03/14/2016
The Immune System: The Mind-Body Connection
Who Gets Sick and Who Stays Well
Presented by Margaret E. Kemeny, Ph.D. from UCSF
2/26/16
I attended this class in February and summarized some of the presentation here.
Freud in 1916 wrote that the body and the mind are both biological processes with two different perspectives. This belief fell out of favor for decades. Recently, this belief has had a resurgence.
Psychoneuroimmunology connections:
There are bidirectional linkages between the CNS (Central Nervous System), endocrine system and the immune system. During stress, the cortex, limbic system and hippocampus (memory) signals to hypothalamus. In turn the hypothalamus releases ACTH that activates the pituitary gland to produce cortisol (a stress hormone).
Stress triggers increase immune response AND inflammation. For example, say you cut your finger (stress), the immune systems responds along with an inflammation increase to fight infection. Once the trauma abates, you want the inflammation to decrease because too much (i.e., chronic inflammation) causes autoimmune/inflammatory diseases (e.g., arthritis, lupus, diabetes, MS, ulcer, etc).
Meta-analysis (300+ studies)
Stress and Immune Response is dependent on time frame:
Acute stress (minutes and hours) enhances the immune system.
Short-term stress (days) suppresses the immune system.
Long-term stress (months/years) suppresses the immune system.
Initially, stressors can trigger higher levels of cortisol that could lead to depression and other problems; e.g., metabolic syndrome (heart disease, diabetes, abdominal obesity, low HDL, high blood pressure). More distant traumas may result in an inadequate cortisol response that could result in inflammatory or autoimmune disease.
Too little cortisol reactivity can impair the ability of this system to constrain inflammation in the body, since cortisol is the body’s own anti-inflammatory.
Cortisol levels have a circadian variation. High levels of cortisol can result in lower immune system response and low levels of cortisol can result in increased inflammation .
Chronic stress can reduce effectiveness of a vaccine. If you are going to get a vaccine, get it when you are not stressed or wait until you are less stressed.
Chronological (your age) aging can be significantly different from biological aging. Biological age is measured by the length of DNA telomere (the cap at the end of the DNA) length.
Chronic stress (even if it is perceived stress) is associated with shorter telomeres. On average, chronic stress can accelerate the shortening of telomeres leading to a biological age over a decade beyond your chronological age. Good news is that cardiovascular exercises can significantly lower the correlation of stress and telomere length.
Low social status triggers cortisol (stress hormone) response. Perceived stigma will affect ANS (Autonomic Nervous System) reactivity (even if the stigma is not true). In other words, misperceptions can drive physiological responses. One study has shown that by “acting happy” or “acting sad”, actors could trigger an immune response.
Depression and Increased inflammation are correlated. Is it causal? Which direction?
Injection of pro-inflammatory cytokines can cause depressive symptoms.
Immune system can affect your emotions.
Possible implications: 1) some individuals’ depression might be due to inflammation 2) use aspirin to treat depression? (not tested yet) 2) depressed patients should be checked for inflammation diseases.
Subjects with greater stress and lower subjective social status were more likely to develop colds. The objective stress is not a factor. In other words, death of a spouse would be a high objective stress but subject can perceive this as a low subjective stress.
For cancer patients, many studies have shown better outcome (e.g., mortality, progression, relapse, etc) with psychological interventions. One simple intervention is to write about your trauma (the theory is that writing is one of the simplest forms of developing awareness).
Similar findings were demonstrated with HIV patients. Many studies have been published on the helpfulness of psychological interventions prior to the advent of anti-retroviral medications.
The class reported on many studies that have demonstrated better physical health as a result of taking care of the mind.
TO DO’s:
C Reactive Protein (CRP) Test measures your pro-inflammation vs anti-inflammation balance, which will indicate risks for cardiovascular disease. Good to ask your doctor for this test annually.
Reminders to do basic self care:
1) Eat healthy - mostly plant diet; avoid processed food
2) Take daily multi-vitamins but avoid mega-vitamins, mega-fortified food, and super supplements.
3) EXERCISE 20 mins a day (e.g., brisk walking). The biggest reduction in mortality occurs when transitioning form being totally inactive to moderately active.
4) SLEEP at least 7 hours per night (less than 6 hours show increase mortality)
5) Drink coffee. A recent (2016) study with large cohorts (close to a 100 thousand), show that people who drink 1-5 cups a day live longer than those who don’t drink coffee
6) Practice psychological well being - surprise? After all, the class was on Mind-Body connection.
A) Find MEANING in life
B) Pursue SOCIAL CONNECTIONS - humans are social animals
C) Engage in PSYCHOTHERAPY
D) MEDITATE / practice MINDFULNESS
Find meaning from trauma. While traumatic experiences can lead to negative emotions, research indicates many can have a very positive response: rearrange priorities, find new meaning, spiritual change, deepening relationships, etc. Many believe we cannot live fully without fully confronting death.
A meta-analytic review (2010) of Mindfulness-based Therapy on Anxiety and Depression (39 studies totaling 1,140 participants) found that mindfulness is effective for improving anxiety and mood symptoms.
A Meta-analysis in 2013 of mindfulness based therapies (209 studies) found that mindfulness is effective and superior to psychoeducation, support, relaxation, etc.
A Meta-analysis in 2014 (17,801 citations) found that meditation programs reduce negative stress, anxiety and depression and are comparable to the use of anti-depressants.
Meditation has been found to affect humans at the molecular level. Two studies have demonstrated that meditation shifted gene expression profiles in leukocytes away from an inflammatory gene profile. Gene expression can be influenced by meditation.
We all face adversities due to the nature of impermanence. Mindfulness will help us wake up to this insight.
Chinese Proverb (Lao Tzu): thoughts lead to words to actions to habits to characters to destiny. In other words, it starts with thoughts. Practice being aware of your thoughts through mindfulness practice.
