The Effect Stress Can Have On CF Symptoms

Identifying triggers for an infection flare-up has been a minefield I am still learning to navigate healthily. We have all heard psychological stress weakens the immune system. When we are stressed, we are more likely to pick up a cold. When we are anxious, we sleep less or miss meals, which lowers our immune defense.¹ You see, there is an obvious picture here.

Yet, living with cystic fibrosis meant identifying stress as a trigger fell way to the bottom of the health hierarchy ladder. I was too busy avoiding flu season, juggling hospital stays, and managing hours of grueling treatment that I had little space for other “real-life” stress. Heck, life was already stressful enough.

How much of an effect does stress really have?

Back in 2012, I unexpectantly lost my Mum to a fatal heart attack on a family vacay. Within 6 weeks, I caught influenza A for the first time in my entire life. I spent a month on oxygen in the hospital. A month after that I started to grow the ultimate CF nemesis, Mycobacterium Abscessus (NTM) alongside my other chronic lung infections.

That year I lost my backbone, my life as I knew it, and the battle to keep my lungs healthy. My pulmonary function permanently slid down the “lung health” scale by about 25%. In one swift hit my lungs and my mental health were shot to pieces.

Asking the wrong questions

I questioned how I caught the flu? Or, how I caught M. Abscessus? Where did I pick them up? Was it my fault? Had I missed one too many nebs on a bad day? I spent hours, days, weeks ruminating over the same thoughts, but not once did I ask myself, “Is this a side effect of the stress I was enduring?"

Side effects of psychological stress

The relationship between emotional stress and physical illness is a complex one. Some studies have proven that short-term stress can boost the immune system.² The fight or flight response helps us to initiate bronchodilation, meaning our airways are forced open. That happens because our prehistoric brain is preparing to face or flee a perceived threat. Perhaps a large dinosaur?

But, what about the effects of long-term chronic stressors that are not dinosaurs? Everyday worries - they pose quite a problem. A 2003 study carried out on the effects of long and short-term stress on airway inflammation found that between 20% and 35% of subjects with asthma experience asthma exacerbations during periods of stress.³

The paper concluded:³

"It is possible that the major effect of repeated stress is to exacerbate the chronic inflammatory response. In humans, this may translate to increased long-term damage of the airway and gradual deterioration in function through remodelling of airways.

CF-related arthritis and CF gut can be attributed to increased inflammatory response driven by stress too. There is wealth of scientific evidence exploring the effects psychological tension can have on gut function.^4-6

In recent years, many medical studies have been carried out examining the gut-brain connection with an emphasis on the enteric nervous system which aids digestion. Any stress on this nervous system can cause gut dysfunction.⁷

My cystic fibrosis symptoms that flare from stress

I found the most recognizable symptom of "stress flu" are chest tightness and wheeze. Alongside that, I have the obvious tight muscles, increased cough, chronic fatigue, headaches, sinus inflammation, and tummy upsets. Once these symptoms flare, it increases the pressure to stay well and that plays into my worry meter. This vicious cycle needed an antidote.

Looking for the "stress flu" antidote

It is impossible to completely avoid psychological stress, but learning to recognize the powerful effect it can be having on my physical health was the first step to finding an interim antidote when life got a little crazy.

Yes, I have bad weeks which feel completely out of my control. However, the internal battle is still very much within my grasp. On those bad weeks when life just is not going my way – I make sure I sit the “stress flu” at the top of my cystic fibrosis trigger pyramid.

I focus on all those self-care tips that help after a long day: a hot bubble bath, a change of scenery, meditating a little longer, an early night, leaning on a friend, a yoga class, making lists, keeping a diary, or going for a walk.

Most importantly, I give extra time and attention to my everyday CF treatments to avoid the snowball effect stress can inevitably have on my lungs, gut, and overall cystic fibrosis symptoms.