"The systemic manifestations of Sjogren's syndrome at the time of diagnosis differ according to individual patient characteristics such as sex, age, and ethnicity, a large international study found."
"This analysis confirmed that individual patient factors including age, sex, ethnicity, and residence strongly affect the systemic manifestations of Sjogren's syndrome. "Both the type of organ affected and the severity of the involvement are modulated by these geoepidemiological factors, which should be considered as critical when a personalized follow-up is planned for a patient newly diagnosed with Sjogren's syndrome," the researchers concluded."
“Conventionally, patients with primary Sjögren’s syndrome are thought to consist of two subtypes — those with predominantly glandular symptoms and those with extra-glandular (systemic) manifestations,” the study noted. “However, many patients do not fit neatly into these subtypes and no consensus criteria exist for such classification.”
"The team sorted individuals based on five common disease symptoms: pain, fatigue, dryness, anxiety, and depression. At the simplest level, the sorting was done by feeding symptom data into a computer program, which grouped individuals with similar symptoms together.
This resulted in four subgroups, which the researchers dubbed: low symptom burden (LSB), high symptom burden (HSB), dryness dominant with fatigue (DDF), and pain dominant with fatigue (PDF)."
Anxiety is our bodies way of reacting to stress. You have both physical and psychological reactions to stress. People who suffer from anxiety disorders experience excessive fear when there is no real danger and then they begin to avoid the situation that causes it. Anxiety causes disruption in a person's everyday life. It can cause an increased risk for cardiovascular morbidity and mortality in the long run.
But what happens when there are real dangers causing your anxiety? This is what people with chronic illness face every day. Some examples of these fears are:
Fear of physical pain. Fear that it's going to continue to worsen or that it will never stop.
Is my condition permanent? Am I going to die? What is this going to mean for the rest of my life?
Being afraid of the treatments. Needles, surgeries, tests, they can all be painful and frightening. Fear of medication side effects is pretty prevalent too.
Fear of not being diagnosed. Some conditions are hard to get an accurate diagnosis for.
Anxiety is believed to start in the amygdala. The amygdala is the area of the brain that controls emotional responses. But it has not been determined if the amygdala is hyper-responsive before the stressor such as symptoms of social phobia, specific phobia, or PTSD appear or if the stressor causes the hyper-responsiveness. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3055419/ Neurotransmitters carry the response to the sympathetic nervous system. Then the heart rate and respiration rate increases, and your muscles tense up. And blood flow is diverted from the other organs to the brain. Now due to your anxiety, your body is on high alert. The fight or flight response is in full gear. You may experience nausea, diarrhea, the urge to urinate, light-headedness, pain, headaches, and other physical responses. According to a Harvard Health article anxiety is associated with many chronic illnesses like heart disease, Chronic Obstructive Pulmonary Disease, and gastrointestinal conditions. If it isn't treated it makes these chronic conditions harder to treat and the patients get worse and their life expectancy is shorter. It is estimated that about 30% of people suffering from anxiety disorders go untreated. If you suffer from a chronic illness and think you might have it, it is important to discuss it with your primary doctor who can help you find out what is causing your symptoms whether it be physical or psychological. Psychological symptoms are no less real or important than physical ones are. That's what your doctor is there for. There are several specific types of anxiety disorders.
Generalized Anxiety Disorder---Patients experience an exaggerated sense of anxiety about health, safety, money, and other aspects of daily life lasting for six months or more. They may also experience headaches, muscle pain, fatigue, nausea, shortness of breath, and insomnia
Phobias---Patients experience an irrational fear of particular things or situations, such as spiders, being in crowds, or being in enclosed spaces.
Social Anxiety Disorder--- Patients experience overwhelming self-consciousness in social situations and a feeling of being watched and judged by others and fear of embarrassment.
Post Traumatic Stress Disorder(PTSD)---Patients relive things from their past that caused an intense physical or emotional threat or an injury such as: childhood abuse, military combat, or an earthquake. They have vivid dreams, flashbacks, or tormented memories. They also experience problems with sleeping or concentrating. They may display angry outbursts, emotional withdrawal, and have a heightened startle response.
Obsessive Compulsive Disorder--- OCD manifests in obsessive thoughts, that then causes the person to compulsively act in a certain way. An example is having a fear of contamination with germs and then feeling compelled to repeatedly wash your hands in an attempt to lessen the anxiety.
Panic Disorder---Patients experience episodes of feelings of terror or impending doom, accompanied by rapid heartbeat, sweating, dizziness, or weakness with no apparent provocation.
