Autoimmune diseases demand a low-stress lifestyle.

Whenever I see a woman with an autoimmune disease in my office, one of the first things I ask her is how she's handling the stress in her life, and if she's finding time to rest.

That's because I know--and research shows--that stress can bring on a flare in diseases such as multiple sclerosis, rheumatoid arthritis, lupus and psoriasis. One study found, for instance, that the daily stress of everyday living affects how women with lupus feel more than major life stresses like moving or starting a new job. (21) I also know that fatigue is a major component of many of these diseases.

Women, this is no time to put yourself last. You have a chronic, lifelong disease that can be held in check by medication and lifestyle changes--if you incorporate both into managing your condition.

So here are some things I recommend:

* Take a walk. It doesn't have to be long, and it doesn't have to be fast. But get outside or to an indoor mall or museum and walk for at least 20 minutes. Studies find such moderate exercise can help with the stiffness and pain of autoimmune diseases and improve your mood. (22,23,24)

* Take an hour a day to rest. You don't have to nap if you don't want to, but just lying in a quiet room reading or meditating can be amazingly restorative. Don't be embarrassed about this. Tell your boss, children and partner that this one hour is what enables you to remain productive and energetic the rest of the day.

* Learn at least one technique to reduce stress hormones in your body. Notice I didn't say reduce stress--I know that's impossible. But studies find that things like deep breathing, meditation and visualization can reduce levels of stress hormones in your body. These hormones are inflammatory--contributing to the inflammation behind many autoimmune diseases.

* Find a support system. This might be your family, or it might be friends. It could even be a support group of other people with your condition. Whoever you choose, you need supportive people in your life who understand why you have days when you can't lift the laundry basket or make it through a grocery shopping trip, and who are there to help you on such days.

* Learn to slow down. Women who cope well with chronic autoimmune diseases say they've learned to slow down. Some change to less stressful jobs or work part-time; others readjust their expectations of what they can accomplish on and off the job. Instead of making your disease fit your life, readjust your life to fit your disease. You'll feel better and will find you're able to cope better. (25)

* Participate in your care. If your doctor doesn't listen to you, minimizes your complaints, refuses to discuss integrating alternative approaches into your care or doesn't recommend other approaches to cope with the side effects of treatment (like osteoporosis drugs to minimize the effects of steroids on your bones; medications to reduce fatigue, etc.), it's time to find another doctor. You should be working as a team with your health care professional to identify what works and what doesn't. Remember who is in charge: you, the patient.

* Understand you are on a journey without end. Living with a chronic illness isn't like having a stroke or even cancer, which can be "cured." When you have a condition like rheumatoid arthritis or lupus, your life is a series of two steps forward and one step backward. Learn to accept this new rhythm in your life. Instead of focusing on a cure, focus on having as many good days as you possibly can.

By Pamela Peeke, MD, MPH

NWHRC Medical Advisor

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Dr. Peeke is a Pew Foundation Scholar in Nutrition and Metabolism, and Assistant Clinical Professor of Medicine at the University of Maryland in Baltimore. She writes about health and lifestyle issues important to all women.

References

21 Peralta-Ramirez MI, Jimenez-Alonso J, Godoy-Garcia J, Perez-Garcia M; Group Lupus Virgen de las Nieves. The effects of daily stress and stressful life events on the clinical symptomatology of patients with lupus erythematosus. Psychosom Med. 2004 Sep-Oct;66(5): 788-94.

22 Li LC. What else can I do but take drugs? The future of research in nonpharmacological treatment in early inflammatory arthritis. J Rheumatol Suppl. 2005 Jan;72:21-4. Review.

23 Rietberg MB, Brooks D, Uitdehaag BM, Kwakkel G. Exercise therapy for multiple sclerosis. Cochrane Database Syst Rev. 2005 Jan 25;(1): CD003980. Review.

24 Sigurdardottir AK. Self-care in diabetes: model of factors affecting self-care. J Clin Nurs. 2005 Mar;14(3):301-14. Review.

25 Schoofs N. Seeing the glass half full: living with Sjogren's Syndrome. J Prof Nurs. 2001 Jul-Aug;17(4):194-202.