How Your Mental Health is Affecting Your Immunity
Updated: Oct 7, 2020
...And what you can do about it
If you're anything like me, you may from time to time be called out for being too much of a "hippie" by certain friends and colleagues, particularly when I start proselytizing about the benefits of bone broth, composting, or organic food. Thought I do admit to having my crunchy-leaning tendencies, I always make sure to back up these claims with actual science. So it was no different when I started thinking about the body-mind connection in terms of immunity - especially during 2020 when so many people's mental health has been taking a beating.
It's not uncommon to hear anecdotal stories or well-meaning, homespun advice from people touting a mind-body connection between mood and sickness. At one end of the spectrum it is that one friend who always claims that they get sick whenever they finally take a few days off, because their body "knows it can shut down and deal with all the built-up stress from work". On the other rather extreme and heartlessly victim-blaming end, there are those who even claim that having "bad thoughts and emotions" causes cancer. So, clearly, there is a lot of chaff surrounding the topic of mental health and immunity, but I was curious to find out if there was any real grain of truth behind all the anecdotes that are bandied about. And it turns out that there is a whole discipline precisely dedicated to figuring that out...
Psychoneuroimmunology (PNI) is the study of the interaction between psychological processes and the human nervous/immune systems. Basically, it asks whether the way that people feel is affecting their biology.
Can your mental state influence how vulnerable you are to certain disease? And, inversely, can it impact your ability to recover from them?
Dr. Steve Cole, Professor of Medicine and Psychiatry and Biobehavioral Sciences at the UCLA School of Medicine, is just one researcher working at the forefront of PNI, by looking at broad patterns of gene expression in cells, using genome-wide transcriptional analysis. He first started working in this area in the early 2000's, when it was shown that HIV-positive gay men, who were open about their sexuality, died at significantly slower rates than their closeted counterparts, because their immune systems were more vigorous.
Throughout the course of his research he has found that negative mental states, like loneliness and stress, as well as negative life experiences, like cancer, trauma, low socioeconomic status (SES), and depression, guide the immune system's ability to function, by affecting a wide range of gene expression programs.
But How Does it Work?
It seems that the mediating factor between all of these negative experiences and your immune system's functioning is inflammation. Usually, inflammation is another one of those subjects that has to be read-up on critically - otherwise you end up being told to douse yourself in turmeric for no real good reason. But inflammation is in fact a very real process, by which the body's immune system fights against infections, injuries and toxins, by releasing proteins and antibodies, and increasing blood flow to any affected areas. Acute inflammation, used in short bursts to heal the body, is great, but the problem arises when the response carries on and inflammation becomes chronic, leaving individuals' immune systems in a long-term, hyper-alert state.
Over time, it is this chronic inflammation that can have a negative impact on health outcomes, and, unfortunately, the negative life experiences discussed above are associated with increased activity of inflammation genes in immune cells. For instance, in his study on loneliness, Dr. Cole found that socially isolated people are significantly more vulnerable to viruses and bacteria, due to the damage caused by chronic inflammation. In essence, (perhaps due to our evolutionary need to be in cohesive social groups) our minds perceive loneliness as a lethal threat, and our body responds as it does with medical threats, which is to ramp up its inflammatory response. Therefore, while inflammation isn't itself the illness, it makes it easier on a molecular level for disease to take hold, and it has been shown to impact the development of illnesses such as cancer, atherosclerosis, and Alzheimer's, amongst others discussed below.
The Bad News
The bad news is that work-related stress, financial instability, and loneliness - three life experiences that have become ubiquitous in 2020 - have been shown to negatively affect people's physical health. For instance, the Whitehall studies (epidemiological studies that have been following civil servants in Britain since the 1960's) have shown that chronic work stress increases the risk of type 2 diabetes, as well as the risk of coronary heart disease. The work of virologist Dr. Ronald Glaser, former director of the Institute for Behavioral Medicine Research, also demonstrated, through the use medical students' blood samples, that during stressful exam periods immune cells were less active and that more Epstein-Barr antibodies were created, meaning that their immune systems had been compromised. Evidence also shows that stress can increase HIV/AIDS's rate of progression, while low SES increases susceptibility to a variety of infectious diseases. Likewise, chronically lonely people have been shown to suffer significantly more from metastatic cancer and heart disease, and they are at increased risk of stroke and Alzheimer's. Lonely working-age adults are 25% more likely to die prematurely, and lonely older adults die at twice the rate of those who have strong social support systems.
The Good News and What You Can do
The good news is that we can flip all of this on its head for our benefit: just as those bad life experiences can negatively affect our physical health, amplifying our happiness can actually serve to make us healthier.
The question, of course, is how can immune cells possibly gauge a concept as abstract as happiness?
In this case, we aren't talking about hedonic happiness (achieved through experiences of material pleasure and enjoyment), but about eudaimonic happiness, which we get through meaningful experiences and by cultivating a sense of purpose. Dr. Cole was able to measure subjects' levels of eudaimonic happiness and found that those with higher happiness scores also had more favourable genetic profiles with regards to antiviral responses and lower levels of inflammatory response. (While those with just high hedonic happiness scores had profiles similar to subjects who were facing adversity.) While it is not yet known exactly why this is the case, the theory is that eudaimonia seems to be able to mediate between negative life experiences and our immune system, minimizing the sense of threat and uncertainty we feel and, therefore, improving our physical health.
Two studies, which looked at carers and lonely adults, respectively, found that taking part in meditation courses positively shifted subjects' white blood cell gene-expression profiles. In fact, research into meditation, in particular, has linked it to better functioning in specific strains of immune cells, increased positive antiviral response, higher antibody production, and negative inflammatory activity. Similarly, taking part in a 10-week stress management course was linked to the downregulation of genes associated with metastasis and inflammation amongst women with early-stage breast cancer.
Meditation and stress-management techniques are just two factors, which can increase our eudaimonic happiness, and they are great activities to perhaps start with when looking to increase this area of psychological wellness. But ultimately, every person's senses of meaning and purpose in the world may be most strongly fostered by a myriad of their own unique preferences and callings. For some, that might be through charity work, travel, religion, social relationships, or intellectual activities. The list is long and idiosyncratic. So it is truly up to each of us to reflect on those things that bring us the most joy and closest to our ideal selves.
If you are interested in learning more, or feel like any of the issues discussed above resonated with you, feel free to contact me directly!
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