These problems can cause complications in chronic illness. For instance, studies have shown that patients that have COPD have high rates of anxiety and panic attacks. This, in turn, causes higher incidents of hospitalization and severe respiratory distress. When you can't catch your breath, anxiety, and panic are pretty understandable. And it would obviously adversely affect your quality of life. Managing Panic Attacks When You Have COPD The development of heart disease and resultant coronary events have been linked to anxiety disorders. Women with high levels of anxiety were 59% more likely to have a heart attack and 31% more likely to die from it than women with low anxiety in the Nurses Health Study. A study done at Harvard Medical School and one done at the Lown Cardiovascular Research Institute showed that people with heart disease who also had an anxiety disorder were 2 times more likely to have a heart attack than other people. Anxiety and heart disease: A complex connection There are treatments for anxiety disorders and they can help treat chronic illnesses and even help prevent heart disease and treat existing heart disease. But treatments need to be tailored to the individual patient. https://www.anxiety.org/treatments
Cognitive-behavioral therapy. This works by helping the patient identify and avoid thoughts that cause anxiety, and then helps them learn how to react differently to anxiety-provoking situations. It has to be tailored to the patients particular type of anxiety. Patients may learn relaxation techniques to lessen their anxiety.
Psychodynamic psychotherapy. When anxiety is caused by an emotional trauma it the patient can sometimes benefit from therapy. Research at Colombia University showed that patients suffering from a panic disorder who were treated with psychotherapy had fewer symptoms and were able to function socially better than patients who were treated with relaxation therapy.
There is a tendency for patients and doctors alike to rely mainly on medications to treat anxiety. But on their own, medications don't work as well as when they are combined with psychotherapy. Many of them come with side effects. But they are useful to get the patients symptoms under control so that therapy can be more effective. These medications consist of anti-anxiety drugs like benzodiazepines(Klonipin, Xanax) There is a newer drug called Buspar that is supposed to have fewer side effects. Whereas the others work quickly, Buspar takes about two weeks to kick in. But it can be taken for longer periods of time than the others. Antidepressants like Zoloft which is a selective serotonin reuptake inhibitor (SSRI) are used to treat panic disorder and generalized anxiety disorder (GAD). They also treat depression. They are considered to have a lower risk of drug dependence or abuse. Beta blockers are used to treat anxiety by slowing the heart rate and reducing blood pressure.
DEPRESSION
Depression can occur independent of or in relation to anxiety and may have overlapping symptoms. It is common for people with chronic illnesses to suffer from depression. It makes their conditions harder to treat and can make it worse. If patients are treated for depression it can lessen their stress and result in an improvement of their symptoms, resulting in increased quality of life. The World Health Organization (WHO) says that depression is the leading cause of disability in the world and the 4th leading cause of the global burden of disease. They estimate that by 2020, depression will be the 2nd public health concern next to cardiovascular disease. https://www.who.int/news-room/fact-sheets/detail/depression
The criteria for depression in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), major depressive disorder (MDD) the most severe form of depression, is an episode that lasts at least 2 weeks with the patient having at least 5 out of 9 depressive symptoms. One of the symptoms has to be depressed mood or loss of interest or pleasure in anything (anhedonia). Symptoms have to cause significant distress and social, occupational impairment or impairment in other areas of their lives resulting in noticeable disability caused by their illness. Symptoms of depression are:
Feeling sad, irritable, or anxious
Feeling empty, hopeless, guilty, or worthless
Loss of pleasure in usually-enjoyed hobbies or activities, including sex
Fatigue and decreased energy, feeling listless
Trouble concentrating, remembering details, and making decisions
Not being able to sleep, or sleeping too much. Waking too early
Eating too much or not wanting to eat at all, possibly with unplanned weight gain or loss
Thoughts of death, suicide or suicide attempts
Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment
People with chronic illness have some of the same risk factors for depression as people in the general population. Things like a personal or family history of depression or loss of family members to suicide are risk factors for depression. There are some conditions that are themselves risk factors for depression due to causing changes within the brain, such as, Parkinson’s Disease and strokes.
