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Can Trauma Cause Sjögren's Syndrome?

Updated: Jun 21

Trigger warning: trauma, PTSD, grief, loss, discussion of sensitive and emotional topics. Please be aware that we will be discussing sensitive and emotional topics that could potentially be triggering or upsetting.

Have you ever wondered if your Sjögren's symptoms could be tied to past traumatic or stressful experiences?

Many people with Sjogren's have noticed that their symptoms first appeared after a traumatic experience or period of intense stress. In this blog, we’ll explore the connection between trauma and Sjogren's in a down-to-earth way. We'll share our experience working with clients, dive into the latest research on how trauma might impact autoimmune conditions like Sjögren's, and uncover the potential mechanisms behind this link. Finally, we'll discuss practical strategies and offer some hopeful solutions to help you manage both trauma and your Sjögren's symptoms.

Our experience with clients

Over the years, we've listened to countless stories from our clients with Sjögren's, and a common thread often emerges: pain, loss, and trauma. Many have shared that their symptoms began during or after intense periods of stress or traumatic experiences.

But it’s not just about how their symptoms started. Ongoing stress or revisiting past traumas can trigger flare-ups, making their Sjögren's symptoms worse.

It's clear from many client stories that trauma deeply affects the immune, hormonal and nervous systems, and can play a significant role in the development and progression of autoimmune conditions like Sjögren's.

But what does the research say about this connection?

What the latest research says about Sjogren's and trauma:

Recent research, like the 2024 study by Hsu et al., has looked into how trauma might link with Sjögren's syndrome. They followed 5,237 people over nine years to see how autoimmune diseases, including Sjögren’s, developed (Hsu et al., 2024).

Here’s what they found: People with a history of PTSD were significantly more likely to develop autoimmune conditions. In fact, they were six times more likely to develop Sjögren’s compared to those without PTSD. The study also noted that these individuals had nearly three times the risk of developing other autoimmune issues like thyroiditis or lupus.

And it gets even more interesting: The severity of PTSD symptoms played a big role too. The more intense the PTSD symptoms, the higher the risk of developing conditions like Sjögren’s. So, as PTSD symptoms worsened, the chances of developing autoimmune diseases increased accordingly.

This research underscores how deeply our mental health and immune system are connected, especially when it comes to trauma and conditions like Sjögren's.

Hsu et al.'s study, while among the most comprehensive on the connection between Sjögren's syndrome and PTSD, echoes findings from other research. Studies by Boscarino (2004), O'Donovan et al. (2015), and Song et al. (2018) have also highlighted how traumatic experiences can affect immune function and raise the risk of autoimmune diseases.

Types of traumatic experiences 

In our experience of working with clients with Sjögren’s, these are the most common traumatic and/or stressful experiences we have observed:   

  • Bereavement and Loss: The death of a loved one can be an incredibly stressful and emotionally traumatic experience. Grieving the loss of a close family member or friend may lead to chronic stress, which has been linked to immune system dysregulation and can be the mechanism behind the onset of autoimmune diseases.

Woman placing flowers on a grave
The death of a loved one can often be traumatic

  • Chronic Stress and Adversity: Persistent stressors such as financial difficulties, relationship problems, or work-related stress can take a toll on both physical and mental health. Chronic stress has been associated with increased inflammation and immune dysfunction, which may contribute to the onset or exacerbation of autoimmune conditions like Sjögren's syndrome.

  • Physical Trauma or Injury: Traumatic events such as accidents, injuries, or surgeries can trigger an immune response and inflammation in the body. In some cases, the immune system may become dysregulated following physical trauma, leading to the development of autoimmune disorders.

  • Emotional Trauma and Abuse During Childhood or Adulthood: Experiences of emotional trauma, including abuse, neglect, or other forms of interpersonal trauma as a child or as an adult can have long-lasting effects on both psychological and physical health. Trauma survivors may be more susceptible to chronic health conditions.

