Stress and Chronic Eye Pain

A dear friend sent me this link to note the reality of how stress can trigger unwanted cascades of inflammation. 

Many patients I see are under enormous amounts of stress. Why some patients can adapt while others have severe consequences likely depends on multiple factors from severity of the stress to family support to genetics to even diet and sleep factors. 
The fact that stress is a factor in many diseases states is without question. 
The real question is what can we do to avoid the potential consequences of stress. 
Additionally measuring objectively stress aside what one “feels” about stress is a little more tricky. Measuring stress hormones and blood pressure and heart rates are one option but that is riddled with confounders (ie does drawing blood or measuring blood pressure increase stress hormones and blood pressure: yes). 
Everyone needs to find their path to managing stress. 
The top 10 options in my view are as follows:
1. Cognitive Behavioral Therapy: this has been used for years. Optimal Work is a great program. 
2. Exercise: at least 10,000 steps has been shown to help with many health issues. 
3. Diet: low inflammatory diet is likely a good thing. 
4. Sleep: being sure 8hrs of uninterrupted sleep is a good goal. 
5. Meditation and prayer. My personal favorite is daily mass and weekly confession. 
6. Friends and Family: it is important to stay connected to friends and family. This can be  a major de-stressor in most cases. Many patients under stress, though, tend to hide in their black holes only to add to their stress and anxiety. 
8. Support Groups: this is also very helpful. 
9. Psychological/Psychiatric therapy and Medications: sometimes this is a must. 
10. Vacations: a must. Not a staycation but a go away real vacation. This helps put things in perspective and helps one see the global picture. A family favorite is helping at the Mustard Seed program of orphaned Jamaican children in Jamaica. 
Maybe this should be #1!

Stress as a trigger of autoimmune disease.

Review article

Stojanovich L, et al. Autoimmun Rev. 2008.


The etiology of autoimmune diseases is multifactorial: genetic, environmental, hormonal, and immunological factors are all considered important in their development. Nevertheless, the onset of at least 50% of autoimmune disorders has been attributed to “unknown trigger factors”. Physical and psychological stress has been implicated in the development of autoimmune disease, since numerous animal and human studies demonstrated the effect of sundry stressors on immune function. Moreover, many retrospective studies found that a high proportion (up to 80%) of patients reported uncommon emotional stress before disease onset. Unfortunately, not only does stress cause disease, but the disease itself also causes significant stress in the patients, creating a vicious cycle. Recent reviews discuss the possible role of psychological stress, and of the major stress-related hormones, in the pathogenesis of autoimmune disease. It is presumed that the stress-triggered neuroendocrine hormones lead to immune dysregulation, which ultimately results in autoimmune disease, by altering or amplifying cytokine production. The treatment of autoimmune disease should thus include stress management and behavioral intervention to prevent stress-related immune imbalance. Different stress reactions should be discussed with autoimmune patients, and obligatory questionnaires about trigger factors should include psychological stress in addition to infection, trauma, and other common triggers.

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