STREEEEEEEEEESSSSSSSSS.....A question.

[ouchyk]

Hi,

Stess is suppose to be bad for psoriatics such as ourselves, and a good question was asked by a fellow member at the conference.

If stress is suppose to lower our immune systems making our p/pa worse ( I know it does for me )...then why are we taking immuno-surpressants?

Why doesn't stress work in our favor instead of against us? Is stress triggering the wrong part of our immunity?

Just thought I would fling this out there...lol.

I asked another member last night and she had a good answer, hoping she'll see this and post her thoughts.

Be well,
Karen

[RichJ]

hi karen,
i know my work stress yesterday made my pain alot worst and made me feel cranky. i hope you will find the answer to your ?. i can't help much but i can share so stress storys :D

have a good night my friend

richard

[ouchyk]

Yeah,

I hear ya Rich! I think I tense up every muscle in my body when I stress out which doesn't help my pain factor...

Calgon, take me away lol

Karen :)

[RichJ]

hi karen,
i agree to. just seen on tv was the leader of isreal had a storke or some thing. i hope he will be ok.

have a good night my friend

richard

[alli]

Karen,
I don't have the answer to your question....I'm just going to put out another question....How about us psoriatics who don't think stress is a factor in their condition? I read so much about stress and flares on this board and I have a hard time understanding what people are referring to.
My P just progressed each day/month/year till it became severe. I never cleared, I never had a remission. I went through some real stress, it didn't get worse. I took time off from life and went sailing for a few months...it didn't get better.
I don't know that stress is even a factor for me.

[ouchyk]

Alli,

Good point!

There was a lot of talk by a dermatologist that I went to see at the conference who pointed to the stress factor in psoriasis and psoriatic arthritis and ways to alleviate it. It was interesting and inspiring, however left Carol asking me that question...

I guess it's the same with the " trigger " theory, I don't know if I ever had one...

Complex immune systems!

Karen :)

[docmks]

Hi,

Stess is suppose to be bad for psoriatics such as ourselves, and a good question was asked by a fellow member at the conference.

If stress is suppose to lower our immune systems making our p/pa worse ( I know it does for me )...then why are we taking immuno-surpressants?

Why doesn't stress work in our favor instead of against us? Is stress triggering the wrong part of our immunity?

Just thought I would fling this out there...lol.

I asked another member last night and she had a good answer, hoping she'll see this and post her thoughts.
Be well,
Karen

WOW! What a great set of questions. I wish you all were enrolled in my classes! When Karen and I were chatting last night these questions came up and I gave a "shoot from the hip" answer. I've been thinking about them ever since, since they relate to several of my passionate interests. What we call the "mind-body connection" is so much better understood than it once was, and to really get to the heart of these questions you need to talk about the physiology and psychology of stress and how it affects the immune system.

But before I give an entire doctoral dissertation, let me give the short answers to the questions first:

If stress is suppose to lower our immune systems making our p/pa worse ( I know it does for me )...then why are we taking immuno-surpressants?

Why doesn't stress work in our favor instead of against us? Is stress triggering the wrong part of our immunity?

1) Let's review what's screwed up about the immune system in PA/P and "why we are given immuno-suppressants".
In brief, stress triggers a cascade of responses that involve the interaction of the central nervous sytem, endocrine system and immune system.
In PA and P we have too much of a kind of a pro-inflammatory cytokine in our connective tissues, like our skin, tendons, bones. This proinflammatory cytokine is called Tumor Necrosis Factor alpha (TNF-alpha). It is a protein found in cells of the immune system and their job is to stimulate inflammation (part of the body's normal response to too much insult or injury). We have too much TNF-alpha, therefore we get an exaggerated response (too much inflammation)! So it is in our makeup to have too much of these proteins that are involved in stimulating inflammation.
When the body is stressed by something physiological or psychological or both, a cascade is initiated: the brain picks up the stress and stimulates the production of chemicals that are designed to help the body cope with the stressor. The chemicals that are involved are norepineprine, epineprine, and cortisol. Cortisol is a major player here in what we call the "fight or flight" response and cortisol acts to decrease not only TNF alpha but it supresses all T-cell mediated immune responses. In other words, it is acting to counterbalance the inflammatory response (and other kinds of immune system responses as well).
YOu may ask, why is this beneficial? That's a good question and from what I can tell, scientists are not entirely sure. Increased cortisol levels have important effects on the production of glycogen, and on the secretion of glucose, this has been interpreted as fueling the body with the energy needed to fight off a stressor (to react to stress). Cortisol is also involved in mobilizing other important chemicals needed to respond to stress including amino acids and fatty acids. SO basically, cortisol is acting to bring about a dynamic steady state (homeostasis) in the face of a stressor, by mobilizing the appropriate chemicals and supressing others.
Long term stress, or very traumatic episodes, can lead to supression or depletion of neurochemical transmitters like serotonin, which is involved in the etiology of depression (among other things).
I'll probably think about other things that I want to add or clarify. I hope this is clear! Please let me know if it's not, and I'll try to explain it better.

Take care all
MK

[docmks]

I forgot to answer Alli's question in my last post. I think that it has to do with our variation in terms of our response to stress. The chemicals that transmit signals in our brain (neurochemical transmitters) like serotonin and dopamine help modulate our response to stress. There is a lot of individual variation here; some people get very depressed in reaction to chronic stress. This in turn will exacerbate physical symptoms (create more inflammation). Others do not show as extreme fluctuations in moods. There are some definate genetic mechanisms at work here. I suspect genetic mechanisms play a role in why your P and/or PA is less susceptible to bouts of stress. Does this make sense? I hope so! If not, I'll try to explain it better.

MK

[Ihurt]

Our immune systems DO get triggered by stress because they OVER REACT, and it physically hurts us. I always compared the effects of stress on the body to ROTor corrosion on our vehicle from being exposed to the elements of bad weather.

To answer the other part of the question which pertains to why we are on IMMUNO SUPPRESSANTS, it's because the immuno suppressant (biologics) are desinged to go after the TNF (Tumor Necrosis Factor) BIND TO IT, and pull it away from the joints and SKIN it trys to attack (because it's confused). This is the function of Remicade, Enbrel and Humira. Methotrexate is a chemotherapy drug which has another use as an anti inflammatory. It reacts to the proteins in our body.

So in lamens terms, WE cannot afford to get stressed, even good stress takes a bad toll on us because our chemicals rush.. I know for myself I always suffer the effects of a "CHEMICAL RUSH/STRESSFUL RESPONSE either a day or two later, sometimes a week later depending on how my adrenaline is pumping. That fight or flight resoponse can bottom me out for days later. In my case, I know for a concrete fact that long term stress (abusive childhood, bad marriage, etc) played a major part in my now confused immune system. Yes, genetically my body was PRE disposed because psoriasis ran on my father's side of the family, and yes Psoriasis is genetically linked to be stronger from father to daughter (my father has P), but I think what triggered the active disease was my stress level. In fact Im conviced, because I know what was happening in my life for the preceeding years.

Ihurt

[cgauton]

Really great answers.
What is not mentioned is that originally stress was important in that it gave us energy to escape preditors. We still react as we have for generations but do not burn off the extra energy etc. that builds in our systems.

To expand the debate further has anyone tried Yoga or one of the eastern relaxation "regimes" to help with stress and by implication PA/P

[ouchyk]

Hi,

I tried tai chi and was a total spaz at it, ( two left feet ) I did find the meditative breathing part of it relaxing but it didn't have any effect on my PA one way or another as far as I could tell.

Karen

p.s. I'd like to try yoga sometime.