What role does psychological stress play in systemic lupus erythematosus?

Multiple observational studies in people with SLE report an association between perceived stress and disease severity, such that increased stress exacerbates SLE symptoms.^[1][2][3] While the mechanisms behind this connection are complex, stress induces changes in the central nervous system that may ultimately lead to immune system activation.^[4] In people with SLE, this immune system activation is problematic, as it can spark the autoantibody “self-attack” that causes SLE symptoms. A stressful event, like exposure to trauma, may even be the environmental trigger that first provokes an SLE diagnosis.^[5]

Considering the relationship between stress and SLE, it is important for people with SLE to find positive ways to manage their stress. This could include an exercise program,^[6][7] a mindfulness practice,^[8] social support,^[9] behavioral therapy,^[10][11] or another individualized approach.