactly like my father. After 14 years of being married it ended up in divorce. Thinking back I definitely believe my diagnosis of lupus steamed from my childhood situation and the divorce. I could remember days when I would be so stressed before I was diagnosed my joints would hurt throughout my body. I’m doing really well now, haven’t had a any serious issues, have an excellent rheumatologist (Dr. Sheyn).
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