Depression is common among people who have chronic illnesses such as the following:
There are many others. The rate of anxiety and depression depends on the type and severity of the chronic illness is. But the rates are higher across the board among people with chronic illness in comparison to the general population. It is particularly prevalent in stroke, cardiovascular and diabetic patients. This is an interesting article about people with the autoimmune condition Sjogren's Syndrome and how they differ from the general population. Sjögren’s Patients Exhibit Different Personality Traits than Healthy Individuals, Study Suggests Studies suggest that people who have depression and another medical illness experience more severe symptoms of both their depression and their physical illnesses. They can have difficulty adapting to both and higher medical expenses than patients who do not suffer from depression. People who have been diagnosed with a chronic illness often feel sadness because of the major changes in their lives due to the disease like fatigue and other physical limitations that make their normal activities harder or impossible. They may also feel frustration. Patients often feel anxiety because of uncertainty about what the future holds and the prognosis of their disease because it may be incurable or unpredictable and precarious. And the fear of death can cause great depression and anxiety. They may experience sleep disturbances as a result. If they are able to regain some of their normal functions and participate in their regular daily life their symptoms were reduced. Chronic illness causes people to be isolated socially due to less contact with friends and family because they can't get out as much. Their friends may also avoid them because they don't know how to deal with their friend's conditions and they may feel like they no longer have anything to relate to. If you have symptoms like shortness of breath, panic attacks, sensitivity to noise, brain fog, etc. it may cause anxiety and other symptoms that may cause you to remain home further exacerbating your social isolation. People with chronic illness often express feelings of guilt which makes their anxiety and depression worse. They feel like they are the blame for getting their conditions. Perhaps they didn't take as good of care of themselves as they feel they should have. They also feel shame because they find it difficult to be grateful for being alive. Another aspect of anxiety and depression in chronic illness is that doctors tend to feel like it is just a normal part of the disease and downplay its importance or in contrast, they might chalk of many of the patient's physical symptoms to their depression causing the patient to rightfully feel dismissed. But to be fair to physicians, the physical symptoms of chronic diseases overlap with depression and anxiety and this makes diagnosis difficult. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3817854/ The condition known as POTS, Postural Orthostatic Tachycardia is complicated when it comes to anxiety and depression. Postural Orthostatic Tachycardia Syndrome (POTS) is a condition in which heart rate increases abnormally when the individual assumes an upright position. In addition to the marked tachycardia, presyncope, and syncope. Considering the marked elevation in heart rate on standing, increased anxiety about this and the feeling of faintness or actual syncope is not surprising. But many doctors are prone to completely dismissing the condition as just anxiety. This Mysterious Blood-Flow Disorder Is Often Misdiagnosed As Depression One study in the United Kingdom found that nearly 50 percent of POTS patients had previously been told they had a psychiatric disorder that was responsible for their symptoms.
In a Vanderbilt University study, Patients with POTS had a markedly diminished quality of life in both physical health and mental/social health domains compared to the healthy volunteers. The scores were comparable to previously published scores for patients with kidney failure requiring hemodialysis. The Vanderbilt data were similar to a prior publication from the Mayo Clinic {PMID: 12059122} that also found diminished quality of life in patients with POTS. https://ww2.mc.vanderbilt.edu/adc/43572
Research has shown that PoTS is not the same as anxiety. However, PoTS is sometimes confused with anxiety because:
Anxiety is so common that, just by chance, many people with PoTS will also have anxiety.
Some of the symptoms of anxiety are similar to the symptoms of PoTS. Palpitations, nausea, light-headedness, gut symptoms, fatigue, and headaches are symptoms that can occur both in anxiety and as a result of PoTS.
Even when we know that PoTS symptoms are not harmful, symptoms can still feel very frightening. Adding scary thoughts to the mix can increase symptoms even more.
Worrying excessively about a thing that could happen in the future can lead to low moods. It can help to recognize that these problems have not yet happened and may never happen. Deal with problems as they come up, and use your time and energy on more positive thoughts.
Anxiety and stress cause our bodies to release a chemical in the blood stream called norepinephrine. People with PoTS seem to be very sensitive to this chemical which can cause symptoms like anxiety. In addition, the parasympathetic nervous system which calms us, may also not be functioning normally in PoTS.
I have shown that people with chronic illnesses are more likely to have anxiety and depression. But people who are depressed are also more likely to have chronic illnesses like cardiovascular disease, diabetes, stroke, and Alzheimer’s disease. Scientists have found that people who suffer from depression show changes in several different systems in the body:
Signs of increased inflammation
Changes in the control of heart rate and blood circulation
Abnormalities in stress hormones
Metabolic changes typical of those seen in people at risk for diabetes
Monocytes are a type of white blood cell developed in bone marrow and matured in the blood.They are called phagocytic because they are a type of cell capable of engulfing and absorbing bacteria and other small cells and particles. They have receptors on them to detect bacteria or other foreign matter. After they attack and engulf bacteria they go to lymph glands and display the remains to the lymphocytes so that the immune system then recognizes it as an invader. Phagocytes also are important in apoptosis. Apoptosisis when a cell either dies from natural causes or from some injury or disease. When a cell dies phagocytes get rid of them by absorbing them the same way they do foreign cells. One of the effects of Lupus is premature apoptosis of cells.
