Key points
- Stress changes markers of immunity
- The effort-to-reward ratio most significantly impacts stress and immunity
- Stress-reduction techniques reliably improve immunity
The effects of stress and immunity have recently been highlighted due to the increased prevalence of mental health challenges related to stress, increased workplace stress, and the impact on our psychosocial environment from the COVID-19 pandemic. It is clear from the evidence that stress impacts immunity and that conversely, stress-reduction can improve immunity. These findings are critical to our understanding of health and should receive more attention in the context of clinical and community care.
Work and life-stress impair immunity
A review of 56 studies published on work-stress and immunity concluded that higher job-stress, including high demands, low control, high strain, job dissatisfaction, poor effort-to-reward imbalance, overcommitment, burnout, unemployment, downsizing, and effects of recession impacted key immune markers (such as NK cell activity, NK and T cell subsets, CD4+/CD8+ ratio, and increased inflammatory markers).1
Stress impacts key markers of immunity
In particular, the effort-to-reward imbalance (i.e. how much reward you get from your work efforts) is associated with lowered immunity and workplace stress is also more commonly associated with lowered immunity than overcommitment, although both are associated with weakened immune responses.2 For example, caregivers of dementia patients suffer poorer immune responses and this is considered to be as a result of the demands of their workplace stress.3 Prenatal stress is also reported to increase the risk of nervous, endocrine and metabolic diseases, and immune dysfunction. Prenatal stress is associated with changes in immune cells, cytokines, immune organs, and hematopoietic stem cells.4
Low reward from work effort is associated with lowered immunity
Effects of stress-reduction on immunity
In a review of 75 studies, a moderate response was found for immune function changes resulting from stress-reduction techniques. This supports the idea that stress impacts immune function, and that conversely, stress-reduction can improve immunity.5
Stress impacts immune function and stress-reduction can improve immunity
References
1. Nakata A. Psychosocial Job Stress and Immunity: A Systematic Review. In: Yan Q, editor. Psychoneuroimmunology: Methods and Protocols. Totowa, NJ: Humana Press; 2012. p. 39-75.
2. Eddy P, Heckenberg R, Wertheim EH, Kent S, Wright BJ. A systematic review and meta-analysis of the effort-reward imbalance model of workplace stress with indicators of immune function. Journal of Psychosomatic Research. 2016;91:1-8.
3. Whittaker AC, Gallagher S. Caregiving alters immunity and stress hormones: a review of recent research. Current Opinion in Behavioral Sciences. 2019;28:93-7.
4. Yan W. Impact of prenatal stress and adulthood stress on immune system: a review. 2012.
5. Schakel L, Veldhuijzen DS, Crompvoets PI, Bosch JA, Cohen S, van Middendorp H, et al. Effectiveness of stress-reducing interventions on the response to challenges to the immune system: a meta-analytic review. Psychotherapy and psychosomatics. 2019;88(5):274-86.