  • Major Life Changes or Transitions: Significant life events such as divorce, relocation, job loss, or retirement can be sources of stress and upheaval. Adjusting to major life changes may trigger physiological responses in the body, including changes in the immune system, which could influence the onset or progression of autoimmune diseases.

From our observations, experiencing one or more of these stressors often correlates with intensified Sjögren's symptoms. But why could this be?

Understanding How Trauma Increases the Risk of Autoimmune Conditions

While researchers continue to explore the exact mechanisms linking trauma to autoimmune diseases, recent studies have identified several pathways based on the latest findings:

1. Chronic Inflammation and Immune Dysregulation

PTSD triggers a prolonged stress response that profoundly affects the body's inflammatory and immune systems. Individuals with PTSD often show elevated levels of inflammatory molecules created by immune cells called cytokines, such as interleukin-6 (IL-6), interleukin-1β (IL-1β), and tumor necrosis factor-alpha (TNF-α).

And although these molecules play a crucial role in normal immune function, if persistently elevated they can lead to chronic and ongoing inflammation in the body, which in turn can lead to the development of autoimmunity.

2. Altered Adrenal Stress Response

The function of the adrenal gland, which regulates the body's stress response and impacts both immune and digestive function through cortisol release, is frequently disrupted in PTSD. This dysregulation results in abnormal cortisol levels, impacting inflammation and immune function.

Lower, higher, or irregular cortisol levels are common in PTSD, impairing the body's ability to regulate immune responses effectively, and also can contribute to fatigue as well as magnifying other Sjögren's symptoms such as digestive issues and pain processing.

3. Autonomic Nervous System Alterations

PTSD can affect the autonomic nervous system, which is the part of the nervous system that controls automatic bodily functions. Increased activity in the sympathetic nervous system and decreased activity in the parasympathetic system are typical. This imbalance can heighten inflammation and compromise immune function, fostering conditions favorable to autoimmune diseases.

Additionally, the glands that secrete tears, saliva, digestive fluids are all controled by the parasympathetic nervous system, and are disabled to a degree by sympathetic nervous system activity, thereby exaccerbating any dryness and digestive issues caused by the autoimmune process.

4. Interactions Between Emotions, the Nervous System and the Immune System

Research increasingly demonstrates extensive communication between the nervous and immune systems (psychoneuroimmunology). In PTSD, chronic stress and psychological trauma can alter brain regions such as the amygdala and prefrontal cortex, influencing immune response regulation.

This interplay can sustain a cycle of inflammation and immune activation, potentially predisposing individuals to autoimmune conditions.

5. Genetic Factors

Genetic pre-dispositions, as well as non-permanent (epigenetic) changes to genes due to trauma exposure can also contribute to Sjögren's. People with PTSD that possess genetic variations that increase susceptibility to inflammation and immune dysregulation are at higher risk of developing autoimmunity as a result. Non-permanent (epigenetic) changes to genes, triggered by trauma, can activate and deactivate genes that play roles in normal immune system function, heightening the risk of autoimmunity.

6. Behavioral and Lifestyle Factors

People with PTSD could be exposed to other risk factors for autoimmune diseases, such as smoking, alcohol misuse, poor diet, and lack of exercise, which can exacerbate immune dysfunction and inflammation​.

Understanding these mechanisms provides insight into how trauma can influence autoimmune conditions like Sjögren's syndrome, highlighting the complex interplay between psychological stressors and physical health.

Regaining hope: Healing from trauma

If you have been personally affected by a traumatic experience, and this has led you to develop an autoimmune condition, all is not lost. Getting treatment for PTSD, including getting psychological therapy and reducing stress, can significantly mitigate the negative effects of PTSD on health. Psychological treatments help reduce chronic inflammation, restore adrenal function, re-balance the autonomic nervous system, and address the immune functions involved. By targeting these areas, various psychological therapies can not only alleviate PTSD symptoms but also improve overall immune health and reduce the risk of developing autoimmune diseases (or help reduce existing symptoms).

Here we present 5 of the most common, evidence-based therapies used to address PTSD:

1. Eye Movement Desensitisation and Reprocessing

EMDR allows people to process and heal from trauma, sometimes without even having to talk about the distressing memories. It uses bilateral stimulation, such as eye movements, taps, or tones, to help the brain process traumatic memories.