There should be a balance between cells dying and new cells being created. But with lupus, the balance is off. This plays into why people with SLE have anemia and bleeding issues.
Phagocytes can communicate with other cells by producing chemicals called cytokines, which recruit other phagocytes to the site of infections or stimulate dormant lymphocytes.
Whereas phagocytes attack any invader, lymphocytes make antibodies against specific invaders.
Sjogren's Syndrome is caused by infiltration of monocytes and B-lymphocytes in epithelial glandular and extra-glandular tissues. I think this infiltration refers to the fact that monocytes are usually in the tissue of the body somewhere. They will move from one place to another in the body through the bloodstream, but usually don't stay in the blood.
When Sjogren's patients have kidney involvement, it can cause renal tubular acidosis type I (RTA I), tubulointerstitial nephritis, diabetes insipidus (DI), nephrolithiasis, and Fanconi syndrome.
For the purpose of understanding, monocytes are white blood cells that are embedding in certain cells and because they are phagocytes, the cause cell damage in organs. In the case of Sjogren's, it is the epithelial cells on the outside of blood vessels and organs. They are there to be a protective layer, for secretion or absorption or sensing. All glands are made of epithelial cells.
So if a salivary gland is infiltrated, it would become damaged and eventually not be able to secrete saliva.
The inability of the kidney either to excrete sufficient net acid or to retain sufficient bicarbonate results in a group of disorders known as renal tubular acidosis RTAs. RTA is a medical condition that involves an accumulation of acid in the body due to a failure of the kidneys to appropriately acidify the urine.
As in Sjogren's Syndrome, RTA in SLE Lupus is rare. If it is present, it likely represents the consequence of significant tubulointerstitial damage, which should signal the need for rapid treatment of the underlying lupus nephritis to avoid future renal insufficiency.
In the setting of a hyperkalemic normal anion gap metabolic acidosis and a urine pH less than5.5, the clinician should have a high index of suspicion for the presence of type 4 RTA.
Conversely, a diagnosis of incomplete type 1 RTA may be entertained in patients with hyperkalemia
and a urine pH which is persistently greater than 5.5.
The word acidosis refers to the tendency for RTA to cause an excess of acid, which lowers the blood's pH. When the blood pH is below normal (7.35), this is called acidemia. The metabolic acidosis caused by RTA is a normal anion gap acidosis.
White blood cells can create antibodies that attach to bits of your DNA from a worn out cell. This attached pair is called an immune complex. It can lodge in your kidney and cause inflammation.Thisis called lupus nephritis.
High monocytes indicate autoimmune activity or infection.
Low levels of lymphocytes or lymphocytopenia is also an indication of
autoimmune activity or infection. In Lupus, it is caused by the body making antibodies against lymphocytes.
Low albumin is also associated with chronic inflammation.
Low albumin is also commonly seen when the kidney leaks protein in the urine when it is
inflamed in lupus (nephritis).
I have Sjogren's Syndrome, pronounced“SHOW-grins”. It is an autoimmune disease that affects the body's ability to produce tears as well as affecting the exocrine (moisture) glands all over the body.
Over the last few years, something that people take for granted has become increasingly difficult for me. I can't cry, or at least not to the degree that I used to be able to or when I ordinarily would have. It really bothered me when my husband died a few years ago. Not only did I not have the release, but I worried that others would think I was cold and uncaring. I loved my husband deeply.
I used to think it was related to depression and due to things that have happened in my life that cause me to dissociate. But it turns out there is more of a physiological reason.
WHAT HAPPENS WHEN YOU SHED TEARS
To begin with, the surface of your eye is made mostly of water. And your tears are divided into two categories: Lacriminization and crying. You have lacrimal glands that are between your eyelids and your eyeball. When the gland on the outer corner of your eye, near the temple, produces a tear, you will blink and that will spread the tear across your eyeball. This takes about ¼ of a second.
Then the tear goes to the lacrimal punctum. Wikipedia describes it as follows: “ There are two lacrimal puncta in the medial (inside) portion of each eyelid. Together, they function to collect tears produced by the lacrimal glands. The fluid is conveyed through the lacrimal canaliculi to the lacrimal sac, and thence via the nasolacrimal duct to the inferior nasal meatus of the nasal passage.”
That is just a complicated way of saying there is a natural drain in your eye and from there it goes into your nasal passages and out your nose. This is why your nose also runs when you cry. Who knew?
lacrimal drainage
During periods of high tear production, like a highly emotional state or severe irritation, the drainage system can't keep up and the tears run down your face. OR at least they are supposed to.
