Psychoneuroimmunology describes the study of interactions between the brain and the immune system (Danes & J Lewis, 2016). Initially, the two were thought to be independent, however over the past few decades, incredible insights have surfaced regarding the numerous ways in which stress influences immunity.
Psychological stress, defined as pressure and challenges on physical and mental well-being that exceed coping abilities, has been found to impair immune responses when the stress is chronic and enhance when it is acute (Schedlowski, 1996). Specifically, this occurs through changes in a type of white blood cell: lymphocytes. Lymphocytes’ neutralization potential—the rate at which lymphocytes neutralize pathogens— and proliferation rate—the rate at which lymphocytes multiply—are compromised when stress levels are high for a prolonged period of time (WHO). At the molecular level, hormones in the blood increase due to stress, and these hormones attach to receptors on white blood cells, thus disrupting immune activity. Since stress results from a variety of means, there is no definitive way to determine what causes hormonal spikes in the blood.
On the other hand, with acute stress, a study was conducted with 39 skydivers, 24 males and 15 females, to analyze blood samples before, during and after high-stress stimulation that these researchers considered to be acute (UCSD). From an evaluation perspective, testing on trained skydivers might not be representative of how the average person’s immune system would react to acute stress. Nevertheless, it was found using computational tools that white blood cells’ messenger RNAs changed to respond to the acute stress and shortly returned to baseline (UCSD). Hence, the danger with chronic stress is that these genetic changes could become permanent and indefinitely impair functions of white blood cells (ZACHARIAE, 2009). It seems to be that different types of stress exhibit varied extents of influence, whether that be exam stress, familial stress, or career stress. Research is continuously pursued to understand the effects of types of stress, especially eustress and distress. One could hypothesize that eustress would have equivalent effects to acute stress because the magnitude of distress is much greater in causing physiological damage. Emotional regulation happens to be a possible solution to how much stress affects the immune system. By being resilient and calm regarding plausibly stressful matters, one would be able to eliminate any such immunosuppression.
A direct example of a stress-mediated inflammatory skin disease proves that the nervous system, to some extent, controls the immune system: atopic dermatitis. The clinical occurrence of this disease rests on the level of psychological stress; certain activations in the brain due to stress directly affect immune cells situated near the skin. Therefore, neuronal receptors and mediators begin to alter inflammatory responses under the skin (Suárez). Based on this and other similar examples of nervous system and immune system interactions, researchers concluded the extensive codependence of the two.
A meta-analysis considered 30 years worth of research concludes that acute stress enhances immune activity but chronic stress decreases the same (Segerstrom, 2004). Regardless, it is significant to address limitations in all those studies, ranging from low sample size, spurious interpretation of what may be considered acute and chronic, testing stress levels, confounding variables, lack of only independent variable manipulation due to some uncontrollable factors, and the extent to which each study in this analysis answers the primary question: how does stress affect the immune system?
Considering the aforementioned codependence of the two systems, one could potentially argue that this would eventually lead to psychological assistance being used as treatments for infections and physiological disorders. As further research in this area emerges, it impels one to wonder if psychotherapy, which generally helps with stress, could be a possible solution to bacterial and viral infections. Understanding in such intricate treatment plans could be the future of an overlapped amalgamation of psychiatry and psychology.
References
Danese, A., & J Lewis, S. (2016, September 15). Psychoneuroimmunology of early-life stress: The hidden wounds of childhood trauma? Nature News. Retrieved October 23, 2022, from https://www.nature.com/articles/npp2016198
UCSD, Moments of acute stress can cause molecular alterations in immune response. UC Health - UC San Diego. (n.d.). Retrieved October 23, 2022, from https://health.ucsd.edu/news/releases/pages/2016-03-01-acute-stress-and-immune-response.aspx
Schedlowski, M., & Schmidt, R. E. (1996). Stress und Immunsystem [Stress and the immune system]. Die Naturwissenschaften, 83(5), 214–220.
Segerstrom SC, Miller GE. Psychological stress and the human immune system: a meta-analytic study of 30 years of inquiry. Psychol Bull. 2004 Jul;130(4):601-30. doi: 10.1037/0033-2909.130.4.601. PMID: 15250815; PMCID: PMC1361287.
Suárez AL, Feramisco JD, Koo J, Steinhoff M. Psychoneuroimmunology of psychological stress and atopic dermatitis: pathophysiologic and therapeutic updates. Acta Derm Venereol. 2012 Jan;92(1):7-15. doi: 10.2340/00015555-1188. PMID: 22101513; PMCID: PMC3704139.
WHO. (n.d.). Who | world health organization. WHO. Retrieved October 23, 2022, from https://apps.who.int/iris/bitstream/handle/10665/326983/WH-1994-Mar-Apr-p4-5-eng.pdf
ZACHARIAE, R. O. B. E. R. T. (2009). Psychoneuroimmunology: A bio-psycho-social approach to health and disease. Scandinavian Journal of Psychology, 50(6), 645–651. https://doi.org/10.1111/j.1467-9450.2009.00779.x
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