Psychosocial interventions like cognitive behavioral therapy (CBT) have always been a boon for emotional and mental health, and a new meta analysis published in JAMA Psychiatry suggests it may provide an immune system boost as well.
Researchers conducted a review of 56 clinical trials, representing 4,060 participants that tracked changes in immunity over time during the course of psychotherapy. Shields, et. al, looked at eight different psychosocial interventions, such as CBT, behavioral therapy, cognitive therapy, and psycho-education, as well as seven markers of immune system function, including inflammation, antibody levels, viral load, and natural killer cell activity.
They found that across the interventions, there was a strong association with enhanced immune system function, and that persisted for at least six months following treatment. The associations were most significant for CBT or combined interventions, but as a whole, all intervention types provided some level of improvement in immune system function. The main takeaway here is that psychotherapeutic interventions have a variety of beneficial effects on the immune system.
There are long-held stigmas attached to people seeking psychotherapy for their mental health. Understanding the numerous benefits can go a long way toward fighting those stigmas and letting people know that therapy can help anyone, even those without a diagnosed mental health condition.
The reason that psychotherapy, and particularly CBT, might have such a direct effect on immune function was not part of the study, which was one of its drawbacks. But the assessment of inflammation markers gives a clue about what the underlying mechanism at play might be.
Inflammation has often been connected to numerous health issues, including cognitive and mental disorders from dementia to depression. A review of the literature published in Frontiers in Immunology highlights that, while many factors play a role in the development of depression, there have been links to increased inflammatory activation of the immune system, which affects the central nervous system. It notes that antidepressants have been shown to decrease inflammation, while higher levels of inflammation can lower treatment effectiveness.
Furthermore, with respect to immune function, inflammation is part of the body’s natural defense mechanism, and it plays a role in healing. But when it goes into overdrive, that’s when the health issues begin to crop up. Keeping it regulated in a way that harnesses the power of inflammation without letting it surge is an important part of maintaining health at every level, says Shields.
The results of this study underscore how much mental and emotional issues can affect physiological reactions, and that goes both ways. For example, we often see people with compromised immune function and chronic health problems facing mental health challenges. Addressing physical health will have an impact on mental wellbeing, and vice versa.
Additionally, lifestyle factors can also play a role. Addressing emotional and mental difficulties can also affect the immune system, including inflammation levels, because it could prompt changes in behavior. For example, if someone is empowered through therapy, they may be more inclined to make changes such as:
- Exercising more
- Eating healthier foods
- Pursuing more social interaction
- Creating a better sleep schedule
- Implementing anti-stress strategies
All of these shifts have been shown in past research to affect immune system function, in part because they reduce inflammation, but also because they improve gut health, a major aspect of psychological well-being.
It’s all interconnected in terms of how your mind and body are responding. Generally, when people start feeling better mentally, they start to implement behaviors that support their health, and that begins to build on each other. It’s a positive reinforcement cycle that continues. For example, if you start exercising more, studies suggest you tend to sleep better. When you get more quality sleep, that lowers inflammation levels and improves gut health, and in turn, that improves mood and emotional resilience.
These systems all work in tandem with one another, and it starts with small changes in some behaviors, along with setting reasonable goals. Subsequently, you will likely find that it gets easier to adopt healthier behaviors from there. The first step of psychotherapy could be the kickoff needed to start this ripple effect.
For many people, finding the right fit of psychotherapy method can take some time, patience, and may involve multiple types of therapies, with some normal frustration along the way. For instance, CBT may be paired with mindfulness, behavioral therapy, and medication. It’s important to talk with a mental health professional about potential options that align with your needs/lifestyle, and never give up until you find the right therapy that is suitable for you.
Shields, G.S., Spahr, C.M., & Slavich, G.M. (2020, June 3). Psychosocial interventions and immune system function: A systematic review and meta-analysis of randomized clinical trials. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2020.0431
Lee, C.H., & Giuliani, F. (2019, July 19). The role of inflammation in depression and fatigue. Frontiers in Immunology. 2019;10:1696. doi:10.3389/fimmu.2019.01696