DIFFERENT TYPES OF TEARS
Under normal circumstances, your body has three different types of tears that it can produce. They are basal, reflex and psychic tears. Basal tears serve the purpose of keeping your corneas lubricated so that your eyes don't dry out. Reflex tears form as a response to irritation like when something gets in your eyes or when you are exposed to the noxious vapors of an onion, or you open a bottle of ammonia.
And last but not least, there are the psychic tears. These are the ones you make when you are experiencing a strong emotion, like sadness or happiness, or anger or physical pain. Some people actually feel better after a good cry due to a pain-killing neurotransmitter produced by your body called leucine enkephalin. These emotional tears also contain more protein than the ones produced in response to an irritation.
YOUR AUTONOMIC NERVOUS SYSTEM AND TEARS
But how does this factor into your emotions? Within your brain, there is an area called the limbic system, and within it is an area called the hypothalamus. This is part of your autonomic nervous system. Your autonomic nervous system or ANS controls the things that you don't, such as tears, sweat, heart rate, breathing, etc. One of the neurotransmitters involved in the ANS is acetylcholine. It affects the lacrimal or tear-producing system.
Under normal circumstances, you feel a strong emotion, and this causes your ANS to signal tear-production.
When you cry, there are other things going on within your ANS. Part of your ANS called the sympathetic nervous system which controls the fight or flight response will also cause you to sweat, and your breathing will slow down, and you will also get what is called the globus pharyngis. That's the feeling of having a lump in your throat. When your ANS isn't working properly it is called dysautonomia.
THE PSYCHOLOGICAL AND SOCIAL RESULTS
Researchers Jonathan Rottenberg and Lauren M. Bylsma from the University of South Florida found that there are benefits to crying. Crying helps your body control breathing when it has been aroused in a negative way. https://www.livescience.com/5238-hate-cry.html
When a person experiences overwhelming stress and arousal, his or her heart rate increases and the body begins to sweat. But as a person cries, his or her breathing slows, rendering a calming effect, according to Rottenberg.
The reason some people find having a good cry pleasant is that the calming effect of crying lasts longer than whatever stressor caused them to cry in the first place.
There are major areas of your life that can be affected when you can't cry. There is more going on here than a response to a stimulus. Evolution has given you this means of crying out in a non-verbal manner to others around you. It allows them to see that you need emotional help. When you receive social input from others it strengthens your emotional bonds with them because they share in your experience. When others say, “I can see that you are sad. I am sorry you are feeling this way. How can I help? Here is a big hug.” You will feel better. And they, in turn, feel empathy and sympathy. These responses are very important when babies cry. They can't speak and therefore need to be able to communicate so that their needs are met. They cry because they are hungry or in pain or are angry. And then their parents respond to them and this causes bonding.
When you cry it can show that you are submissive or vulnerable. This can cause potential attackers to perceive you as weak and underestimate you, or feel empathy toward you, thereby avoiding an attack. In a relationship, it might cause the other person to change their behavior in many ways.
In other social situations, crying can show trust a need for affection, and this results in bonding.
There have been studies that show women actually do cry more than men. However, men cry over the most of the same things as women do, like, death, homesickness or a romantic breakup. Women cry more over small things, but men cry more in response to happiness. The differences between the sexes can be attributed to several things. Culture, male testosterone levels( which inhibit crying) and their work environments.
When you can't produce tears, how do others know that you feel grief, despair, frustration, helplessness, powerlessness, pain, happiness, anger and empathy, pride, longing, anger, frustration sadness or love? If you are able to produce the sobbing sounds of crying, people might not feel empathy toward you if they don't have the visual cue of tears and then assume you are faking the emotion. If they don't see them signaled by the shedding of tears, then we lose out on the social interaction and response that we should get. The result is that we can be isolated socially. Tears are as important as facial expressions. “research provided further evidence for the facilitating effect of tears on processing emotion recognition and social judgments. Their function seems to surpass the connection with merely enhancing sadness recognition. Rather, tears seem to play a significant role as a visual signal in terms of promoting (pro)social behavior.” Emotional Tears Facilitate the Recognition of Sadness and the Perceived Need for Social Support
Studies have found that people feel better when they are with another person when they cry, which indicates that crying helps us to bond and get emotional support from other people. Dry eyes aren't just a medical issue.
