The Mind-Body Connection and Autoimmune Disease

The mind-body connection has been contemplated for centuries. In recent years, more evidence suggests that persistent stress and worry may contribute to imbalance in the body and increased risk for autoimmune disorders and other diseases.

Autoimmune disorders are collectively one of the most prevalent diseases in the US, affecting up to 10% of the population, or 24 million people. Both rates of autoimmune diseases and stress levels have increased exponentially over the last decade, especially during the ongoing Covid-19 pandemic and associated public health measures like social distancing, which can contribute to isolation and resulting stress and anxiety.

Some research suggests a link between stressful events and changes in the endocrine and sympathetic nervous systems, and that these changes can ultimately impair immune function. A large meta-analysis of nearly 300 independent studies published over 30 years indicated that psychological stress was associated with a suppressed immune system. Other studies have linked stress with immune dysregulation and a number of autoimmune and atopic diseases such as inflammatory bowel disease, allergy, atopic dermatitis, and celiac disease.

In a large study published in JAMA in 2018, evidence was found that stress-related disorders are significantly associated with subsequent autoimmune disease. The study findings were consistent with previous evidence linking psychological stress and stressful life events to immune system dysregulation, and found that:

• Individuals diagnosed with a stress-related disorder were more likely to be diagnosed with an autoimmune disease and more likely to develop multiple autoimmune diseases.
• The increased rate of autoimmune disease was less significant among those individuals with post-traumatic stress disorder who were being treated with an SSRI, a type of antidepressant drug.
• Under stress, the activated autonomic nervous system may play a role in immune function impairment and may indirectly promote an inflammatory response.

Among five-year-old children, researchers measured the association between high psychological stress in the family (i.e., serious life events, parenting stress, lack of social support, and parental worries) and immune response. Results indicated that psychological stress may not only suppress the immune system but may also contribute to an autoimmune reaction against pancreatic cells and diabetes-related autoantigens.

A more recent study that looked at stress/depression levels of older patients aged 55-65 years old found that a depressed state negatively affects natural killer cell activity.

Behavioral changes in diet and lifestyle may positively affect the immune system and potentially prevent immune balance, including improved sleep, and reduced alcohol intake and cigarette use. Additionally, psychological interventions (e.g., cognitive behavioral therapy, mindfulness, and relaxation) have been found to effectively reduce stress and may improve immune function.

One study of women newly diagnosed with breast cancer looked at psycho-immune outcomes of an eight-week mindfulness-based stress reduction (MBSR) program. Compared to the control group, women in the MBSR group exhibited decreasing trajectories of perceived stress, fatigue, sleep disturbance, and depressive symptoms. Data from breast cancer patients also suggest that mind-body complementary therapies (e.g., mindfulness, meditation, yoga, tai chi, qigong, guided imagery, and affirmations) may positively affect the immune system of patients.

Breast cancer survivors who participated in Iyengar yoga sessions for eight or 12 weeks showed reduced morning and evening cortisol levels, along with improved fatigue and emotional well-being. In another study, breast cancer patients who received tai chi chuan training showed significant improvements in bone health, immune function, and quality of life.

While a causal link between autoimmune disorders and stress has yet to be fully established, growing evidence suggests that modifying unhealthy behaviors along with integrating mind-body interventions into a patient’s daily life may help improve stress and prevent immune system dysfunction.