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 .
Does Stress Affect My Arthritis
You will be better able to manage stress in your life if you:
- find ways to change negative thinking
- build a support system
- learn to relax
Did you know that stress can negatively impact your arthritis? Stress can increase muscle tension, which can be related to increased pain among people with osteoarthritis and rheumatoid arthritis. In addition to the everyday stress that everyone has, having arthritis may increase your stress at times. You may feel stress from not being able to do the activities at the same rate or in the same way you used to. You may find it hard to rely on others for help. You may feel stress about how your joints look. Learning to manage stress can help you feel better mentally and physically as well as reduce your pain.
Learning to change negative patterns of thinking is an action you can take that will also help you manage stress. For help with that skill, see Changing Your Point of View.
Building a support system will also enable you to better handle stress. With a support system, you are less likely to feel you are alone when things get rough. Also, your support system can help you put your feelings and circumstances in perspective. For help in knowing how to build a support system, see How can I get the support I need to manage depression?
Ra’s Effect On The Brain
Learn about the possible links between rheumatoid arthritis and cognitive effects and how to manage them.
A lot of people with rheumatoid arthritis report having trouble with memory, attention, and mental focus. They forget names and appointments, struggle to find the right words and have trouble making and carrying out plans. Some say that the loss of mental clarity, commonly called brain fog, is almost as distressing as arthritis itself.
Limited Research
Its hard to say exactly how common fuzzy thinking is in RA because researchers have largely ignored it.
We have relatively good literature on cognitive problems in lupus and fibromyalgia, where brain fog is well established, but nobody has really studied RA, explains Patti Katz, PhD, a professor of medicine at the University of California, San Francisco.
Katz and her colleagues looked at 15 studies on RA and cognition published between 1994 and 2016. Many were small less than 100 patients and not all were high quality. Yet most showed that people with rheumatoid arthritis performed more poorly on cognitive tests than their peers or controls. Memory, verbal communication, attention, concentration and problem-solving seemed to cause the most trouble.
Who Gets It and Why?
There are several theories why cognitive problems may be more common in RA and other inflammatory types of arthritis.
But Katz thinks it might not be that simple.
Some factors that may contribute to brain fog include:
What the CDC Says
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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.
Ra As Internal Stressor
In addition, RA can affect your bodys production of the stress-related chemical cortisol. In other words, RA is a type of internal stressor. With time, stress chemicals like cortisol may increase your risk for serious health conditions such as heart disease, , and . These problems can lead to even more stress.
As you likely already know, you may feel stressed because of your RA symptoms. No one likes moving slowly, and can make it difficult to move around and get places on time. It can be stressful when daily activities or hobbies you love to do feel difficult or painfulor even seem impossible.
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Yoga Improves The Bodys Response To Diseases
Since yoga helps to reduce stress, it can reduce the levels of cortisol in the body. Cortisol is a hormone closely associated with states of mental and emotional stress.
When we release stress, the secretion of cortisol is suppressed. Nowadays, its known that maintaining high levels of cortisol in the body can lead to alterations in the immune system. Its believed that cortisol may weaken the immune system giving way to the entry of pathogens.
When cortisol is controlled, the body is better suited to fight arthritis. Its not known to what extent this can delay the condition, however, its another thing patients can do.
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.”
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Diagnosis And Treatment For Arthritis Flares
If you think youre going through a flare that hasnt improved after a couple of days, call your rheumatologist or primary care doctor. They will want to monitor how you feel and may want to order imaging and blood tests to see whats going on. They can also prescribe medications to get the flare under control.
Yoga Helps To Reduce Inflammation From Rheumatoid Arthritis
A study carried out by researchers at the University of Ohio showed that yoga can be effective against inflammation. Fifty women with varying experience of practicing yoga were included in the experiment.
They were subjected to stress, which, as we previously mentioned, is a trigger for rheumatoid arthritis inflammation. In addition, blood tests were performed in which the indicators related to inflammation were verified. When comparing results, it was established that women who practiced more yoga had lower levels of inflammation.
