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.
Stress and Arthritis: Cause and Effect
Stories abound of people who connect the evolvement of their arthritis to a stressful incident in their lives. The stressful incident (such as a car accident, death in the family, divorce, loss of job, or other personal tragedy) is regarded as the precipitating event which triggers the disease. Opinion varies on this theory because it is so difficult to prove, based on the variety of human experiences and human responses. Studies in laboratory rats have shown a definite relationship between stress and the development of arthritis. Researchers have been hesitant to formulate conclusions for humans based on the animal studies.
The quandary over implicating stress arises because stress is impossible to measure. What one person considers stressful may be considered a challenge by another person. An event is viewed as stressful based on a person's perception of the event. There are also a variety of stressors and it is difficult for researchers to assess if they all have equal impact. Even though the issue of a cause and effect relationship between stress and disease remains complicated for researchers, recent research has implied that a high level of stress can disturb sleep, cause headaches, lead to high blood pressure, heart disease, depression, and likely contribute to other illnesses.
Arthritis and Stress: 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 stressof 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 of 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.
The University of Washington, Department of Orthopedics, lists three components of a successful stress management program: learn how to reduce stress; learn how to accept what you cannot change; and learn how to overcome the harmful effects of stress.
1 - Identify the causes of stress in your life.
2 - Share your thoughts and feelings.
3 - Try not to get depressed.
4 - Simplify your life as much as possible.
5 - Manage your time, and conserve your energy.
6 - Set short-term and life goals for yourself.
7 - Do not turn to drugs and alcohol.
8 - Utilize arthritis support and education services.
9 - Become as mentally and physically fit as possible.
10- Develop a sense of humor and have some fun.
11- Get help to cope with hard-to-solve problems.
Accepting what you cannot change
1 - Realize that you can change only yourself, not others.
2 - Allow yourself to be imperfect.
Overcoming the harmful effects
1 - Practice relaxation techniques.
2 - Learn to overcome barriers to relaxation.
Corticosteroid Use and Stress
Many arthritis patients are prescribed a corticosteroid, such as prednisone, as part of their treatment plan. Without some precautionary measures, stress can be dangerous to someone taking corticosteroids. Corticosteroids are closely related to cortisol, which is a hormone produced by the adrenal glands. Cortisol helps regulate salt and water balance and carbohydrate, fat, and protein metabolism. When the body experiences stress the pituitary gland releases a hormone which signals the adrenal glands to produce more cortisol. The extra cortisol allows the body to cope with the stress. When the stress is over, adrenal hormone production reverts to normal.
Prolonged use of corticosteroids results in diminished production of cortisol by the body. With insufficient cortisol production, the body could be left inadequately protected against stress and open to additional problems such as fever or low blood pressure. Physicians often prescribe an increased dose of corticosteroid to compensate for this when there is a known or expected stressful event.