Stress is part of modern life. When we are on the threshold of a new challenge or an important event, we can experience stress mixed with excitement and a sense of challenge. This form of “good” stress, or eustress, is important for growth, development, and achievement.
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However, prolonged stress and overwhelming or traumatic events can negatively affect our health. These “bad” forms of stress – or distress – can make us sick, depressed, anxious and, in the long term, increase our risk of heart disease, stroke, type 2 diabetes, dementia and even cancer.
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Anxiety can also affect our ability to fully recover from COVID. Symptoms that continue for a month or more are called long-term COVID. Those affected may experience fatigue, brain fog, difficulty breathing, loss of taste and smell, difficulty sleeping, anxiety and/or depression. For some, these symptoms can last for many months or even years, making it impossible to return to life before COVID.
In a Harvard University study published last month, people who suffered from psychological distress before their COVID infection were more likely to experience long-term COVID. The researchers found that those with two types of distress (depression, likely anxiety, perceived stress, worry about COVID, and loneliness) had a nearly 50% higher risk of long-term COVID than other participants.
So how can anxiety affect the body’s ability to fight infection?
First, we need to look at inflammation
Inflammation is the body’s way of responding to an infection or injury.
When the immune system encounters a virus, for example, it launches an attack to neutralize infected cells and store a memory of that virus so it can respond more quickly and effectively next time.
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Many things can cause inflammation, including bacteria and viruses, injury, toxins, and chronic stress.
The body has many different responses to inflammation, including redness, warmth, swelling, and pain. Some inflammatory responses can occur silently within the body, without any of these typical symptoms. At other times, inflammation can mobilize energy resources to cause exhaustion and fever.
During inflammation, immune cells release substances known as inflammatory mediators. These chemical messengers cause small blood vessels to widen (dilate), allowing more blood to reach injured or infected tissue to help with the healing process.
This process can also irritate nerves and cause pain signals to be sent to the brain.
What does anxiety have to do with inflammation?
In the short term, stress causes the release of hormones that suppress inflammation, ensuring that the body has sufficient energy resources to respond to an immediate threat.
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However, when experienced over a prolonged period of time, the stress itself can lead to “silent” low-grade inflammation. Chronic distress and related mental health conditions, such as anxiety and depression, are associated with elevated levels of inflammatory mediators. In fact, repeated exposure to mild and unpredictable stress is sufficient to trigger an inflammatory response.
Repeated exposure to stress can produce an inflammatory response. Stacey Garrielle Koenitz Rozells/Unsplash
Preclinical (lab-based) studies have shown that chronic mild stress can lead to depression-like behavior by promoting inflammation, including activation of immune cells in the brain (microglia). When anti-inflammatories were given during exposure to mild stress, they prevented depression-like behavior. However, if given after the event, the anti-inflammatories were ineffective.
When inflammation continues, such as with prolonged periods of distress, the immune system changes the way it responds by reprogramming immune cells. Effectively, it switches to “low vigilance mode”. In this way, it remains active throughout the body, but lowers its ability to respond to new threats.
Because of this, the response may be slower and less effective. Consequently, the recovery process may take longer. For a virus like COVID, it’s possible that prior exposure to distress can similarly affect the body’s ability to fight infection and increase the long-term risk of getting COVID.
How can anxiety affect recovery from COVID?
Much remains to be learned about how COVID infection affects the body and how psychological factors may affect short- and long-term clinical outcomes.
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COVID has far-reaching effects on multiple body systems, affecting the lungs and heart to the greatest extent, and increasing the risk of blood clotting and stroke.
Because the virus resides in human cells, an immune system switched to “low-vigilance mode” as a result of psychological distress may miss early opportunities to destroy infected tissue. The virus can then gain an advantage over the defense (immune) system.
Conversely, distress can suppress the early response, tipping the scales in favor of the invader.
An immune system that has already switched to low-vigilance mode could miss early opportunities to destroy the virus. Whoislimos/Unsplash
So what can we do about it?
Vaccines work by helping to train the immune system to find the target sooner, giving the immune system a head start.
Behavioral interventions that improve the ability to cope with stress reduce inflammation and may help improve the immune response to COVID.
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It’s also important to note that exposure to COVID increases your risk of depression, anxiety, or other mental health issues. Knowledge of this bidirectional link is a critical first step to improving clinical outcomes.
A lifestyle medicine approach that helps reduce anxiety levels and treat mental health symptoms has important benefits for physical health. This is likely not only to be the result of direct effects on the immune system itself, but also through related improvements in health behaviors such as diet, exercise and/or sleep.
More research is needed to better understand the impact of distress on the immune system, mental health, and outcomes of COVID, and to highlight ways to intervene to prevent long-term COVID and support recovery.
Susannah Tye, Group Leader, Queensland Brain Institute, University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Also read | How unhealthy is red meat? And what is the benefit of eating vegetables?
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