A recently published study in the Journal Rheumatology sheds light on the intricate connection between autoimmune diseases and mental health. Contrary to common perception, the impact of autoimmune diseases extends beyond physical health and can significantly affect mental well-being. The study reveals that over 50% of individuals with autoimmune diseases also experience symptoms of depression and anxiety. To gain a deeper understanding of this phenomenon, we spoke with Dr. Sanjay Garg, a mental health specialist at Fortis Anandapur in Kolkata.
The Interplay Between Autoimmune Disease and Mental Health
Autoimmune diseases involve the immune system mistakenly attacking the body’s healthy cells and tissues, leading to inflammation and damage. Dr. Garg explains, “Autoimmune disorders can manifest with a range of symptoms such as pain, fatigue, nausea, headache, as well as mental health issues like depression, anxiety, and even dementia.”
The research conducted a comparison between 1853 patients with Systemic Autoimmune Rheumatic Diseases (SARDs), 463 control groups, and 289 clinicians. The findings indicated that 55% of SARDs patients currently experience depression, while 57% reported anxiety. Notably, many individuals with autoimmune diseases hesitated to disclose their mental health problems or seek assistance due to fears of stigma. Those who did express their concerns often felt ignored or experienced a lack of documentation of their symptoms.
Barriers to Addressing Neuropsychiatric Symptoms
The study identified several barriers that hindered the recognition of neuropsychiatric symptoms:
- Limits in knowledge, guidelines, objective tests, and interdisciplinary collaboration.
- Subjectivity, invisibility, and credibility of symptoms.
- Underreporting, under-eliciting, and inadequate documentation.
Unveiling the Prevalence of Autoimmune Diseases
A Lancet study unveiled that 10% of the global population, with 13% of women and 7% of men, grapple with autoimmune diseases. Thus, comprehending the link between these conditions and mental health becomes paramount.
Dr. Garg elaborates, “There is a growing awareness that mental illnesses originate in the brain, arising from various damages and malfunctions, often accompanied by neuroinflammation.”
Impact on Brain and Mental Health
Autoimmune disorders can inflict damage on brain regions such as the orbito-frontal cortex, anterior cingulate gyrus, and dorsolateral prefrontal cortex—critical components influencing mental health. The inflammation and swelling caused by these disorders can lead to conditions like depression, anxiety, psychosis, and cognitive impairments.
Dr. Garg underscores that the risk of mental health issues in individuals with autoimmune disorders can range from 25% to 80%, potentially including a significant risk of suicide. This risk isn’t confined to adults; even children, as in the case of PANDAS (Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infection) after a throat infection, can be susceptible.
Strategies for Coping with Mental Health Challenges
Addressing mental health struggles associated with autoimmune disorders involves implementing simple yet effective strategies, including:
- Enhancing social support systems.
- Adopting a balanced diet.
- Engaging in regular exercise.
- Seeking help early to prevent long-term consequences.
Depending on the individual’s condition, medications like antidepressants, mood stabilizers, antipsychotics, anti-anxiety drugs, or even steroids may be recommended. Dr. Garg highlights the importance of family education and psychotherapy, whether supportive or cognitive-behavioral, to assist both patients and their families in coping with distress. Ongoing research aims to uncover a clearer understanding of the intricate relationship between autoimmune diseases and mental health.