The research showed that new yoga practitioners had higher levels of IL-6 protein. IL-6 is the protein thats directly related to inflammatory processes.
There was a 40 percent difference between beginners and experienced practitioners. This proves that yoga can effectively reduce the inflammation caused by rheumatoid arthritis.
As you can see, the benefits of yoga for rheumatoid arthritis has been proven. Its important to emphasize that any practice leading to a state of relaxation can be beneficial. The important thing is try out all the alternatives which will allow you to increase your quality of life.
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Chronic Stress And Long
Aches and pains are common symptoms of stress, however, ongoing pain or stiffness may be a sign of a more serious problem.
A 2018 study published by PubMed revealed Stress-related disorders were significantly associated with risk of subsequent autoimmune disease.
Autoimmune diseases cause your immune system to produce antibodies which attack and damage the bodys healthy tissue instead of fighting infection. In certain conditions, such as rheumatoid arthritis and lupus, the antibodies attach to connective tissue within the joints leading to pain, stiffness, swelling, andwithout treatmentpotentially permanent joint damage.
Autoimmune diseases are often incurable however, early intervention and treatment can help prevent further damage and joint deterioration.
Figure Out What Stresses You Most
Even though some events seem inherently stressful including dealing with a year-plus-long pandemic stress is influenced as much or more by an individuals reaction to a situation as to the event itself.
Some people are more naturally resilient to stress, but anyone can learn to build their resilience, such as by teaching themselves to reframe situations in a more positive light. Scientists are also coming to see that many things play a role in our stress response, including gender for example, women are more apt to seek social support in stressful times .
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It helps if you can determine the factors that bring on most of your stress. Stress can result from many different situations. Some stress is relatively self-limiting, but other stresses are more chronic, and we do make attempts, as clinicians, to figure out where these stresses may be coming from, Dr. Roseff says.
In some cases, to determine this you might benefit from an outsiders perspective, especially a psychotherapist or other mental health professional, says Daniel Muller, MD, a rheumatologist at UCHealth in Ft. Collins, Colorado, and a coauthor of Integrative Rheumatology.
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The Effect Of Stress On Arthritis
Stress. There is no avoiding it completely. It is a part of everyday life. Just when you think it is gone, it is back again. It is the way the mind and body react to tension and pressure. Too much stress can increase pain, can make a person prone to illnesses, and can make it more difficult for people with arthritis to cope with the added burdens imposed by their disease.
Exploring The Connection Between Stress And Autoimmune Disease
In this new study, researchers analyzed more than 100,000 people diagnosed with stress-related disorders and compared their tendency to develop autoimmune disease at least one year later with 126,000 of their siblings, and another million people who did not have stress-related disorders.
The study found that individuals diagnosed with a stress-related disorder
- were more likely to be diagnosed with an autoimmune disease
- were more likely to develop multiple autoimmune diseases
- had a higher rate of autoimmune disease if younger.
*Patient-years is an expression that combines how many and for how long people are assessed in a study. If the frequency of a condition is 9 per 1,000 patient-years, that means 9 people would develop the disease among ,1000 patients monitored for 1 year, or among 500 patients monitored for 2 years, and so on).
A particularly important observation was that, for those with PTSD who were being treated with an SSRI , the increased rate of autoimmune disease was less dramatic. While these observations are intriguing, they dont tell us why or how a stress-related disorder might provoke or cause autoimmune disease.
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Mental Health And Rheumatoid Arthritis: Toward Understanding The Emotional Status Of People With Chronic Disease
Ewa Mojs
1Institute of Psychology, Adam Mickiewicz University in Poznan, Poland
2Department and Clinic of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, Poland
3Department of Stomatological Surgery and Periodontology, Poznan University of Medical Sciences, Poland
4Department of Clinical Psychology, Poznan University of Medical Sciences, Poland
Abstract
1. Introduction
Chronic illness is indicated by the World Health Organization as the leading cause of premature death in the world. According to WHOs estimates, it is responsible for 63% of all fatalities . Chronic illness is defined by its slow progression and long duration, two traits which force patients to adapt to new, changed circumstances, and which affect most aspects of life, usually negatively, consequently significantly lowering health-related quality of life .
