If a person already has lupus, can stress actually cause a flare up of the disease?

Speaking on behalf of my fellow rheumatologists (lupus experts), the answer is undeniably "Yes." Again, stress may not cause any problems for any individual patient. However, it is believed that stress not only can cause fatigue and a general lack of well-being, but it can also cause a flare up (reactivation) of the lupus. This typically means that features of the lupus, including fatigue, muscle and joint aching and stiffness, fevers, and blood test abnormalities can worsen. Stress can also have indirect effects on lupus disease. For example, it is known that women with systemic lupus not infrequently experience a worsening of symptoms prior to their menstrual periods. (This phenomenon, together with the female predominance among those with the disease, again suggests that female hormones play an integral role in the clinical characteristics or expression of systemic lupus.)

Moreover, at the 2001 Annual Scientific Meeting Of The American College Of Rheumatology, it was reported by researchers that stress reduction improved certain measures of lupus disease activity. As a matter of fact, based on their experience with a variety of patients, doctors who treat lupus have long accepted this concept of a relationship between stress and lupus.

Finally, here are a few words about stress, exercise (one way of managing stress), and lupus. It was also reported at the 2001 Annual Scientific Meeting Of The American College Of Rheumatology that supervised aerobic exercise did not seem to worsen disease activity in lupus patients. Furthermore, another report even demonstrated that aerobic exercise actually decreased fatigue and increased an overall sense of well-being in lupus patients. This benefit of exercise is encouraging news. As doctors, we always wonder about the effects of over-exercising patients with lupus. It seems that a balance can be reached that can allow patients with lupus to pursue physical exercise.

Conclusion

The bottom line is that stress can be unhealthy for anyone. However, stress is often, but not always, something that we can control to some extent. We certainly can learn to control portions of our reactions to stress. In persons afflicted with lupus, stress can have direct consequences, not only on their overall health, but also on their disease.