WHAT PEOPLE THINK WHEN THEY SEE RED IRRITATED EYES
Humans are also the only primates with the sclerae(the white outer layer of the eye) allowing both the color of the eye and how red the conjunctiva is to show up. Scleral redness shows important biological and social information about you. Other people make judgements about your sadness, healthiness, and attractiveness based on their perception of the redness of your eyes.
When your eyes are red it is mostly caused by blood vessels in your conjunctiva becoming dilated. The conjunctiva is the transparent membrane that covers the sclera or white part of your eye. When your eyes are red, others perceive you to be sadder, older, less healthy, and thereby, less attractive. On an evolutionary level, you don't appear to be biologically fit to a prospective mate. Binocular Symmetry/Asymmetry of Scleral Redness as a Cue for Sadness, Healthiness, and Attractiveness in Humans
People who have Sjogren's Syndrome and eye irritation can become isolated because of other people's perception of them.
EMOTIONAL BLUNTING
Something worse than all of this is that another problem can be overlooked. There is a condition or symptom of depression and almost suicidal depression. Sometimes it is called emotional blunting and other times it is called a flat affect. The Inability to CryMedical Definition of Flat affect
I had an experience with this once. I was put on an antidepressant. It caused me to feel this way. It was one of the scariest things I have ever experienced. I couldn't react to things in a normal way. I have a great sense of humor and I would be watching television and see something funny. I would think wow I know that is hilarious. But I couldn't laugh. It was like I could logically understand that it was fun and feel it but I couldn't express it. And it was similar with anger. I could see how a person might say, “that should make me angry, so I should react in a certain way.” Sadness was very strange too. Because not only couldn't I shed tears, now I couldn't even express sadness verbally. I think this is pretty close to what people on lithium feel. You can feel but you can't express. After that, I have this fear of ending up in a nursing home after a stroke, unable to speak and unable to cry, locked in my own misery.
If you have Sjogren's Syndrome and you are on SSRI's you might want to pay attention to how you experience emotions. Nienke van Leeuwen, a Ph.D. candidate in health psychology at Utrecht University in the Netherlands, found that 22 percent of patients with the Sjogren's Syndrome had "significantly more difficulty" identifying their own feelings than control participants did (Clinical and Experimental Rheumatology, 2012).
A Dutch study of 300 people showed that 22% of the patients with Sjogren's Syndrome were clinically 'alexithymic'. This means they were having difficulty identifying and describing emotions. This was compared to only 12% of healthy controls. Other studies showed that those with higher levels of alexithymia had worse mental well being, proving a link between the two.
Dr. William Frey, a biochemist at the Ramsey Medical Center in Minneapolis discovered that emotional tears contain stress hormones that are being excreted through crying. When you cry, your body also produces endorphins. Endorphins are the hormones that make us feel good and are also pain relieving. Two of these are the endorphin leucine-enkephalin and prolactin. Another is adrenocorticotrophic hormone (ACTH), which is an indicator of stress in your body. Your body is getting rid of these hormones and toxins caused by stress. Emotional tears have a 24% higher albumin protein concentration that regular tears caused by irritation. Dr. Jerry Bergman writes, “Suppressing tears increases stress levels, and contributes to diseases aggravated by stress, such as high blood pressure, heart problems, and peptic ulcers.
Crying can also lower your manganese level. Elevated manganese can cause anxiety, nervousness, irritability, fatigue, aggression, and emotional problems. Manganese Induced Oxidative Stress
When you can't produce tears, even light and air can be irritating and painful and lead a person to avoid going outside. The result is yet another way to become isolated. People with dry eyes can also end up with complications like infections and ulcers.
As you can see, tears serve more of a purpose than just keeping foreign bodies out of our eyes. And the ability to cry or not cry shouldn't be taken for granted. We are the only primates that can do it and this ability is a profound influence on our lives. I pray that someday soon there will be an answer for people like me. I know that God intended for us to be able to express a whole range of emotions and although I often can't cry about it, I am still sad.
Ecclesiastes 3:4 says that there is an appointed time for everything, “A time to weep and a time to laugh; A time to mourn and a time to dance”. Romans 12:15 says we are supposed to “Rejoice with those who rejoice, and weep with those who weep”. The shortest and one of the most profound verses in the Bible is John 11:35, “Jesus wept”.
People with autoimmune diseases have a particularly hard time keeping their skin moisturized and protected. And people with Sjogren's Syndrome have an even harder time because their body doesn't produce moisture to start with.
All of the options in the moisturizer aisle can seem overwhelming. They all make claims about what they will do for you. But there are particular ingredients you need to look for. I don't like to just go by advertising or word of mouth. I want to know what is in any products I use and they science behind it. I suppose that is because my Father was a chemist who worked until he retired at Proctor and Gamble. He often discussed with me the products that they made and why they were superior to others at the time. When I was a teenager, I actually tested out some of their products before they were on the market as a volunteer.
