In individuals experiencing Ehlers-Danlos syndrome (EDS), a combination of symptoms and stress from persistent pain might increase the chance of developing mental health disorders.
EDS is a term that describes a collection of diseases that impair the connective tissue, rendering it fragile and susceptible to injury. Joints, skin, blood arteries, and organs are supported and structured by connective tissue, serving as structural support. Patients experience movement challenges and an increased risk of injury due to a weakening of the connective tissue, resulting in mental health problems.
Many patients with Ehlers-Danlos syndrome (EDS) suffer from chronic pain and tiredness due to their condition. This may contribute to the high prevalence of stress problems among individuals with EDS. Several studies have found that stress affects more than 50% of hypermobile EDS.
There is mounting evidence that people suffering from hypermobile type Ehlers-Danlos syndrome are more likely to experience stress (hEDS) than the general population. In addition, there is little but rising evidence of a connection between the drug and depression, eating disorders, and neuro-developmental problems. Genetic risks, issues with autonomic control of bodily processes, sensitivity to external and internal stimuli, and a diminished sense of spatial orientation are some of the underlying causes of Parkinson’s disease. Recent studies have also revealed an increase in reaction in the brain regions responsible for emotion processing, which may explain the high level of emotional sensitivity. Mental health and psychological approaches should be used to manage the condition to alleviate symptoms and improve the patient’s ability to cope. This can be accomplished through appropriate drug treatment, psychotherapy, and psychological rehabilitation combined with modern physiotherapy. A comprehensive strategy should be used to guarantee accurate assessment and guide the implementation of more specialized therapies.
What is Stress?
Everyone has feelings of stress from time to time. You could have stressed before making a significant choice, when significant changes occur in your life, or when confronted with a difficult situation. However, chronically worried sensations that interfere with school, job, or personal relationships might be a symptom of a more serious underlying problem.
Dread may manifest itself in many ways, from a moderate level of anxiety to a strong and abrupt attack — a rapid burst of fear that comes on suddenly and lasts for several minutes and may result in significant bodily reactions — and everything in between. Specific events or ideas can cause panic attacks or be triggered by no specific incident or thought.
If you are suffering from stress or panic attacks and EDS, you should visit a doctor to learn about treatment and management alternatives.
Stress impact on EDS
The link between Joint Hypermobility Syndrome/hypermobile type Ehlers-Danlos syndrome (JHS/hEDS) and stress was discovered in 1988. It was the first time it was reported. We were intrigued by coincidence and decided to investigate the connection further. Before this study, a few scattered observations in the literature pointed in the direction of this new research. When rheumatologists Rotes-Querol and Argany studied patients with hypermobility in 1957, they discovered that they suffered from a high level of nervous stress. Inflammatory hEDS (juvenile hEDS) is a disorder linked with difficulties in the muscles, joints, and bones caused by a collagen deficit or genetic changes that influence collagen production. JHS/hEDS refers to the syndromes of joint hypermobility syndrome (JHS) and the hypermobile form of Ehlers-Danlos syndrome (hEDS) as a single entity. Throughout this article, we examine the psychopathology associated with JHS/hEDS, as well as the probable reasons for such an association, as well as debates, management, and future research directions.
Psychopathology
The relationship between JHS/hEDS and anxiety disorders has been extensively researched over the past 30 years, and current research indicates a strong link between the two. According to one research study, approximately 70% of hypermobile individuals had some anxiety condition, compared to only 22% of the control group. Since then, anxiety has been related to JHS/hEDS on several occasions, confirming the validity of these findings. While the evidence for JHS/hEDS involvement in other illnesses is less well-established, there is some evidence to recommend that they may be associated with mood and personality disorders as well as addictions, eating disorders, and psychosis, among other things.
