Caring for Yourself and Reducing the Stress

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Caring for Yourself and

Reducing the Stress

For many people with lupus, the disease

isn't a major illness. But for some, it's a serious condition.

Recognizing when your symptoms are getting worse and

knowing how to treat them can reduce your chance of permanent tissue or organ

damage. Early treatment can also reduce the time you spend on higher doses of

medications, which can cause serious side effects. Working with your doctor and

taking medications only as prescribed is important.

Because ultraviolet light can trigger a flare, use

sunscreens with a sun protection factor (SPF) of at least 15 and avoid tanning

beds even if your symptoms don't include skin problems. You should avoid being

in the sun when it is at its strongest, 10 a.m. to 3 p.m.

In addition, managing lupus means taking good general

care of yourself. You can take the following steps to improve the function of

your immune system:

Get

adequate rest and regular exercise.

Don't

smoke. Smoking increases your risk for cardiovascular disease and can

worsen the effects of lupus on your heart and blood vessels.

Limit

alcohol. Alcohol can affect your liver, kidneys, heart and muscles, and

may interact with your medications.

Eat a

healthy, low salt, low saturated fat balanced diet.

Take

vitamin and mineral supplements after consulting with your doctor.

If

you're a woman with lupus and are considering pregnancy, seek medical

counseling to determine what steps you can take to ensure the safest

possible pregnancy. Planning and preparing for pregnancy can help reduce

risks to you and your baby.

Regular

aerobic exercise to build up endurance, and rest as needed.

Avoidance

of both physical and emotional stress which may cause flare-ups.

Get

enough sleep. You may be able to get by on 8 hours a night, or you may

need more.

Plan

for additional rest periods throughout the day, as needed.

Do not

exhaust yourself.

Getting

enough rest does not mean no activity at all. A well designed exercise

program is important to maintaining strength, endurance, and overall

fitness.

Every

week, make a simple plan of your work and activities. The plan can help

you organize the events of your life and ensure that you have a good

balance of rest and activity.

Each

day, review your plan and decide if you are physically up to the

activities for that day. Be flexible; if you don't have the strength to do

an activity today, do it another time.

Don't

try to complete a large task or project all at one time; divide it into

several steps.

Dealing

with stressful issues and problems takes a lot of energy. If you

feel stressed out, talk with your doctor or nurse. They may be able to

provide you with help for your problem or direct you to someone else who

can.

Join a

Lupus Support Group .. You are not alone in this disease and the support

you will receive from fellow Lupus survivors will keep your stress level

to a minimum.

Stress And Lupus

By: Dr. Craig Hassed, M.D.

" The

mind in addition to medicine has powers to turn the immune system around. "

Jonas Salk

There is presently an enormous explosion of research in how

stress affects the body. A lot of this research focuses on how the mind effects

the immune system. The technical term for this field of study is

psychoneuroimmunology, or PNI for short. PNI has major implications for

autoimmune and inflammatory conditions like arthritis and lupus. Immune cells

or White Blood Cells are like the body's defense system and they are

continually patrolling the body.

Anything which they see' as self they will leave alone,

and anything which looks foreign they will destroy. The problems occur when the

WBCs do not destroy the things which they should, like infections and cancer

cells, or destroy tissue which they shouldn't, like joints as in rheumatoid

arthritis and lupus. These latter sort of conditions we call autoimmune because

the immune system is turned against the self.

The communication between the mind, through the brain and

on to the immune system takes place via nerves, which are like the hard-wiring , and through hormones and

chemicals called neuro-transmitters which are like a blood-borne postal

system. The immune cells also send messages back to the nervous system,

especially the part of the brain concerned with emotion. Thus we are finding

out about the complicated mechanisms which explain how it is that thought and

emotion have such a powerful effect on illnesses.