The following information on the difference between creams, lotions, and ointments come from the website of the National Eczema Association. They have a list of approved moisturizers there.
OINTMENTS
Ointments are semi-solid greases that help to hydrate the skin by preventing water loss. Petroleum jelly has no additional ingredients, whereas other ointments contain a small proportion of water or other ingredients to make the ointment more spreadable. Ointments are very good at helping the skin retain moisture but they are often disliked because of their greasiness.
CREAMS
Creams are thick mixtures of greases in water or another liquid. They contain a lower proportion of grease than ointments, making them less greasy. A warning: creams often contain stabilizers and preservatives to prevent separation of their main ingredients, and these additives can cause skin irritation or even allergic reactions for some people.
LOTIONS
Lotions are mixtures of oil and water, with water being the main ingredient. Most lotions do not function well as moisturizers for people with dry skin conditions because the water in the lotion evaporates quickly.
Ingredients
Ingredients fall into three categories. Humectants such as glycerin and urea absorb water from the air and hold moisture in the skin. Other humectant ingredients to look for are hyaluronic acid, alpha-hydroxy acids, sorbitol, propylene glycerol, and sodium lactate. Emollients like mineral oil, lanolin and petrolatum fill spaces between skin cells to replace lipids and smooth and lubricate the rough skin. Other emollients to look for are jojoba oil, isopropyl palmitate, propylene glycol linoleate, squalene and glycerol stearates.Occlusives such as petroleum jelly and cocoa butter, are oily substances and they form a film on the top of skin which seals in cracks and prevents moisture from escaping.
Water: This is the main ingredient of moisturizers, and it serves to carry oil-based ingredients onto and into the skin, but oil-based ingredients also help lock water into the skin
Ceramides
Ceramides are waxy lipid molecules that are found in skin cell membranes that help prevent moisture loss. They are involved in things like programmed cell death of cells. Ceramides in your moisturizer will help maintain and repair your skin barrier, so that moisture stays sealed in and it helps your body's natural moisture defenses. That is especially important for people who have eczema and psoriasis because studies have found that they have fewer ceramides than people who have normal healthy skin.
Cerave, as the name implies has ceramides in it. It also has Dimethicone, Hyaluronic Acid, Glycerine.
If you follow this link you can get a coupon for it from their website: Cerave Coupon The Itch Relief type also contains Pramoxine Hydrochloride which is an external analgesic, Shea Butter, Tasmannia Lanceolata Fruit Extract,
Curel says it has a proprietary ceramide-rich formula.
Peptides are chains of amino acids. Amino acids include the 22 proteinogenic ("protein-building") amino acids, that combine into peptide chains ("polypeptides") which form the building-blocks of proteins. In this case, the peptides and amino acids are involved in building proteins in the skin.
Products that contain short chain amino acids can penetrate the top layer of skin and stimulate the cell production.
Collagen is an important protein in skin. It is involved in the thickness and pliability(stretchiness) of skin. Collagen breaks down for things like environmental factors (sun and stress, chemical exposure) and age. This causes wrinkles. Peptides stimulate the production of collagen thereby reducing wrinkles
Elastin has the ability to stretch and return to its original length—like a spring or rubber band. Elastin is the major component of ligaments (tissues that attach bone to bone) and skin. In people who have connective tissue disease, it is common for collagen and elastin to become injured by inflammation. So if you have MCTD or SLE Lupus or Sjogren's Syndrome, Scleroderma, Rheumatoid Arthritis, or Psoriatic Arthritis your collagen is probably not functioning properly.
Hyaluronic Acid works by binding to moisture. It can hold up to 1,000 times its weight in water, making it an excellent natural skin plumper. Hyaluronic acid helps your skin repair and regenerate itself after suffering from dryness, environmental stresses, or irritation. It helps the collagen and elastin in your skin stay moist and helps it to keeps it elasticity. It is also lightweight and isn't oily, which is good if you are acne-prone.
Fatty Acids
Fatty acids come in things like Olive oil, avocado, almond oil, and shea butter which are essential fatty acids that help lock in moisture. Your body needs fatty acids for fuel to do things like produce moisture. But it doesn't produce it on its own, so you have to either ingest it or apply it topically. Foods that have Omega-3 fatty acids in them are things like salmon, mackerel, walnuts, soy, flaxseed, and safflower oil. I take a supplement that combines fish oil, flaxseed oil and borage oil in it.
