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Acute stress can enhance immune function whereas chronic stress suppresses it (McEwen, 2000). Chronic stress produces cardiovascular reactivity, immunologic, and endocrinologic alterations (Kiecolt-Glaser, Malarkey, Cacioppo, & Glaser, 1994) and can negatively affect functional and structural changes in the brain (McEwen, 2000) and increase immune activation in patients with PTSD.
For example, it is well known that stress can trigger autoimmune diseases such as rheumatoid arthritis and that people with PTSD are at higher risk for autoimmune function (Boscarino, 2004). In these cases, the body’s immune system becomes hyperreactive, reflecting another level of systemic overreaction to perceived threat after the traumatic events have passed. People with PTSD have increased levels of inflammatory markers and increased reactivity to antigen skin tests (Pace & Heim, 2011).
The separation of nonhuman primate offspring from their mothers (grief) results in suppression of the immune system (Cohen, 1994). Widows and widowers are also found to be more susceptible to illness during the first year of the loss of their spouse. By contrast, high levels of social attachment behaviors appear to be protective against immunosuppression (Cohen, 1994).
Culture Factors, Stress, and Immunity
The Covid-19 pandemic and Climate Change contribute to disasters, and other global shifts and changes. This requires that the trauma clinician include social and environmental stress as causes of PTSD, which affect all aspects of individual and community function and that induce extensive losses. Addressing loss and grief as a result of disasters is central to coping and surviving with trauma.
Environmental disasters are multi-focal and not easily addressed in the short or long term (Goldstein, Osofsky, & Lichtveld, 2011). The mental and physical health effects of the stress of environmental contamination on Akwesasne Mohawk Indian land persist (Papadopoulos-Lane, 2010) and interact with historical trauma. The Exxon Valdez oil spill in Prince William Sound, Alaska in 1989 ruined traditional fishing grounds and food sources for Alaska natives and non-natives alike. Hurricane Katrina struck the southeastern USA in 2005, displacing thousands from their homes.
The effects are felt for years and often generations. The Deepwater Horizon Oil spill of 2011 affects ways of life with bodies, lands, seas, and wildlife exposed to neurotoxins. Its effects on health arising from traumatic stress experiences are amplified by the effects on immune function of actual exposure to chemicals, biological, and waste products that occurred following the nuclear accident at Chernobyl in Ukraine, the Gulf War, and the inhalation of toxic fumes and air by rescue workers following 9/11.
These effects are further exacerbated by the delays or denial of the reality of exposure by government officials that affect victims. Of the psychological and physical trauma of radioactive exposure at the Hanford nuclear reservation, which was built on Yakima Indian land, Russell Jim director of the environmental restoration project says:
During the fifty years of Hanford’s operation, especially when the Columbia River was highly contaminated by the reactors, the site managers knew full well that tribal people were being poisoned. But they simply ignored their own data and considered us to be expendable”
(R. Jim, personal communication, September 12, 2004).
Self-care includes supporting brain health and immune function as an important part of the health plan for all communities. This stress can be chronic and persist for years during attempts to receive reparations or clean-up that are often inadequate. PTSD is not limited to residents of these locales. First responders, both residents and visitors, are also vulnerable to high rates of secondary trauma.
You might also like this course Integrative Medicine and Nutrition for PTSD, Complex Trauma, and Traumatic Brain Injury. 30 CE credits are included.
References
Bivona, G., Agnello, L., & Ciaccio, M., The immunological implication of the new vitamin D metabolism. Central-European journal of immunology, 43(3), 331–334.
Boscarino, J. A. (2004). Posttraumatic stress disorder and physical illness: Results from clinical and epidemiologic studies. Annals of the New York Academy of Sciences, 1032, 141–153.
Cashman, K.D. Vitamin D Deficiency: Defining, Prevalence, Causes, and Strategies of Addressing. Calcif Tissue Int 106, 14–29 (2020).
Charoenngam, N.; Holick, M.F. Immunologic Effects of Vitamin D on Human Health and Disease. Nutrients 2020, 12, 2097
Cohen, S. (1994). Psychosocial influences on immunity and infectious disease in humans. In R. Glaser & J.K. Kiecolt-Glaser (Eds.), Handbook of human stress and immunity (pp. 301–319). San Diego, CA: Academic Press.
David O Meltzer, Thomas J Best, Hui Zhang, Tamara Vokes, Vineet Arora, Julian Solway med Rxiv 2020.05.08.20095893.
Goldstein, B.D., Osofsky, H.J., & Lichtveld, M.Y. (2011). The Gulf oil spill. The New England Journal of Medicine, 364(14), 1334–1348.
McEwen, B.S. (2000). The neurobiology of stress: From serendipity to clinical relevance. Brain Research, 886(1–2), 172–189.
Pace, T.W., & Heim, C.M. (2011). A short review on the psychoneuroimmunology of posttraumatic stress disorder: From risk factors to medical comorbidities. Brain Behavior and Immunity, 25(1), 6–13.
Papadopoulos-Lane, C.A. (2010). Cognitive appraisals, stress, and emotion about environmental contamination in the Akwesasne Mohawk Nation [Doctoral dissertation]. Albany, NY: State University of New York.
She served as a Fulbright scholar on traditional medicine, a Clinical Fellow at Harvard Medical School, and a National Institutes of Health-funded research scientist in mind/body medicine.
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