I was listening to a podcast a few weeks ago and the guest was talking about the physiology of our fight-flight-freeze response and how it can specifically relate to certain chronic illness. The guest used the following examples: lupus as being the fight response, and CFS/ME as being the freeze response. I had never thought of it this way and it made me interested in this topic. (The podcast is called Therapy Chat if anyone is interested but I can’t remember the specific episode number, sorry!). Fight-flight-freeze is also known as the stress response, which is a product of evolution that kept our species alive for a long time, however, if you ask many people with chronic illnesses (especially autoimmune diseases) you’ll have a lot of people tell you about chronic stress, trauma history, and attachment issues, all of which can dysregulate our stress response. Usually this occurs in childhood, and I can specifically remember 5 years where I had chronic stress (at school only, due to a traumatic friendship).
I’m going to try to explain the stress response in the easiest, most non-technical way possible (because honestly my eyes glaze over when I have to read about brain anatomy, and I’m guessing I’m not alone in that). So there are a few different parts of our autonomic nervous system, most notably the sympathetic nervous system (fight and flight) and our parasympathetic nervous system (freeze). There is also our vagus nerve which is really important in understanding the nervous system but I’ll leave polyvagal theory for another time. Sympathetic activates us to either fight or run away in order to survive, whereas the parasympathetic suppresses everything in order to keep our bodies alive when we can’t fight or flight. The problem is that when our stress response is chronically activated, it can impair our physical and mental health. I want to put a caveat here for the rest of this post, correlation does not mean causation, however, most theories do point to chronic stress as being causation (at least partially – biopsychosocial approach) for a lot of illnesses.
I think it’s also important to talk about stress-related disorders, because they tend to also be diagnosed in people with autoimmune diseases. Examples include acute stress disorders (same symptoms as PTSD but only lasting between 3-30 days), posttraumatic stress disorder (which most people seem to have a basic understanding of), and adjustment disorders (occurs during major life changes). Attachment disorders can also contribute. One study I looked at found that people with a stress-related disorder were more likely to not only develop an autoimmune disease, but to actually be diagnosed with multiple ones, and had a higher rate of them if they were younger when having the stress-related disorder.
Let’s talk about chronic stress – when our stress response is activated for a long period of time (i.e., daily stress as opposed to one major stressor) – because a lot of research has been done in this area. Here is a bunch of things that chronic stress can do:
- contribute to high blood pressure
- contribute to anxiety, depression, OCD, anorexia nervosa, and substance use disorder (and withdrawal)
- contribute to obesity (increase appetite, leading to weight gain)
- suppress or dysregulate immune function (leading to inflammatory disorders and hyperactive immune systems such as in RA and lupus)
- suppress the reproductive system
- suppress growth in children (lots of studies of children in orphanages)
- digestive problems
- switch off disease-fighting white blood cells, increasing risk of cancer
- worsen symptoms in lupus patients
- contributes to malnutrition
- contributes to poorly controlled diabetes
- contributes to hyperthyroidism
So that’s a lot. I mentioned ME/CFS as the beginning of this post as well, which is associated with the physiological state of freeze, as examined by metabolic changes. Some research indicated that people with ME/CFS are “wired,” meaning a combination of both the fight/flight and freeze responses, leading them to feel wired and tired at once. I hope this gives you some understanding of what is going on with you if you have any of the illnesses mentioned in this post. Understanding is one thing, but what can we do to help ourselves, especially if we are in a chronic stress response? While there is no right answer, there are definitely things we can try (and a bunch have worked for me!)
- Deep breathing (into the diaphragm) – for many people this lowers stress (it sometimes increases anxiety for me, so I personally find it more effective to do mindful breathing)
- visualizations and guided imagery – try this one out.
- Prayer – this is a mindful activity that many people find helpful
- Yoga and Tai Chi – mindful movement can be very grounding – listen to this podcast episode about it.
- Walking (and other forms of exercise) – for many people this lowers the stress response, for some people it can increase it due to heart rate increases
- Journaling – you have to like to write/journal for this one but it can be helpful to get your thoughts out of your head
- Biofeedback – this is a technique in which you can learn to control some of your bodily functions (i.e., heart rate)
- Progressive Muscle Relaxation – try this one out.
- Massage – I personally find massages to be both relaxing and therapeutic
- Acupuncture – there is research showing it helps with both stress and chronic pain
- Social Support – from friends, family, colleagues, support groups (in person or online), and pets!
Hopefully that gives you a few ideas for how to lower your stress response. Keep making the most of it!