It has been well shown that when a person is chronically

stressed, anxious or depressed that the immune system works poorly. Like

people, when stressed we tend to over-react, under-react, become inefficient

and make mistakes. When we are happy, focussed and at peace with ourselves then

we work better and the immune system also works more efficiently and makes

fewer mistakes. It is as if the body is mirroring what happens in our minds.

The mechanisms are infinitely complex but the principle is simple: a healthy

and happy mind is fundamental for a health body. As Marsilio Ficino, a great

philosopher, once said:

" The

body is the shadow of the soul. "

If we are stressed then inflammatory conditions like

lupus, asthma, rheumatoid arthritis or dermatitis can be aggravated. Rheumatoid

arthritis (RhA) is very similar to lupus but unfortunately less research has

been done on lupus than RhA. Nevertheless PNI research has shown many

interesting findings. For example, in stressful situations some people will

actually be shown that their immune systems work better. This is because stress

only has a negative effect on the body depending on how we see the situation.

If we have learned to cope well, stay calm, keep things in

perspective, keep optimistic and not make `mountains out of molehills' then

stressful life-events have very little negative effect on the body. However, if

we have very poor ways of coping with stress then even small events can cause

major problems. So, the important message is that every investment in coping

with stress better seems to protect us from the negative effects of illness.

Either we don't get sick when we otherwise would, or if we do get sick we do

not get as sick.

Lifestyle factors also influence immune function. Healthy

behaviors like exercise, managing stress, getting enough sleep, eating balanced

meals, not smoking, eating breakfast, and working moderate hours were all

associated with better immune function. Stress and depression also make a

healthy life-style more difficult to maintain and effective stress management

makes it easier to make healthy changes.

It would seem that meditation promoting better mental

health, a positive attitude, good social supports and humor are all powerful in

improving the function of the immune system. As previously said, autoimmune

diseases are where the immune system attacks healthy tissue as if it were

foreign, in other words it sees self

and not-self.

In genetically `at-risk' individuals the immune cells may

have previously encountered an invader like a virus or antigen which the immune

cells mistakenly thinks looks similar to healthy tissue. In such cases the

immune system gets fooled in a case of `mistaken identity'. Exactly how the

emotional state can effect this process of immune recognition is not clear. PNI

offers potential to start to explain some of the triggers and aggravating

factors for autoimmune conditions.

To illustrate, a recent study of rheumatoid arthritis

patients found that stress in the prior week was clearly associated with

increased inflammation, pain and disease activity. Lupus is also significantly

affected by stress. The authors conclude that, " comprehensive treatment of

SLE requires management of life stress. " There are other studies but

unfortunately it is easier to attract funding for studies into new drug

treatments than it is into the softer' areas of science.

One innovative study, however, did test the therapeutic

potential of stress reduction benefiting the disease by examining journal

writing as a form stress release. Patients with moderate to severe asthma and

rheumatoid arthritis were randomized into two groups. Both groups had usual

medical care but one was given the exercise of writing in a journal for three

consecutive days about the most stressful event in their lives.

Four-month follow-up showed that the group that kept the

journal had significantly fewer symptoms and reduced disease activity.

Interestingly no psychotherapy or processing the events was required to produce

the benefit. Other inflammatory conditions such as psoriasis have also been

shown to be amenable to meditation in helping this skin condition to clear more

quickly when combined with orthodox medical treatment.

Elsewhere it has been shown that in the treatment of the

inflammatory condition called dermatitis combining relaxation therapy,

cognitive behavioral therapy, and an education program with standard medical

care lead to significant improvements in the condition and a reduction in the

need for steroids. All these psychological treatments were superior to

education alone or standard medical care.

Contact the Lupus Foundation of America or the local

Chapter that serves your area for more information about lupus, or the programs

and services the LFA offers including support group information and physician

referral.

Hugs,

Deanna

LUPUS Serenity

Prayer...

Lord, grant me the serenity to accept the things I cannot

change, the courage to change the things I can, and the wisdom to hide the

bodies of doctors I shot when they said, You're perfectly healthy, it's all in

your head "