Living with Lupus

Trauma & PTSD Increase Lupus Risk 3x

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Stress can lead to lupus flares & a lower quality-of-life. But, new research suggests trauma and PTSD may even increase the risk of developing lupus.

The link between stress and lupus symptoms is nothing new — though that doesn’t make it any easier to manage stress. Previous research has shown decreases in reported quality-of-life and increases in lupus flares in response to life stressors.

Now, new research is exploring the links between psychosocial stresses and the development of autoimmune diseases. This is interesting because it suggests that stress might not only trigger symptoms in people currently battling lupus. Trauma, and the body’s stress response, may actually lead to an autoimmune disease.

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Current findings on trauma and post traumatic stress disorder (PTSD)

A study published on September 20, 2017 in the journal Arthritis and Rheumatology explored the detrimental impact of physical health in people that have experienced a significant trauma. Post traumatic stress disorder is a common condition that can impact those that have experienced or witnessed a trauma. This trauma can range from participation in a war zone to the death of a loved one.

Not all traumas will result in a person developing PTSD. The United States Office of Veteran’s Affairs estimates that 7-8% of the population will experience PTSD at some point in their lives.

Also, the prevalence of PTSD differs by sex. 10% of women will experience PTSD during their lifetime compared to 4% for men.

To be diagnosed with PTSD, the following symptoms must be present:

  • At least 1 re-experiencing symptom
    • Flashbacks
    • Bad dreams
    • Terrifying thoughts
  • At least 1 avoidance behavior
    • Not visiting certain locations or places because they remind a person of the trauma
    • Not thinking about certain things or people to avoid the trauma
  • At least 2 arousal and reaction symptoms
    • Outbursts
    • Difficulty sleeping
    • Anger
    • Easily startled or on edge
  • At least 2 cognition symptoms
    • Negative thoughts about yourself or the world
    • Loss of interest in previously enjoyable activities
    • Difficulty remembering details of the trauma
    • Feelings of guilt or blame that are undue

NOTE: If you believe that you may be experiencing PTSD, speak with your lupus treatment team and consider visiting a mental health professional.

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Exploring the research

The study mentioned above used a longitudinal observational research design with a large cohort of American women. Researchers can’t impose a trauma on participants as part of the trial for ethical reasons. Because of this, longitudinal trials of this type have large numbers of participants and then use self-reporting, diagnoses, and other criteria to create condition groups.

For this trial, 54,763 American women participated. Researchers followed up with these people for 24 years. They also captured:

  • Diagnoses of lupus (SLE) based on the American College of Rheumatology definition
  • Short Screening Scale for DSM-IV PTSD
    • The DSM is the diagnostic tool for mental health issues
  • The Brief Trauma Questionnaire (BTQ)
    • The BTQ is a 10-question survey and scoring mechanisms to determine if a person has been exposed to certain traumatic events

From the initial cohort, 73 people eventually developed lupus (SLE). The researchers then analyzed the association between SLE development and exposure to trauma during the 24-year period.

The data revealed two interesting findings:

  1. Women who met the diagnostic criteria for PTSD were 2.94 times more likely to develop lupus; and
  2. Regardless of PTSD symptoms, women who experienced trauma were 2.87 times more likely to develop lupus

Because of these results, the researchers concluded that: “psychosocial trauma and associated stress responses may lead to autoimmune disease.”

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Additional research into the trauma-lupus link

While the study above was the first longitudinal study to explore this link, prior research has viewed stress as a trigger for lupus. In fact, a 2008 study noted that genetic, environmental, hormonal, and immunologic factors may only account for 50% of the onset of an autoimmune disease. The remaining 50% was referred to as “unknown trigger factors.”

Adding to the case for stress or trauma, the researchers highlighted an interesting statistic: As many as 80% of people with an autoimmune disease reported “uncommon emotional stress before disease onset.

Taken with the recent research, it is possible that these emotional stressors could a symptom of a trauma or PTSD. In this way, the previously hypothesized issue with stress could truly be a response to trauma.

What’s next?

Additional research is needed to further explore this connection between trauma, emotional stress, and the development of autoimmune diseases. Psychological stress is known to be harmful, but the physiological implications are still being untangled. Current research is exploring how neurotransmitters (which are impacted by stress) alter the production of cytokines (the signaling cells in the immune system).

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