That’s because stress is known to worsen autoimmune diseases like RA. “Mental or emotional stress has been shown to trigger disease relapses. And stress increases blood levels of inflammatory mediators that directly contribute to pain, swelling, and tissue damage,” says Richard Bucala, MD, PhD, rheumatologist in chief at Yale School of Medicine in New Haven, Connecticut. He notes that since treatment aims to reduce these mediators, stress can actually impact the effectiveness of prescribed drugs. RELATED: The Science Behind Stress and Rheumatoid Arthritis Symptoms Of course, it’s a vicious cycle, because having a serious disease can itself produce its own level of stress. The role of this important factor in rheumatoid arthritis was discussed in three panels presented in June at the virtual congress of the European Alliance of Associations for Rheumatology (EULAR). Here are the important lessons everyone can take away from these panels.
Life Stressors Even a Year Earlier Can Exacerbate Rheumatoid Arthritis Disease
What’s New
When people with RA were asked whether they’d had a major life stressor in the past year, those who did were likely to have more severe symptoms of their disease. RELATED: What Is Self-Care and Why Is It So Important for Your Health?
Research Details
Scientists in Pakistan studied 507 people with RA in an inflammatory disease registry created there in 2019 known as PRIME. Some 36 percent of those in the study reported experiencing a traumatic psychological event within the prior year, such as divorce, a big financial loss, the death or illness of a close relative, an injury to themselves, or other similar events. When scientists analyzed the data, they found a clear association between having a major psychological stress and having more active RA disease, they reported at EULAR and published as an abstract in May 2021 in Annals of the Rheumatic Diseases.
Why This Matters
This study adds to the research confirming the link between stress and the worsening of RA disease. It also documents how that stressor may have happened a while prior — a year in some cases. The researchers concluded that stress-management techniques “may be important adjuncts to traditional pharmacotherapy” for treating the disease. RELATED: The Best Stress Busters for People With RA
Your Level of Stress at Home Is Also a Major Factor in the State of Your RA
What’s New
Home is supposed to be an oasis from the stressors of work and the world, but many people with RA say home is actually a key source of their stress.
Research Details
This study was conducted by the same group of Pakistani researchers using data from the same PRIME Registry of 507 people. As part of the registry, people were asked about the level of stress in their home. They were also assessed to detect various symptoms of their disease. The researchers then divided everyone into two groups: those with no or mild stress levels at home, and those with moderate to severe stressors. The results, presented at EULAR 2021 and published in May 2021 as an abstract in Annals of the Rheumatic Diseases, found that some 48 percent — nearly half of the sample — reported that their home stress level was moderate (nearly 30 percent) or severe (18 percent). When researchers matched up stress levels to the state of the person’s RA disease, they found those with higher levels were more likely to have disease activity and more deformed joint counts.
Why This Matters
It’s important to examine the reasons your home life may be stressful and work to improve those factors, whether that be instituting a bedtime schedule for your children, undertaking couples’ or individual therapy, or whatever is needed. RELATED: 10 Ways People With Rheumatoid Arthritis Build Resilience Doctors, too, should inquire about stressors. “This study demonstrates the need to implement adjunct therapies as part of RA treatment that include strengthening social support systems and encouraging stress management strategies,” says Betty Hsiao, MD, a rheumatologist at Yale Medicine. Not Having Social Support Is an Important, if Overlooked, Stressor Affecting RA
What’s New
Having people you can count on in your life is obviously important to happiness, but according to this research it can also improve RA symptoms and your odds of remission.
Research Details
Swedish physicians gave a questionnaire to more than 3700 people with early RA and a matched group of nearly 6000 others without the disease. They wanted to see whether having low social support in life, as well as not having decision-making power at work, might impact a person’s RA. In addition to the questionnaire, the researchers also had information from another database on most of the RA patients’ disease activity. When they compared rheumatoid arthritis disease progression with these two situations, they found that decision-making at work did not have an effect, but having low social support did, the scientists reported at EULAR and published as an abstract in May 2021 in Annals of the Rheumatic Diseases. Not having someone to count on was associated with a reduced chance for remission. This was true after three months, one year, and even five years, and was especially the case for women. Lacking this social support especially worsened outcomes in people who also had other known risk factors for increased disease, including smoking, not exercising, and being obese.
Why This Matters
It’s important for people with RA to improve all the things that might worsen their disease. Boosting a social circle to include people who will be there when you need them is one important factor, this research shows. RELATED: Psoriatic Arthritis Research: News You Can Use From EULAR 2021
