The connection between Post-Traumatic Stress Syndrome (PTSD) and SLE may be linked to how trauma affects the body's stress response systems. Chronic stress, which can be a hallmark of PTSD, may lead to systemic inflammation that can contribute to the development of SLE.
In addition, the chronic and unpredictable nature of lupus, along with the physical and emotional toll it takes, can be a significant stressor. In particular, patients who suffer a severe life threatening lupus flare, especially if a prolonged hospital admission is needed could lead to PTSD symptoms. It's a two-way street; lupus can trigger PTSD, and PTSD can, in turn, affect lupus disease activity and flares.
Studies indicate that people with PTSD may have a significantly higher chance of developing lupus and other autoimmune rheumatic disorders. When contrasted with women who had not experienced trauma, women with PTSD were found to have nearly three times the risk of having lupus.
What is PTSD?
Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after a person has experienced a traumatic event, or a series of traumatic events. It's characterised by persistent, distressing symptoms that can impact a person's ability to function in daily life.
Symptoms of PTSD
PTSD can manifest in a variety of ways. Symptoms can include intrusive memories, avoidance behaviours, negative changes in thoughts and mood and heightened arousal and reactivity (being easily startled and or feeling tense, on guard, or on edge), flashbacks, nightmares (also difficulty getting to sleep/staying asleep), difficulty concentrating, engaging in risky, reckless, or destructive behaviour, severe anxiety and irritability (angry or aggressive outbursts).
PTSD can worsen lupus symptoms
• Increased inflammation: Chronic stress and PTSD can increase levels of stress hormones (like cortisol) and pro-inflammatory cytokines, which may exacerbate lupus disease activity.
• Flare-ups: PTSD and stress are known lupus triggers.
• Poorer outcomes: People with PTSD may have more trouble following medical regimens, increasing disease complications.
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PTSD Treatments
PTSD can be overcome with the right support and treatment. While it's true that PTSD symptoms can be persistent and affect daily life, various therapies and medications are effective in managing and reducing PTSD symptoms.
Psychotherapy (Talking Therapy)
• Cognitive Behavioral Therapy (CBT): This helps people challenge negative thoughts and reframe traumatic memories. For lupus patients, CBT can also include education on pain management and coping skills.
• Trauma-focused therapies like EMDR (Eye Movement Desensitisation and Reprocessing) have been shown to help reduce PTSD symptoms.
Medications
• SSRIs/SNRIs (like sertraline, venlafaxine): These can reduce PTSD symptoms and help with depression and anxiety, which are common in lupus.
• Sleep medications: PTSD often causes sleep issues and better sleep can improve lupus flares.
Stress-Reduction Strategies
• Mindfulness-based stress reduction (MBSR): Studies suggest that meditation and mindfulness practices reduce lupus related stress and improve mental well-being.
• Relaxation techniques (like deep breathing, progressive muscle relaxation) can decrease sympathetic nervous system activity, which may reduce inflammation and help control lupus flares.
Untreated Post-Traumatic Stress Disorder (PTSD) can lead to a decline in various aspects of life, including mental and physical health, relationships and overall well-being. It can also worsen existing mental health issues and increase the risk of developing new ones, such as depression, anxiety and substance abuse so it’s important to seek professional medical help.
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There’s a clear link between PTSD and lupus, with both physical and psychological factors at play. If you’re managing lupus and suspect PTSD symptoms, seeking advice from a mental health professional alongside your rheumatologist can be very helpful. While the link between PTSD and SLE is strong, further research is needed to fully understand the underlying mechanisms and how to prevent or manage these conditions.
Professor David D’Cruz says “For many years, there has been a consensus that stress can aggravate symptoms of lupus and other autoimmune rheumatic diseases. The recent research summarised here, confirms not only that stress can cause lupus flares, but that PTSD not only increases the risk of lupus flares but in otherwise healthy people, PTSD can increase the risk of developing lupus. This research will be very helpful for patients with SLE and also for healthcare professionals who manage lupus patients.”
Further reading:
Research papers:
The link between post-traumatic stress disorder and systemic lupus erythematosus.
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Angie Davidson
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