The Intersection of PTSD and Autoimmune Disease Risk: Understanding and Empowering Wellness

Based on Publication by Vladimir Hedrih on February 28, 2020
Publication reviewed by Devon Frye

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A recent study (Boggs Bookwalter et al., 2020) has brought to light a concerning association between Post-Traumatic Stress Disorder (PTSD) and the elevated risk of developing autoimmune diseases. These findings contribute to a growing body of research highlighting the intricate connection between PTSD, stress, and physical well-being.

In a prior study, Song et al. (2018) scrutinized data from over 100,000 individuals diagnosed with stress-related symptoms. Astonishingly, their research unveiled that individuals diagnosed with stress-related symptoms were significantly more prone to developing autoimmune conditions compared to those without such diagnoses, a year down the line.

PTSD and the Risk of Autoimmune Diseases in U.S. Military Personnel

The latest study delved into the correlation between PTSD and the likelihood of developing autoimmune conditions, including rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel diseases, and multiple sclerosis, among U.S. active-duty personnel. Participants were drawn from the Millennium study cohort, which aimed to investigate the health consequences of military service during the years 2001, 2004, 2007, and 2011. This cohort comprised approximately 120,572 individuals who were in active duty at the time of the baseline survey and had not received prior diagnoses of autoimmune conditions.

Study participants were categorized into two groups: those with PTSD and those with other mental health conditions (excluding PTSD). The baseline findings revealed that 8 percent of males and 9 percent of females had been diagnosed with PTSD. Interestingly, both male and female participants with a PTSD history were more likely to have previously experienced other mental health conditions, combat exposure, or physical and sexual trauma. Combat exposure was more prevalent among males, while sexual and physical trauma were more common among females (p. 3).

The study’s findings indicated that U.S. military personnel on active duty with a history of PTSD faced an increased risk of developing autoimmune conditions, with an average time span of approximately five years between the baseline assessment and follow-up. Notably, the risk for developing autoimmune diseases was approximately 60 percent higher among personnel with a history of PTSD compared to those without such a history (p. 3).

The study authors posit that the biological changes occurring in individuals with PTSD, and potentially those experiencing high levels of stress, influence the immune system by triggering heightened inflammation, activating genes, and expediting the emergence of immune cells (p. 6). Collectively, these factors suggest a link between PTSD, stress, and autoimmune conditions, which appears consistent among both combat survivors and individuals who have experienced physical or sexual trauma.

Stress, the Gut, and Autoimmunity

Ongoing research into the gut microbiome offers insights into the mechanisms that underlie the reported associations between PTSD and autoimmune disorders. The gut is now recognized as the habitat of a vast microbiome, encompassing bacteria, viruses, pathogens, and fungi, all of which engage in complex interactions with the brain. When this intricate balance is disrupted, the consequences can be profound. Factors such as dietary choices, changes in bodily chemistry, and more can tip the scales in favor of certain organisms over others.

One critical outcome is the deterioration of the gut lining, commonly referred to as “leaky gut.” In this compromised state, the intestinal walls no longer provide an effective barrier between the microbiome within and the rest of the body. Toxins and bacteria can infiltrate these weakened walls and enter the bloodstream.

This sequence triggers an immune system response, including inflammation, which can breach the blood-brain barrier and manifest as various mental health symptoms. In some cases, the body’s immune response goes awry, leading to autoimmune diseases.

Once an autoimmune response has been erroneously initiated, even minor exposures to the initial triggering factors – such as viruses, infections, environmental toxins, stress, or trauma – can reignite inflammation. Werbner et al. (2019) suggest that stress contributes to alterations in gut activity, provoking immune responses that may include the body mistakenly launching an attack against itself.

The latest findings contribute to an expanding body of evidence with significant implications for mental health practitioners, educators, and patients. There is a growing call to explore the biomedical origins of inflammation and autoimmune responses as potential root causes of mental health symptoms.

References:

Bookwalter, D. B., Roenfeldt, K. A., LeardMann, C. A., Kong, S. Y., Riddle, M. S., & Rull, R. P. (2020). Posttraumatic stress disorder and risk of selected autoimmune diseases among US military personnel. BMC Psychiatry, 20(1), 23.

Song, H., Fang, F., Tomasson, G., Arnberg, F. K., Mataix-Cols, D., de la Cruz, L. F., … & Valdimarsdóttir, U. A. (2018). Association of stress-related disorders with subsequent autoimmune disease. Jama, 319(23), 2388-2400.

Werbner, M., Barsheshet, Y., Werbner, N., Zigdon, M., Averbuch, I., Ziv, O., … & Koren, O. (2019). Social-Stress-Responsive Microbiota Induces Stimulation of Self-Reactive Effector T Helper Cells. mSystems, 4(4), e00292-18.