New research published in the journal Emerging Infectious Diseases (Almendrala, 2014) studied reasons why children survive ebola more often than adults. One conclusion was that children have stronger immune responses to the disease than do adults. The levels of a protein called RANTE, which is a molecule that helps cells in the immune system communicate with each other, were higher in children than in adults. This protein also assists T-cells, the ‘killers’ of invading bacteria and viruses in our bodies. A possible reason for the higher levels of RANTE in children has to do with better health and a stronger immune system. This includes lower stress levels overall.
The recent ebola outbreak with its threat to citizens of the United States brought with it a renewed interest in the psychological aspects of not only ebola but any large-scale mass outbreak of an infectious disease. This interest involves the role of stress and the immune system in confronting such a disease.
We are very aware of the threat to our physical well-being that outbreaks of infectious diseases bring. The psychological impact has not been addressed sufficiently to this point.
News about contagious disease outbreaks brings fear. Most news reports focus on the sensational aspects of these diseases (Grohol, 2013). The difficulty separating fact from speculation and outright falsehood serves to increase anxiety regarding the disease in question. The threat, whether real or embellished, of contracting one of these diseases leads to anxiety and stress.
Psychological Impact of Ebola and Other Outbreaks
Clearly, the dangers of ebola or any other infectious disease that can hit and spread quickly are terrifying. The media and talking heads on television play up the sensationalistic aspects of any outbreak. “If it bleeds, it leads” is the mantra of both print and talking (and now electronic) news programs. In the case of ebola, bleeding is certain.
So not only the disease itself, but also too much information about the disease, travels fast in today’s world. This information often brings very significant psychological consequences with it.
Regarding the recent ebola outbreak, the amount of information and misinformation about the disease led to a significant impact on the psyche of the nation (Harlan, 2014). This same article reported a recent poll by the newspaper and ABC News indicated 66% of Americans to be worried about an epidemic of ebola in the U.S. and 40% to be worried about catching the virus.
Is there realistic cause to be so concerned about this terrible disease becoming an epidemic? Probably not. But the concern is there nonetheless.
The psychological impact of infectious diseases has resulted in greater fear responses historically when compared to other types of illnesses (Pappas, et al., 2009). Some of the reasons for this out of proportion fear include the fact that infections are transmitted easily and silently, in the past these types of outbreaks have resulted in large numbers of deaths, there seem to be both old and new forms of infectious diseases emerging, and, possibly most influencing, the media becomes entranced with each new outbreak. Once an outbreak occurs, personal rights are infringed upon in order to control the disease. The efforts put forth resemble those mobilized to fight some type of foreign invasion.
The sheer amount of information and effort have an overwhelming effect on many people. Seeing report after report of the struggle to contain and stop an infectious disease outbreak brings anxiety, uncertainty, and fear.
A sense of “germ panic” (Tomes, 2000) can take over. This panic can follow close on the heels of any outbreak that attains major proportions in the popular media. Movies and novels based on the possibility of other countries using these types of infectious diseases as weapons or based on the concept of “superbugs” striking back at people make panic more likely.
The overabundance of reporting about infectious disease outbreaks soon reaches the level of what Tomes (2000) called “infotainment”. Our reliance on the internet for news and information adds to this concept. And everyone knows you can’t lie on the internet.
Add to this the lack of the magic pill to cure viral infections, like ebola, and society is set for very significant psychological impacts of these diseases. In addition, there are always those on the lookout for conspiracies and their dire consequences for the American public. Misunderstood diseases such as ebola lend themselves to the paranoia experienced by people consumed with the idea of conspiracies of any type.
Thus the stage is set for the psychological sequelae of an outbreak of infectious disease.
- Shame. More than in any other type of disease, shame may be seen frequently in those who contract infectious diseases (Heru, 2014). This shame is related to the fact of having an infectious disease, in having to wear a mask, and in being isolated. Also involved is probably shame related to having been exposed to the disease, possibly through some fault of one’s own.
- Loss. Due to the need for isolation, at least in the diagnostic phase of an infectious illness, loss of contact with loved ones is a potentially great blow (Robertson, et al., 2004). The loss of intimacy with spouses and significant others adds to the impact and feeling of loss. Changes in normal routines bring with them feelings of loss, as well. The isolation is often psychological as well as physical.
- Depression. The experience of loss both of intimacy and social contact can bring on feelings of depression (Heru, 2014). Stress resulting from the symptoms of a chronic illness or a shorter term infectious illness leads to very significant distress. Symptoms of depression including loss of enjoyment, loss of energy, weakness, loss of appetite, difficulty sleeping or sleeping all the time can come with the illness itself and may be a result of the illness as well.
- Anxiety. Uncertainty regarding the future may be the most likely source of anxiety when a person suffers from an infectious disease. Questions always arise about what will be the results of this illness long-term. People may even wonder whether they will have a future, especially in the case of ebola infection with its high mortality rate.
- Stigma. Those diagnosed with an infectious disease must be isolated in an effort to reduce the likelihood of them exposing others to the disease. This isolation is a public event which can lead to others shunning the patients, even after the illness has abated and the patients are no longer ill. The reaction of others like this is rooted in the fears we have of these types of diseases and the frequent misinformation we consume from various sources. Stigma of this kind affects not only the individual patients, but also members of their families who may have never shown any symptoms of the illness.
- Fractured Relationships. In addition to the fear, anxiety, depression and increased stress both patients and family members experience when faced with infectious diseases, family members and friends may be continually alert to signs of possible relapse. The stress of being on alert constantly can lead to relationships waning or even disappearing. Others simply don’t want to take the chance of becoming infected, even accidentally. Staying away becomes a safety mechanism.