Research has shown that EMDR is effective in alleviating trauma symptoms and improving emotional regulation.

An eye represents Eye movement desensitization and reprocessing (EMDR) therapy
EMDR uses bilateral stimulation, such as eye movements, to help the brain process traumatic memories.

2. Acceptance and Commitment Therapy

Emphasizes accepting one's thoughts and feelings without resistance or guilt and committing to actions that align with personal values.

Research has shown ACT to be effective in reducing trauma symptoms and enhancing the ability to adapt to challenging emotional states.

3. Cognitive Behavioural Therapy

Focuses on identifying and changing negative thought patterns and behaviors through techniques like changing distorted thoughts and developing coping skills.

Numerous studies have demonstrated CBT's effectiveness in reducing PTSD symptoms and improving overall functioning.

4. Narrative Exposure Therapy

NET helps individuals chronologically document their life story, enabling them to process and integrate traumatic experiences through structured storytelling.

It has been found to be effective in reducing PTSD symptoms, particularly in individuals with complex trauma, such as refugees or survivors of multiple traumatic events.

5. Somatic Experiencing (SE):

Focuses on the body’s physiological responses to trauma. It aims to release physical tension and trauma stored in the body.

Some research supports SE's effectiveness in reducing trauma symptoms, particularly physical manifestations of trauma.

These evidence-based therapies offer diverse approaches to effectively address PTSD, catering to different aspects of trauma processing and emotional healing

Trauma: a potential root-cause of Sjögren's

To conclude, while the connection has long been suspected - and is something that we at Beyond Sjögren's have always taken into close consideration - there's now mounting evidence suggesting that trauma, alongside related stress, could significantly contribute to the development of Sjögren's syndrome, although a direct cause-and-effect relationship hasn't been firmly established yet.

Current research highlights a strong association between PTSD or trauma and the onset of Sjögren's, indicating that trauma may play a substantial role, though it's far from the only determinant—clearly, not everyone with PTSD develops Sjögren's, and not everyone with Sjögren's has experienced trauma (and even if they have it still might not be the cause in their case).

It's important to recognize that various underlying factors can interact in complex ways. For instance, a traumatic event might potentially trigger the reactivation of a dormant virus in the body, setting off a cascade of symptoms and complications. Therefore, a comprehensive and holistic approach which addresses all possible root causes is highly recommended.

How our holistic approach to Sjögren's can help

In addressing Sjögren’s, adopting a comprehensive and holistic approach is essential to achieve significant and sustained improvements to symptoms and energy levels.

That's why our personalised treatment programs take into consideration both psychological and trauma-related factors, alongside critical physical factors such as diet/nutrition, digestive function, infections, environmental factors, and hormone imbalances.

Our programs are tailored to comprehensively assess and target these diverse root causes, aiming to improve your symptoms as well as optimizing your path to healing and well-being.

If you're interested in exploring how our programs might be able to help you, schedule a free 20-minute consultation with Jeremy to discuss your situation and possible next steps.

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Article references:

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.

Song, H., Fang, F., Tomasson, G., Arnberg, F. K., Mataix-Cols, D., Fernández de la Cruz, L., Almqvist, C., Fall, K., & Valdimarsdóttir, U. A. (2018). Association of Stress-Related Disorders With Subsequent Autoimmune Disease. JAMA, 319(23), 2388–2400.

Hsu, TW., Bai, YM., Tsai, SJ. et al. Risk of autoimmune diseases after post-traumatic stress disorder: a nationwide cohort study. Eur Arch Psychiatry Clin Neurosci 274, 487–495 (2024).

O'Donovan, A., Cohen, B. E., Seal, K. H., Bertenthal, D., Margaretten, M., Nishimi, K., & Neylan, T. C. (2015). Elevated risk for autoimmune disorders in iraq and afghanistan veterans with posttraumatic stress disorder. Biological psychiatry, 77(4), 365–374.

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