Disorders of the Neurodevelopmental System
A growing body of evidence suggests that JHS/hEDS are associated with many neurodevelopmental problems, including attention-deficit/hyperactivity disorder (ADHD) and developmental coordination disorder (DCD) (DCD). If you are having attention deficit hyperactivity disorder (ADHD), studies have discovered that individuals with ADHD had more excellent rates of joint hypermobility (JH) and issues with automatic control of bodily processes (dysautonomia) than adults without ADHD. Other investigations have discovered a high prevalence of JH or EDS in conjunction with ADHD. Specifically, when it comes to DCD, children with DCD exhibit more symptoms linked with JHS/hEDS than those usually developing. The association between JH and DCD may be related to impaired positional sense in afflicted children.
Psychiatric and Psychological Treatment for hEDS
There is substantial evidence that JHS/hEDS patients take more anxiety medicines than the general population. High levels of anxiety and despair are common in JHS/hEDS patients, and it has been demonstrated that negative emotions can exacerbate the sensation of pain in these patients. Pain and physiological signals and sensations are susceptible in individuals with JHS/hEDS. JHS/hEDS patients also exhibit sensitivity to discomfort and bodily signals and feelings. These factors, associated with more excellent pain perception and lower pain tolerance, may impact the pain experience.
JH is related to the use of dysfunctional coping methods. However, there have been no studies investigating coping techniques in JHS/hEDS; more investigation into the psychological elements of pain perception is needed to design effective treatment regimens. Cognitive-behavioral therapy (CBT) methods have been developed, with evidence suggesting that CBT is beneficial in the pain treatment of individuals with JHS/hEDS.
Causes
However, while it is plausible that some mental symptoms, risk or defensive behaviors, and personality traits might result from adaptation and problems in dealing with long-term diseases, biological explanations for this relationship have been proposed. The possibility of a genetic connection between anxiety and depression should be investigated further. In addition, anatomical abnormalities in emotional-regulating brain regions and a connection between anxiety disorders and poor regulation of automatic physiological systems have been proposed as possible explanations. Anxiety is related to hypermobility, and hypermobility scores were shown to be associated with other emotional regions of the brain as well as with other physical characteristics. Different bodily inputs can have an impact on one’s ideas, feelings, and actions. Given the rising evidence of increased body awareness and sensitivity among JHS/hEDS, it is possible that an excessive amount of frightening information is received, resulting in psychological discomfort and mental disorders.
Controversies
In the context of JHS/hEDS, certain concerns are surrounding mental illnesses that need to be addressed. First and foremost, individuals suffering from long-term pain and diminished functioning frequently experience anxiety and despair, regardless of whether they have hEDS. Another item to mention is that hEDS are connected with several diseases, such as dysautonomia, which can produce a huge range of physical problems that might be mistaken for anxiety-like symptoms in some people. According to the American Heart Association, patients with rapid heart rate fluctuations may be misdiagnosed with panic episodes. The severe fatigue induced by inadequate sleep, for example, might be misinterpreted for depression in specific individuals. The ability to recognize the source of the problem is critical.
Another point of contention in hEDS is diagnosing children presenting with pain, bruises, dislocations, disorientation, and fatigue. The symptoms of hEDS might be misinterpreted as simply a mental disease in the kid or parent. In contrast, both physiological and mental symptoms frequently occur in the same individual. Individuals who conduct evaluations of hEDS patients must have appropriate training.
Management
It is necessary to investigate and correctly analyze the mental difficulties that patients are experiencing. Pain, unpleasant emotions, and poor emotional control are all everyday experiences. All of these considerations can aid in the development of evidence-based treatments such as cognitive-behavioral therapy (CBT). Future research directions include: (1) developing a complete condition model to understand it better. More research into the underlying processes is required, particularly to identify genetic connections between the two conditions. (2) Examining the relationship between pain and bodily awareness and these two factors and mental results is needed. (3) It is necessary to design and evaluate combinations of therapies to provide improved evidence-based management. (4) It is necessary to put in place care guidelines. (5) It is necessary to test and implement preventive methods, particularly among youngsters. This may aid in the development of more specialized therapies as well as the prevention of negative consequences in maturity. However, while the relationship between JHS/hEDS and anxiety has been well established, there is minimal evidence in other mental illnesses, and these should be explored more in the future.
