I remember when I was a new therapist and just starting to see clients I immediately started to notice a pattern.  Many of my clients who had Posttraumatic Stress Disorder (PTSD) were also struggling with chronic health issues most often related to autoimmune disease.  This was 14 years ago and at the time much less was known about the interplay between physical and mental health.  Thankfully, we are now entering a time where so much research is emerging about this connection and, most importantly, how to more holistically help people.

Autoimmune diseases and mental health disorders are often considered separate realms of health, but they share a significant, interconnected relationship.  And, understanding and addressing these connections can lead to more effective, holistic treatment strategies that improve both physical and mental well-being.

The Bidirectional Relationship

Autoimmune diseases, classically defined as when the body’s immune system mistakenly attacks its own tissues, affect millions of people worldwide. Common examples include hashimoto’s thyroiditis, rheumatoid arthritis, lupus and multiple sclerosis. These chronic conditions can significantly impact a person’s quality of life, leading to persistent pain, fatigue, and sometimes disability.

Mental health disorders, such as depression, anxiety, and post-traumatic stress disorder (PTSD), are also widespread and can be both a consequence and a trigger of physical health issues. Research suggests a bidirectional relationship between autoimmune diseases and mental health conditions:

  1. Impact of Autoimmune Diseases on Mental Health:
    • Psychological Stress: Chronic pain and physical limitations can lead to significant psychological stress, increasing the risk of depression and anxiety.
    • Inflammation: Autoimmune diseases often involve chronic inflammation, which is also linked to mental health disorders. Cytokines, proteins involved in inflammation, can affect brain function and mood regulation.
    • Medication Side Effects: Treatments for autoimmune diseases, such as corticosteroids and immunosuppressants, can have psychological side effects, including mood swings and depression.
  2. Impact of Mental Health on Autoimmune Diseases:
    • Stress and Immune Response: Chronic stress and trauma can dysregulate the immune system, potentially triggering or exacerbating autoimmune diseases. Stress can alter the body’s immune response, making it more prone to attacking its own tissues.
    • Behavioral Factors: Mental health issues can lead to poor self-care behaviors, such as neglecting medication, poor diet, and lack of exercise, worsening autoimmune disease symptoms.
    • Inflammatory Response: Depression and anxiety can also increase inflammation in the body, potentially aggravating autoimmune conditions.

The Role of Trauma

Trauma, particularly early-life trauma, has been implicated in the development of both autoimmune diseases and mental health disorders. Adverse childhood experiences (ACEs), such as abuse, neglect, and household dysfunction, are linked to a higher risk of developing chronic diseases, including autoimmune conditions. The mechanisms behind this link include:

  • HPA Axis Dysregulation: Trauma can disrupt the hypothalamic-pituitary-adrenal (HPA) axis, the body’s central stress response system. This dysregulation can lead to prolonged inflammatory responses, increasing the risk of autoimmune diseases.
  • Epigenetic Changes: Trauma can cause epigenetic changes, altering gene expression without changing the DNA sequence. These changes can affect immune function and stress response, contributing to the development of autoimmune diseases and mental health disorders.
  • Behavioral and Psychological Impact: Trauma can lead to long-term changes in behavior and psychological health, increasing the risk of depression, anxiety, and PTSD, which in turn can impact physical health.

A Nutrition Perspective

Nutrition plays a pivotal role in managing both autoimmune diseases and mental health. It’s important to understand the interplay between diet, immune function, and psychological well-being:

  1. Inflammation and Diet:
    • Anti-Inflammatory Foods: Autoimmune diseases are characterized by chronic inflammation. Diets rich in anti-inflammatory foods, such as omega-3 fatty acids (found in fish), antioxidants (found in fruits and vegetables), and whole, minimally processed foods can help manage inflammation.
    • Elimination Diets: Identifying and eliminating trigger foods, such as gluten or dairy, may alleviate symptoms for some individuals. Personalized nutrition plans can make a significant difference in managing autoimmune conditions.
  2. Nutritional Deficiencies and Mental Health:
    • Vitamin D: Deficiencies in vitamin D are common in individuals with autoimmune diseases and are linked to both physical and mental health issues. Adequate levels can support immune function and mood regulation.
    • B Vitamins: These are crucial for brain health. Deficiencies can lead to symptoms of depression and anxiety. A balanced diet rich in B vitamins (found in leafy greens, legumes, and lean meats) supports mental well-being.
  3. Gut-Brain Axis:
    • Gut Health: The gut-brain axis highlights the connection between digestive health and mental health. Probiotics and prebiotics can improve gut health, potentially alleviating symptoms of both autoimmune diseases and mental health disorders.
    • Dietary Fiber: High-fiber diets support gut microbiota, which play a role in regulating inflammation and mood. Foods like fruits, vegetables and properly prepared legumes and grains are essential.
  4. Holistic Nutrition Plans:
    • Personalized Nutrition: Each individual’s needs are unique. Tailored nutrition plans that consider the specific autoimmune condition, lifestyle, and mental health status can optimize health outcomes.
    • Collaboration with Therapists: Working alongside therapists allows for a holistic approach to health. Addressing emotional eating, developing healthy eating habits, and managing stress through diet are all part of comprehensive care.

Integrative Approaches to Treatment

Given the intricate relationship between autoimmune diseases and mental health, a holistic approach to treatment is essential. Integrative treatment strategies might include:

  • Comprehensive Care: Coordinated care between mental health therapists, rheumatologists, neurologists, psychiatrists and functional medical doctors can ensure that both physical and mental health needs are addressed.
  • Psychological Interventions: Cognitive-behavioral therapy (CBT), mindfulness-based stress reduction (MBSR), and other therapeutic approaches can help manage the psychological impact of chronic illness.
  • Lifestyle Modifications: Encouraging healthy lifestyle choices, such as regular exercise, a balanced diet, and adequate sleep, can improve both physical and mental health outcomes.
  • Stress Management: Techniques such as yoga, meditation, and relaxation exercises can help manage stress and reduce inflammation.


The intertwined relationship between autoimmune diseases and mental health highlights the need for a comprehensive, integrative approach to treatment. By addressing both the physical and psychological aspects through therapy and nutrition, clients can achieve improved health and well-being. The collaboration between therapists and nutritionists or nutritional therapy practitioners, along with other healthcare professionals, paves the way for a holistic path to wellness, ensuring that individuals receive the support and care they need on all fronts.

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