A basic problem that RA patients must cope with is pain. As the disorder advances, pain levels usually increase . The unpredictability of pain is one trait disrupting well-being patients cannot predict the end of an ongoing episode of pain nor the onset of another one. This negatively impacts the sufferers emotional state and greatly increases their negative affect.
2. Methods
2.1. Study Participants
The Relationship Between Psychosocial Variables And Neuroendocrine And Immune Mechanisms In Ra
Research clearly demonstrates links between psychosocial functioning and disease activity, and associated pain and disability in RA . Further, exacerbations and overall outcomes in RA incorporate complex interactions between psychosocial and disease-related variables . Personality, psychological stressors, threat appraisals of RA, perceived ability to cope with RA and associated pain and disability, coping strategies, and social support have been shown to be related to pain levels, disability and RA disease activity . Further, research indicates that psychosocial factors may act upon RA disease activity and associated physical adjustment through neuroendocrine and immune mechanism modulation .
Previous research indicates that psychosocial variables have complex relationships with both neuroendocrine and immune processes . However, there is a paucity of research that has examined the interrelationships between psychosocial, neuroendocrine and immune variables, and their contribution to susceptibility and exacerbation of illness, including RA. Nonetheless, findings to date suggest that psychosocial variables, such as psychological stress , appraisals , depression , beliefs in coping abilities and social support may contribute to illness by disrupting stress system hormone release, which in turn affects immune mechanisms on bodily processes, including susceptibility to and exacerbation of illnesses such as RA .
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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.
How Stress And Worry Can Affect Rheumatoid Arthritis Patients
Arthritis is an inflammatory condition that affects various joints of the body. It is not known exactly why arthritis develops, though it is known that some forms of arthritis, including rheumatoid arthritis, are autoimmune diseases. An autoimmune disease is a condition that develops when our immune system, which is designed to protect us from foreign pathogens, goes haywire and starts to attack our own body. Thus, in the case of rheumatoid arthritis, the immune system starts to attack our own joints.
The reason why autoimmune disease develops is not entirely clear, but it is speculated that external factors, including trauma or stress, can trigger the development of these diseases. One study reported that people who suffered two or more traumatic childhood events were twice as likely to develop rheumatoid arthritis compared to people who had not experienced any childhood trauma. Thus, trauma or long-term stress can lead to the develop of rheumatoid arthritis.
Additionally, researchers gathered blood samples to look at the blood profile of patients for indicators of stress and inflammation . The results of this study indicated that people who worried more also had more intense disease activity, increased inflammation and swelling of joints, and more severe pain.
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How Does A Patient Calm Down Rheumatoid Arthritis
Stress can cause rheumatoid arthritis and rheumatoid arthritis itself can also cause stress. Treatments that dont work or their side effects might affect the patients mind. Joint pain and swelling can make routine activities difficult for the patient. All these things that come with rheumatoid arthritis can make the patient stressed, which can further trigger joint inflammation.
The patient can calm down rheumatoid arthritis by following a few steps
- Take pain medications: Analgesics help a lot to relieve joint pain. Take them as scheduled as prescribed by the doctor. Make sure to drink enough water during the day.
- Use a warm or cold compress: Warm packs reduce stiffness and ice packs work on the inflamed joint.
- Go for massage therapy: Getting a massage can ease pain and relieve stress and anxiety.
Fights Stress And Rheumatoid Arthritis
Theres a relationship between stress and rheumatoid arthritis. Joint pain can cause stress and frustration.
Its also known that high levels of stress can generate a greater impact on the joints. When stressed or upset, sensitivity tends to increase. Mental stress can also cause physical stress, cramps, muscle exhaustion, and different pathologies.
Therefore, an important benefit that yoga can provide is an improvement to a persons mental state. When a person is in a better mental state, its easier to address specific issues. In other words, yoga can help a person suffering from this disease to see it in a different light.
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