Early in my immunology research career, it became difficult for me to ignore the effects of stress on immune system outcomes. Needing to fill the gaps in my understanding, I layered additional training onto an already busy life, becoming trained in the theory and practice of treating trauma. Many of the projects and research publications that my team and I developed following the new perspective, reflect the need to include stress responses in any consideration of the immune system. I doubt that there will ever be a way to know to what extent stress plays a role in harmful Immune response to the SARS-CoV-2 virus. Those stresses have in many cases been compounded, as we deal now with ongoing consequences including Long COVID.
Rehashing the causes for COVID-era stress is beyond the scope of these posts. However, I’ve been interested in finding strategies to tackle stress that occurs in the context of Long COVID. Having my own experience with Long COVID, I have reflected on what is possible for an individual where deep fatigue or a variety of other symptoms that may stand between the problem and a solution. Additionally, low-cost or free solutions make more sense than those with a price tag attached.
It's useful to admit that stress is largely not an event itself, but rather an individual’s response to the stimulus. For example, one person might find the noise of children playing to be stressful, while for another, the same sounds bring joy and happy memories. In other words, the way that an individual frames an experience can make a big difference in it being a stress or not.
The human response to danger and threat involves hormonal and cytokine secretions that signal to the body. The evolutionary objective of these signals as well as those that are released in response to safe and social stimuli have evolved in ways that increase the likelihood of surviving.
Short-term stress, let’s call it being chased by T-Rex, tells the body to put other needs aside while nerves and muscles focus on avoiding the danger. Recovery from a fearful or stressful experience involves the body returning to a rest-and-digest/ social engagement/sense of safety state. But when the danger and threats are constant or overwhelming, body systems can become exhausted from the constant state of fear, danger and vigilance. In particular, the nervous system can get stuck in fight-or-flight. Additionally immune system cells become set to a pro-inflammatory state ready to respond to the ongoing perceived threats to safety.
Since my objective has been to recover from Long COVID, it has meant addressing all of the obstacles that have stood in my way. If you have read earlier posts, my diet was an issue leading to inflammation. While I can now again eat many of the foods to which I had become sensitive, I still need to be cautious so as not to create an inflammatory response. Equally, I recognize stress as a cause of inflammatory responses.
As discussed in earlier posts, my perspective on Long COVID is that it is long (chronic) because of one or more sources of chronic inflammation. Stress and perception of threat or danger cannot be overlooked in addressing Long COVID. Conditions such as isolation, illness, issues with employment, available resources and more that have been associated with the pandemic, predispose the body’s response systems to release proinflammatory signals at times of stress.
“…the cytokine (signaling) system is the fundamental communicator within our bodies and brains having major governance over our physiologic and psychologic states and our behaviors. The “proinflammatory” cytokines dictate the threat state. The “anti-inflammatory” cytokines dictate the safe state.” (Hanscom, et al. 2020)
So, how have I managed to keep T-Rex and her family at bay?
Dr Stephen Porges, father of Polyvagal Theory, writes that “feelings of safety emerge from inside the body.”
I’m fortunate that more than two decades ago when I began to see the relationship of stress to immune responses, I began regular practice in meditative disciplines, qigong, gardening and enjoying time with family, friends, and my dogs. In particular, I embraced nature as a tonic for stresses in my own life.
I seek out sources of inspiration and awe, a Monarch Butterfly on a flower in the garden, the flush of apple blossoms in spring, the smell of maple sap being boiled down to make syrup, the exuberant laughter of children. I take time to notice my inner sensations and feelings. I stay in the moment and cultivate the sense of pleasure and safety.
Being aware and in the moment are key. Visualization of the experiences that bring joy and peace can help to create new resources on which to build resiliency.
Early on in my own recovery and now backed by other medical and scientific opinion, beyond my own, I realized that the stress-inflammation-fatigue axis of Long COVID is NOT the result of deconditioning. It is a medical condition in which mitochondria that have been damaged by the SARS-CoV-2 virus are not able to produce the energy molecule ATP at previous levels. Scientists and doctors are aware of mitochondrial dysfunction and have established protocols to unwind this condition. I found, and others report, that trying to power through the fatigue can result in more fatigue and falling deeper into the Long COVID illness. The technical term is ‘post-exertional-malaise’.
The solution for me has been to respect the multiple aspects of Long COVID and to patiently address them. I avoided inflammation, got adequate sleep and moved gently into tolerable levels of movement and exercise. Day by day, taking care of my diet, being aware and responsive to stress, being gentle with myself, I gradually recovered. It took time, but I can honestly report that most of the time now I have more energy and resilience than I have had for decades.
I want to leave you with a list of mostly free on-line resources that I’ve found helpful in the daily challenge of dealing with stress both before and during Long COVIC.
Interestingly, listening to soothing music, such as lullabies, and vocal and instrumental tones that imitate or reflect positive social interactions, are known to promote a sense of safety. Over time, listening can change neurologic responses. Many pieces from composers like Mozart are often mentioned as being beneficial.
Here are some links.
KidzPartyPop, Mozart for Babies, Relaxing Classical music.
2CELLOS, Benedictus by Karl Jenkins
Healing Soul, Calming music for the nerves
Soothing Relaxation (at) Peder B Helland Music: Beautiful relaxing music.
Combining meditation with movement, The 8 Brocades Qigong Practice with Mimi Kuo-Deemer. When Long COVID fatigue was still a significant issue, I did just one or two repetitions of each of the 8 Brocade practices or did the practices sitting. Healthful and builds vitality and endurance.
As a fan and practitioner of qigong, I include this inspiring version of the 8 Brocades: Shaolin Qi Gong, 20 Minute Daily Routine, Ba Duan Jin
From the Bodymind Science (BMS) site, there is a page of short free videos that use visualization and sound to help relieve stress and develop resilience. These are some of my favorites: http://www.bodymindscience.info/aq1teacher-package/
Also, from BMS, there is an introduction to Resilient Family, Happy Child. Made to meet the needs of adults, as well as younger family members, there are 12 training videos, plus 18 visualization videos that demonstrate methods that are basic to developing resilience and self-care skills. The Resilient Family, Happy Child app is US $4.95 in the App Store or from Google Play. (Please note that on older phones the thumbnails on this app may not appear as images, rather as colored lines. The videos however open easily.) (Disclaimer: I have a financial interest in Bodymind Science site and apps.)
Links to other resources:
Polyvagal Theory: A science of Safety by Stephen W. Porges, 2022
https://www.frontiersin.org/articles/10.3389/fnint.2022.871227/full
Polyvagal and Global Cytokine Theory of Safety and Threat COVID-19 Plan B, Hanscom et al. 2020, https://scimedjournal.org/index.php/SMJ/article/view/155
Wonderful resources. I am an early educator, having taught children birth through age 5 for 30 years. I am also a parent of a person with autism. He has limited communication, both expressive and receptive. Love the autism app. I will give it a try. I am most interested in tools for non verbal or developmental disabilities or senior folks. How can I support the youngest and oldest in finding a sense of peace? Thank you for sharing.
It was great to look at this again. I've been looking back at some of my own writing as well. I've also been thinking about stress and the immune system. My mom is now struggling with some lingering covid problems which surprised me because she shouldn't be. However, the only explanation I have been able to come up with as to why she may now be having problems recovering from covid is because of going through my dad's cancer diagnosis and treatment last year. I highly suspect a stress connection.