Autoimmune Disease and Mental Health

Physical Toll and Emotional Strain

Autoimmune diseases often present with unpredictable flare-ups of symptoms. The unpredictability can lead to feelings of anxiety and a sense of loss of control over one's life. Moreover, the physical discomfort or pain associated with many autoimmune conditions can create stress, which in turn can exacerbate mental health issues like depression and anxiety. Chronic pain, common in autoimmune diseases, is known to have a strong association with depression.

Fatigue and Cognitive Symptoms

Many individuals with autoimmune conditions report significant fatigue, which can be both physically and mentally draining. This fatigue can affect cognitive functions such as memory, attention, and processing speed, a phenomenon sometimes termed "brain fog." Such cognitive difficulties can lead to frustration, reduced self-esteem, and feelings of inadequacy, further impacting mental well-being.

Social Isolation and Stigma

The physical limitations imposed by autoimmune diseases can limit social interactions. Activities once taken for granted may become challenging, leading to social withdrawal. Additionally, because many autoimmune conditions are "invisible illnesses"- meaning symptoms might not be overtly apparent to others - patients may face misunderstanding or lack of empathy from friends, family, or colleagues. This can lead to feelings of isolation or perceptions of stigma, which can further contribute to mental health issues such as depression.

Treatment Challenges

The treatments for autoimmune diseases, including corticosteroids and other immunosuppressive drugs, can have side effects that influence mood and cognition. For instance, corticosteroids are known to cause mood swings, irritability, and even depressive or manic episodes in some individuals. Recognizing and managing these side effects is crucial for the overall well-being of the patient.

The Mind-Body Connection

The relationship between autoimmune diseases and mental health bidirectional. Just as the physical symptoms of autoimmune conditions can impact mental health, stress and mental health conditions can influence the course of autoimmune diseases. Stress, for example, is known to be a potential trigger for flare-ups in certain conditions. That being said, it's important not to overstate our understanding of the mind-body connection when we talk about autoimmune disease and anxiety disorders. How one triggers the other and whether or not stress or anxiety can actually cause an autoimmune disease is still the subject of research and not well understood.

However, the intricate interplay between mind and body highlights the importance of a holistic approach to patient care. Integrating psychological support with physical treatment can offer a more comprehensive strategy. Techniques such as cognitive-behavioral therapy, mindfulness, and stress-reduction practices can be invaluable adjuncts to conventional medical treatments.

The implications of autoimmune diseases on mental health can be profound, which highlights the inseparable connection between the physical and the psychological. Recognizing and addressing the mental health challenges faced by those with autoimmune conditions is not only essential for their psychological well-being but might also influence the course and prognosis of the autoimmune disease itself. As our understanding of these interrelationships grows, and it needs to, it underscores the need for integrated care models that address both the body and the mind.

Importantly, Lupus, rheumatoid arthritis, Type 1 diabetes, and multiple sclerosis tend to be higher among minority groups, and this needs to be taken strongly into consideration when providers assess the need for mental health care services among these often under-served populations.

Learn More About Autoimmune Disease and Mental Health

• Is There a Link Between Mental Health and Autoimmune Diseases? at GoodRx Health.
• New Study Found People with Autoimmune Diseases Underreport their Mental Health Status at the Lupus Foundation - Lupus.org.
• How does autoimmune disease affect our mental health? from the Autoimmune Registry (August 31, 2022)
• Understanding the Psychoemotional Roots of Immune Disease from the Institute for Functional Medicine.
• Autoimmune Diseases information on MedLinePlus.gov.
• What Are Common Symptoms of Autoimmune Disease? on Johns Hopkins Medicine.
• Autoimmune Diseases from Cleveland Clinic.

Sources

• Autoimmune disease and stress: Is there a link? at Harvard Health.
• For Those With Autoimmune Diseases, Mental Health Is Often Overlooked at Health.com.
• The Emerging Link Between Autoimmune Disorders and Neuropsychiatric Disease in the Journal of Neuropsychiatry and Clinical Neurosciences, 2011 Fall; 23(1): 90–97.
• Experts call for urgent mental health support for people living with long term autoimmune diseases at the University of Cambridge (26 Jul 2023)
• Prevalence and identification of neuropsychiatric symptoms in systemic autoimmune rheumatic diseases: an international mixed methods study Rheumatology, Volume 63, Issue 5, May 2024, Pages 1259–1272.
• Autoimmune Diseases and Severe Infections as Risk Factors for Mood Disorders - A Nationwide Study at JAMA Psychiatry, August 2013.
• Minorities, Autoimmune Disease and Mental Health at the Autoimmune Association's website (Autoimmune.org)