Listed below are some recommendations for dealing with stress and anxiety more effectively:
Make sure you get adequate sleep.
A good night’s sleep can help people with EDS feel less tired, a frequent condition symptom. Make an effort to obtain adequate sleep by turning off gadgets an hour before bedtime and reducing caffeine intake in the evenings. Having a better night’s sleep might help you feel more refreshed in the morning.
It may be an excellent idea to restrict the consumption of alcoholic beverages and nicotine since they can both interfere with sleep.
Maintaining a consistent bedtime and wake-up schedule can be beneficial in ensuring that you receive enough sleep and avoid feeling fatigued during the day.
Consume a nutritious diet.
It is suggested that everyone consumes a healthy diet — however, what constitutes a “healthy” diet may differ from person to person. Seek the advice of your doctor as well as a qualified dietitian to ensure that your diet has all of the required vitamins and minerals that you require. Because several vitamins are needed to produce neurotransmitters or signaling molecules in the brain, a deficiency in specific vitamins may contribute to general anxiety and sadness. On the other hand, some vitamin supplements might interact with medications, so it’s crucial to discuss what you’re taking with your doctor before taking them.
It is unclear if there is a direct link between food and the symptoms of EDS. For the time being, Ehlers-Danlos Support UK is seeking funds for a scientific experiment to establish whether a change in diet will alleviate the symptoms of hypermobile EDS.
Exercise daily
Although no detailed research has been performed to establish if exercise is helpful for persons with EDS, research has shown that it can benefit people with various chronic illnesses.
As a result of EDS, you may find it challenging to exercise since your joints may be delicate and prone to dislocation, and your skin may be extremely brittle. As a result, you must collaborate with your healthcare team to develop a fitness regimen that is safe for you. Simple, low-impact exercise, such as walking, can be beneficial. Consult with your doctor and physiotherapist to devise a safe fitness regimen that you may follow daily.
Engage in conversation with others
It is critical to have a sense of belonging to other individuals. Try to spend time with other people, whether as part of your job, volunteering, buddy group, or religious activity. Commit yourself to meet together with pals regularly. This may be something as easy as getting together for a cup of coffee to catch up and speak with friends and family. These relationships can assist you in establishing a sense of belonging in your community and establishing support networks.
Mindfulness or meditation
Trying mindfulness or meditation methods might assist you to feel more grounded and may even help you obtain a better perspective on the things that are making you nervous. These approaches are often a mix of breathing exercises and mental concentrating exercises, the latter being the most common. While you are not required to meditate in a group, having others to encourage you may be beneficial, especially when you are just starting. It is possible to find mindfulness and meditation groups in virtually any city – start by looking for local groups in your area!
What types of mental health issues are prevalent among EDS patients?
Anxiety, sadness, and other mood disorders are prevalent in EDS patient groups, according to research.
Patients with EDS are more likely than the general population to suffer from somatoform diseases, defined as pain and tiredness that have no known explanation.
What factors contribute to mental health issues?
Researchers believe that genetics has a role in mental health; however, they are unsure how this is true. People’s genetic makeup may put them at risk for having mental health problems, but the environment may be responsible for the emergence of symptoms in some cases.
Pain is one of the essential elements that contribute to mental health difficulties in people with EDS. Many patients may also be concerned about the possibility of suffering dislocations while going about their everyday activities. Sleep problems may be caused by the illness, resulting in a lack of sufficient restorative sleep. In conclusion, persistent tiredness might develop or worsen mental health disorders.
What is the prevalence of mental problems in EDS?
The incidence of mental problems in classical and hypermobile EDS may be as high as 43 percent in some cases. Anxiety levels may reach as high as 25%, while depression levels may reach 26 percent.
In part due to the rarity of other forms of EDS, researchers have only done a small number of studies on the mental health and psychiatric difficulties experienced by people with these conditions.