The impact of these psychological sequelae leads to increased stress levels. Research is plentiful that shows the relationship of stress and vulnerability to illness. It is important to understand the mechanisms involved in this relationship.
Stress and the Immune System
A large body of research into the effects of stress on the immune system strongly suggests that the state of mind relates closely with the state of health (American Psychological Association, 2006). Increased levels of psychological stress leads to greater risk of infectious diseases (Carnegie Mellon University, 2012).
A meta-analysis of 300 studies on stress and health (Segerstrom & Miller, 2004) showed stress of any significant duration, a few days or months or years, negatively affected immune system functioning. Considering the amount of information bombarding people about ebola and other infectious diseases, stress resulting from this information probably reaches significant duration levels. This, then, leads to lessened immune system viability, leading to more risk of infectious diseases taking hold.
What is the mechanism behind this negative effect of stress on the immune system? Researchers speculate it is inflammation (Carnegie Mellon University, 2012). Inflammation is thought to increase the likelihood of the development and progression of diseases. Under stress, the body loses the ability to regulate inflammation.
Recent events surrounding the ebola outbreak and its presence in the U.S. have brought about significant levels of worry, concern, and stress (Hayden, 2014). It is thus likely even those not close to the areas where patients have contracted the ebola virus are feeling the effects of stress on their immune systems. Lowered immune functioning leads to higher risk of illness. Thus, many people likely will contract some type of illness in the near future than would have if the ebola outbreak had not occurred.
But these people can do some things to stave off any infections. They can strengthen their immune systems.
Strengthening the Immune System
It appears some researchers have theorized that the effects of ebola, and by extension other infectious diseases, can be lessened if a person’s immune system is healthy (Young, 2014). If nutrition is much less than optimal, the immune system doesn’t function adequately. This makes people more likely to fall prey to infectious diseases.
The countries in Africa where the latest outbreak of ebola began have a significantly difficult time feeding their population. Thus, the people there have compromised immune systems and a greater susceptibility to infectious diseases. Logically, increasing nutrition status and strengthening the immune system will increase the population’s ability to withstand exposure to ebola.
Even though we in the United States have sufficient food for the most part, our immune systems are weakened due to stress. This stress comes as a byproduct of our fast-paced society and the pressure we place on ourselves to accomplish goals. Thus, stress-related deficits in our immune systems makes us vulnerable to infectious diseases.
Logically, decreasing stress will lead to stronger immune systems and less vulnerability to disease. Following are some simple steps to lower stress and strengthen your immune system.
- Learn to relax. There are many relaxation methods available. Find one that “fits” you and use it regularly.
- Sleep and eat right. This has been promoted by mothers everywhere. And they’re right. Enough sleep and eating well help lower stress.
- Moderate exercise is also necessary for optimal functioning.
- Make sure your expectations for yourself are realistic. If you have trouble deciding about this, enlist someone you trust to give you guidance.
- A stress journal in which you write down what stressed you, how you felt, what you thought, and how you acted will help you specify what you can change, what you can modify, and what you may have to accept.
- Learn to say “no”. You don’t have to do everything, all the time.
- Avoid people who may be the source of your stress, if you can.
- Control what you talk and think about. If there are certain topics that stress you all the time, stay away from them to the extent you can.
All these things, and more, can help you deal with your stress more adequately and lower the stress load in your life overall. Doing this will strengthen your immune system and make you less vulnerable to disease in general. Knowing this will decrease the psychological impact of any infectious disease breakout.
Almendrala, A. (2014). Children are more likely to survive ebola, and now scientists may know why. Retrieved from http://www.huffingtonpost.com/2014/11/11/ebola-chidlren-adults_n_6135102.html.
American Psychological Association. (2006). Stress weakens the immune system. Retrieved from http://www.apa.org/research/action/immune.aspx.
Carnegie Mellon University. (2013). How stress influences disease: Study reveals inflammation as the culprit. Retrieved from http://www.sciencedaily.com/releases/2012/04/120402162546.htm.
Grohol, J.M. (2013). Resilience and disease. Retrieved from http://psychcentral.com/lib/resilience-and-disease/0001139?all=1.
Harlan, C. (2014). An epidemic of fear and anxiety hits Americans amid ebola outbreak. Retrieved from http://www.washingtonpost.com/business/economy/an-epidemic-of-fear-and-anxiety-hits-americans-amid-ebola-outbreak/2014/10/15/0760fb96-54a8-11e4-ba4b-f6333e2c0453_story.html.
Hayden, C. (2014). Ebola virus, malnutrition, and the immune system. Retrieved from http://haydeninstitute.com/additional-resources/additional-resources-specific-conditions/ebola-virus-malnutrition-and-the-immune-system
Heru, A. (2014). Psychosocial issues: Coping with mycobacterial disease. Retrieved from http://www.nationaljewish.org/healthinfo/conditions/psychosoc/coping-with-mycobacterial-disease/
Pappas, G., et al., (2009). Psychosocial consequences of infectious diseases. Clin Microbiol Infect. 15:743-747.
Robertson, E., et al., (2004). The psychosocial effects of being quarantined following exposure to SARS: A qualitative study of Toronto health care workers. Can J Psychiatry. 49:403-407.
Tomes, N. (2000). The making of a germ panic, then and now. American Journal of Public Health. 90(2): 191-198.
Young, E. (2014). Ebola threat minimized by a healthy immune system. Retrieved from http://guardianlv.com/2014/10/ebola-threat-minimized-by-a-healthy-immune-system/