The Science of Chronic Stress, Inflammation, and Mindfulness

Physical and psychological stress can ignite the slow burn of inflammation deep within the body fueling chronic disease. Mindfulness may help us put out that flame.

Illustration by Anna and Elena Balbossa

Inflammation. Since the early 1990s, when researchers began connecting the dots between a plethora of chronic illnesses and a previously unrecognized form of inflammation—properly called “metainflammation”—it’s been identified as a glaring health concern, a subcategory of wellness unto itself, about which headlines are made and books are written. 

Since then, doctors and healers of all stripes have advised countless (often questionable) treatments to fight inflammation, from diet changes and exercise to drugs, herbs, and supplements. Clearly inflammation is a battle we have yet to win.

Yet in this still-new terrain, researchers have also sussed out a possible common denominator in this complex condition: stress. 

And meditation is showing promise as an accessible and effective way to combat it.

Why We Get Inflamed

To understand why meditation may work against metainflammation, it helps to understand exactly what inflammation is, and what effects it can have on our health. 

First, there’s more than one kind of inflammation. Acute inflammation is triggered when you’re wounded or battling an infection. One of the body’s most elegantly engineered processes, your blood vessels constrict to stop bleeding. Then swarms of inflammation-promoting cells, starting with neutrophils, flood the injured area. (You may notice redness and swelling at the wound site during this process.) These trigger scab formation and skin healing, and help form new blood vessels, until it’s almost like the whole thing never happened. The inflammation naturally ebbs away once healing is completed.

If acute inflammation is like a raging fire that burns in place until an infection is obliterated, metainflammation is like having embers burning deep within your body. You may never notice the smoldering until it erupts as chronic illness, notes Garry Egger, PhD, Director of the Center for Health Promotion and Research.

Instead, this low-grade, chronic, and systemic inflammation quietly spreads, affecting arteries and certain organs and causing allostasis, a disruption of their normal processes. Allostasis is present in many, if not most, forms of chronic disease. “We can’t say it ‘causes’ such disease, but it is highly correlated,” Dr. Egger says.

A Chronic Connection  

The triggers of metainflammation are like a huge crazy quilt that reflects the costs of living in a modern, industrialized society: processed, packaged, and fast foods; inactive lifestyle; obesity; not enough fruits and vegetables; too little sleep; pollution; chemicals that disrupt our endocrine system (and promote obesity); and social issues, including inequality and economic insecurity.  These familiar life conditions all cause physical and psychological stress, which in turn can ignite the slow burn of metainflammation deep within the body.  

But as with many physiological processes, how metainflammation leads to disease isn’t cut-and-dried. Instead, research suggests it’s a response your immune system mounts to a variety of triggers, which over time leads to the development of various chronic conditions.

Reversing widespread inflammation doesn’t happen overnight, but a good start is reducing the physical and psychological stressors that can be triggering the reaction.

In other words, how people develop chronic diseases related to inflammation is complicated, says Leonard H. Calabrese, DO, Professor of Medicine, Cleveland Clinic Lerner College of Medicine at the Cleveland Clinic in Ohio.

Metainflammation can interfere with immune system regulation, says Dr. Calabrese. People’s immune systems react differently to this dysregulation—depending on myriad factors, from your genetic history to environmental or lifestyle factors—and they may respond with inflammatory diseases such as rheumatoid arthritis, Crohn’s disease, or psoriasis, to name just a few.

In fact, some 70% of all diseases, including diabetes, arthritis, asthma, chronic obstructive pulmonary disease, heart disease, irritable bowel syndrome, depression, chronic anxiety, and even some forms of cancer may have an inflammatory trigger.

Putting Out the Fire

Reversing widespread inflammation doesn’t happen overnight, but a good start is reducing the physical and psychological stressors that can be triggering the reaction. Along with a diet rich in plant-based foods and exercise, mindfulness meditation is a noted help. 

“I think the evidence is strong that mindfulness—especially the more you practice—‘downregulates’ inflammatory genes,” says Dr. Calabrese. Simply put, that means that a consistent mindfulness practice can “turn off” the process by which genes trigger inflammation.

In a UCLA/Carnegie Mellon study conducted in 2012, a course of Mindfulness-Based Stress Reduction (MBSR) reduced C-reactive protein (a significant marker for inflammation). The researchers concluded that MBSR could be an effective treatment for blunting pro-inflammatory gene expression in older adults.

It seems to target neurogenic inflammation—which is caused by inflammatory mediators released from sensory nerve endings, and is a key factor in chronic inflammatory diseases, says Melissa Rosenkranz, PhD, associate scientist, Center for Healthy Minds, University of Wisconsin–Madison.

In addition to decreasing inflammation, meditation may be a key in keeping it from developing in the first place. 

When you’re under psychological stress, your nerve endings release substance P, a chemical “messenger” that acts on immune and other cells to create inflammation, notes Dr. Rosenkranz in her study.

Mindfulness (and potentially other meditation practices) combats this type of inflammation by helping to “train the mind to not get caught up in the story that we construct about the events of our lives,” says Dr. Rosenkranz. In other words, it’s reducing our reactivity to stressful events that lessens inflammation. 

Preventive medicine

In addition to decreasing inflammation, meditation may be a key in keeping it from developing in the first place. 

Suppose you inherit a set of genes from your parents that could predispose you to developing type 2 diabetes, for example. It’s not a forgone conclusion that you’ll automatically become diabetic at some point in your life, because gene expression—whether those genes will activate to trigger diabetes—is affected by the food you eat, your stress levels, the amount of exercise you get, and many other environmental factors, says Parneet Pal, MBBS, MS, Chief Science Officer at Wisdom Labs in San Francisco. 

Recently, Dr. Pal led a small pilot study to track the effects of a 12-week mindfulness program in the workplace. 

Before and after her study, Dr. Pal’s research team measured the changes in the participants’ gene expression on a set of 53 genes related to inflammation and immunity. These particular genes trigger inflammation and lower immunity when the body is under stress.

After 12 weeks of a regular mindfulness practice, Dr. Pal said that among the participants, “there was a significantly lower expression of inflammatory genes and a greater expression of genes boosting immunity. Beyond that, participants also experienced improved levels of social well-being—they felt better,” noted Dr. Pal.

“The practice of mindfulness,” adds Dr. Rosenkranz, “is about changing your relationship to life’s slings and arrows—not about keeping them at bay. A reduction in inflammation, as a consequence of mindfulness practice, is a fortunate side effect.” 

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