Stress and lupus
-
Upload
lupusdmv -
Category
Health & Medicine
-
view
132 -
download
1
Transcript of Stress and lupus
STRESS AND LUPUS
Howard Hauptman, MD
STRESS
2011 APA SURVEY
• MOST AMERICANS REPORT FEELING MOD-HIGH STRESS LEVELS
• 44%: STRESS LEVELS INCREASED IN PAST 5 YEARS
• 39%: OVEREAT OR EAT UNHEALTHY 2/2 STRESS
• ≥ 50%: EXERCISE IS IMPORTANT, BUT ≤ 33% WAS SATISFIED WITH LEVEL OF EXERCISE
STRESS
• A REACTION TO A STIMULUS THAT DISTURBS PHYSICAL OR MENTAL EQUILIBRIUM
• PREVENTS US FROM LIVING IN A STATE OF CONTENTMENT AND FULFILLMENT
• BOTH ACUTE OR CHRONIC STRESS CAN CAUSE ILLNESS
STRESS
• OUT OF BALANCE BETWEEN: DEMANDS PLACED ON US
V.S.RESOURCES TO DEAL WITH THEM
• GOAL: DEMANDS, R ESOURCES
DEMANDS
• ACUTE: INFECTIONS TRAUMADANGER ENVIRONMENTAL: NOISE, HUNGER…
• CHRONIC: WORK RELATIONSHIPS/FAMILYCHRONIC ILLNESS
DEMANDS
• MAJOR LIFE EVENTSDIVORCE
DEATH OF A LOVED ONELOSS OF JOB
MAJOR ILLNESS
STRESS
• GOOD VS BAD STRESS:STIMULATES SAME CHEMICALS/HORMONESFIGHT OR FLIGHT RESPONSE
• ACUTE VS CHRONIC: SUDDEN NEGATIVE CHANGES : DANGER, INFECTIONS, ENVIRONMENTAL TRAUMA: ACCIDENT, WAR, NATURAL DISASTER ROUTINE: DAILY, WORK, FAMILY PRESSURES CHRONIC ILLNESS
STRESS RESPONSE
• BRAIN: INCREASED HORMONE PRODUCTION;CORTISOL, CATECHOLAMINES,
NEUROTRANSMITTERS• HEART, LUNGS, CIRCULATION• IMMUNE SYSTEM• MOUTH, THROAT, SKIN, MUSCLES• RELAXATION RESPONSE
MECHANISM OF ACTION
CORTISOL
SIGNS OF STRESS
• DIFFICULTY SLEEPING• EASILY ANGERED• FEELING DEPRESSED• LOW ENERGY• INCREASED ALCOHOL/SUBSTANCE ABUSE• CHANGE IN EATING HABITS
STRESS AND DISEASE
• UP TO 80% OF PATIENTS REPORT UNCOMMON EMOTIONAL STRESS BEFORE DISEASE ONSET
• LINKED TO DISEASE FLARES
• UNDERLYING DISEASE CAN CAUSE INCR. STRESS
STUDIES
• BF/CBT VS CONTROLS IN SLE: LESS PAIN, IMPROVED PSYCHOLOGICAL AND PHYSICAL FUNCTION
• VACCINE STUDY: BETTER RESPONSE TO VACCINATION IN NON-STRESSED PATIENTS
• RETROSPECTIVE STUDIES: SLE,RA FIRST/RECURRENT FLARES ASSOCIATED WITH STRESSFUL PERIODS
• ?LIFETIME VS LIFESTYLE STRESSORS?
FACTORS THAT INFLUENCE THE RESPONSE TO STRESS
• EARLY NURTURING• PERSONALITY TRAITS• GENETIC FACTORS• IMMUNE DISEASES• LENGTH, INTENSITY OF STRESSORS
STRESS REDUCTION
COPING WITH STRESS
• GET PROPER HEALTH CARE• SEEK HELP: HEALTH CARE PROVIDER, FAMILY,
FRIENDS, COMMUNITY• SET PRIORITIES• EXERCISE DAILY• SCHEDULE HEALTHY/RELAXING ACTIVITIES• STRESS COPING PROGRAMS
STRESS COPING PROGRAMS
• EXERCISES: AEROBIC, YOGA, TAI CHI• MINDFULNESS BASED PROGRAMS:
MEDITATION• COGNITIVE-BEHAVIORAL THERAPY (CBT)
COGNITIVE BEHAVIORAL THERAPY
• IDENTIFYING SOURCES OF STRESS• QUESTIONING THE SOURCES OF STRESS• RESTRUCTURING PRIORITIES• FINDING METHODS TO MANAGE/REDUCE
STRESS
STRESS
• CHOICES WE MAKE:DISTINGUISH WHAT WE HAVE CONTROL OVER VS NO CONTROL!
• “OUT OF CONTROL EVENT”• MANAGING EXPECTATIONS: REALISTIC GOALS• “SMALL STEPS”