Anxiety Disorders and Stress Q 15
Mr. Bartowski who is newly diagnosed with rheumatoid arthritis asks the community nurse how stress can affect his disease. The nurse would explain that:
A. The psychological experience of stress will not affect symptoms of physical disease.
B. Psychological stress can cause painful emotions, which are harmful to a person with an illness.
C. Stress can overburden the body's immune system, and therefore one can experience increased symptoms.
D. The body's stress response is stimulated when there are major disruptions in one's life.
Correct Answer: C. Stress can overburden the body’s immune system, and therefore one can experience increased symptoms.
The stress response causes stimulation of the hypothalamic-pituitary-adrenal axis, which can further compromise an immune system that has been activated by the autoimmune disorder of rheumatoid arthritis. Consequently, the client can expect disease symptoms to exacerbate when under stress.
Option A: Research says that rheumatoid arthritis can be caused by stress. Stress triggers rheumatoid arthritis by setting off the immune system’s inflammatory response in which cytokines are released. Cytokines are chemicals that play an important role in inflammation and can increase the severity of rheumatoid arthritis in some patients. The greater the exposure to stress, the greater the inflammation becomes. This triggers a rheumatoid arthritis flare.
Option B: Around one out of five patients with rheumatoid arthritis has depression due to the illness. Depression, in turn, further aggravates rheumatoid arthritis and leads to a greater number of painful joints, reduced functioning (higher number of days in bed), and increased visits to the doctor’s clinic. All these further affect the patient’s mental health and cause more stress and depression.
Option D: Stress can cause rheumatoid arthritis and rheumatoid arthritis itself can also cause stress. Treatments that don’t work or their side effects might affect the patient’s mind. Joint pain and swelling can make routine activities difficult for the patient. All these things that come with rheumatoid arthritis can make the patient stressed, which can further trigger joint inflammation.