What Type of Trauma Potentially Leads to PTSD or Other Problems?
PTSD can be caused by a combination of intense traumatic experiences — physical, sexual, or emotional abuse, domestic violence, war experiences, assault, major accident, life-threatening occurrences — familial history of anxiety and depression, and how your brain reacts to the chemicals and hormones your body releases in reaction to stressful events, according to the Mayo Clinic. The research team looked at 106,464 patients in Sweden who had been diagnosed with stress-related disorders between 1981 and 2013 and compared them with 126,652 of their siblings and nearly 1.1 million individuals who did not suffer from stress disorders. This was strictly an observational study, so researchers were not able to adjust for other factors that may relate to the findings.
What The Researchers Learned About People With Autoimmune Diseases
Results: The study found that more than one-third of autoimmune diseases in the exposed population may be associated with a stress-related disorder, reports reports lead author Huan Song, MD, PhD, of the Center of Public Health Sciences at the University of Iceland in Reykjavík, and the department of medical epidemiology and biostatistics at the Karolinska Institutet in Stockholm, Sweden. The research was done at the Karolinska Institutet. The study found evidence supporting a causal link between stress-related disorder and autoimmune disease:
Clear time-order relationship; stress-related disorder leading to autoimmune diseaseExposure (in form of PTSD, or with co-occurred psychiatric comorbidities) leads to increased risk of outcomeThe treatment for the exposure ensued reduced risk of having the outcome. (For example, persistent use of SSRIs lessened the risk of autoimmune disease.)
Many People Experience Traumatic Events, Are at Risk for PTSD
Trauma and trauma survival may be more common than you think. About 70 percent of American adults have experienced a traumatic event, and about 20 percent of them go on to develop PTSD as a result, according to the nonprofit PTSD United. That translates into around 7 to 8 percent of Americans having PTSD at some point in their lives, and about 8 million adults having it in any given year, according to the National Center for PTSD.
More Study of Severe Stress and Autoimmune Disease Link Is Needed
Causality in health sciences is only established by pooling results from several different studies — no single study is a sufficient proof. Future studies are needed for further understanding of the underlying biological, and, potentially, behavioral mechanisms. “Although we demonstrated a robust association between stress-related disorder and autoimmune diseases, as [this is] an epidemiological study, we have limited capability to explore potential causal biologic mechanisms linking stress-related disorders to autoimmune diseases. Further studies are needed to understand the underlying mechanism. Nevertheless, our study represents the most solid evidence to date for the association between severe stress reactions in humans and subsequent risk of autoimmune disease,” says Dr. Song.
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 (HPA) 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.”