Glycerin
Glycerin is a simple polyol compound derived from sugar alcohol. It is colorless and odorless. Glycerin and glycols help to retain water in a product, in hair or the top layers of skin by drawing moisture in and then retain it. Glycerin can actually absorb moisture from the air.
Ethylhexyl glycerin
Ethylhexyl glycerin (oct oxy glycerin) is a topical skin care ingredient and deodorizing agent, often indicated as a conditioning ointment in the treatment of eczema. As its name suggests Ethylhexyl glycerin is made using glycerin.
Sodium PCA,
Sodium PCA is used in lotions and hair care products because it is naturally in skin cells and it binds to water in cells and that means it is great for water absorption.
Caprylic/Capric Triglycerides
Caprylic/Capric Triglycerides is a mixed triester derived from coconut oil and glycerin. It comes in the form of an oily liquid and is sometimes mistakenly referred to as fractionated coconut oil. Caprylic mainly works as an emollient, dispersing agent and solvent.)
Piroctone Olamine
Piroctone Olamine is used to treat skin conditions and dandruff. It is an antifungal.
Licochalcone
Locochalcone is a molecule contained in licorice root extract which helps control oil production and is anti-bacterial as well as anti-inflammatory. In short, it helps calm and soothes skin.
Dimethicone
Dimethicone is used as a moisturizer to treat or prevent dry, rough, scaly, itchy skin and minor skin irritations (e.g., diaper rash, skin burns from radiation therapy). It softens and moisturizes the skin and decreases itching and flaking.
Triethanolamine (TEA)
Triethanolamine (TEA)This emulsifier
helps to blend the oil/water mix that makes up moisturizer.
Vitamin A
Vitamin A is usually in the form of retinol or retinoic acid in
moisturizers. It is anti-aging. It works by stimulating collagen
production, which fills in lines and wrinkles
Vitamin C & vitamin E
Vitamin C & vitamin E are
antioxidants and they help repair cellular damage caused by sun,
pollution and free radicals that are created during oxygenation.
Magnesium Aluminum
Magnesium Aluminum Silicate is a naturally occurring mineral derived from refined and purified clay that is used primarily as a thickener in cosmetics and beauty products. It is an off-white powder used in the pharmaceutical manufacturing process as an absorbent; anticaking agent; opacifying agent; slip modifier; and an aqueous viscosity increasing agent. But magnesium is considered as ”the mineral of beauty” in traditional Chinese medicine. Magnesium deficiency results in lower levels of fatty acids on the skin. This results in less elasticity and moisture and that, in turn, causes dryness and inflammation. If you take magnesium to boost the levels in your cells, it helps protect the cells and detoxifies them and encourages healthy skin tissue growth. It helps in DNA replication and repair. It also prevents free radical damage and inflammation.
In a 2007 study cited in the “American Journal of Clinical Nutrition,” Magnesium was discovered to help reduce inflammation caused by an excess amount of E-selectin and C-reactive protein.
When the skin is injured or damaged or when acne-causing bacteria enter the skin, E-selectin is produced. This results in acne inflammation. Magnesium helps reduce E-selectin’s effects and prevents the inflammation.
Magnesium aluminum is sometimes called Kaolin or China Clay.
At the Skin Store website I found this:
“Kaolin (also know as China clay, hectorite or magnesium silicate) is a naturally occurring soft clay. In cosmetics, kaolin helps to cleanse and exfoliate dead skin cells and debris from the surface. It adds absorbency, texture, and bulk to cleansers.
...Because it’s safe nature and has great absorbency and soothing properties, it’s quite the popular ingredient in formulas designed to purify
Kaolin wages war on acne and breakout-prone skin by improving the skin’s balance and decreasing levels of pore-clogging oils, dirt and toxins. General skin inflammation, caused by the usual environmental factors can also be addressed with kaolin cleansers. Kaolin increases circulation to the impacted areas of skin, helping to stimulate healing and to reduce irritation. Using a cleanser that contains kaolin prior to applying makeup can help to control oil production and prevent unwanted shine.”http://www.skinstore.com/blog/skincare/beauty-glossary-kaolin/
Eczema is associated with a magnesium deficiency. If you have a deficiency of magnesium your body will produce histamines. Those histamines will cause you to be itchy and have red blotches or hives on your skin. They are caused by blood vessel swelling that causes fluid to leak into the skin and other tissues.
Taking supplements gives some people diarrhea. But if you can take it, it helps avoid kidney stones and calcification in the joints too. It also good for circulation and high blood pressure. Doses less than 350 mg daily are safe for most adults. When taken in very large amounts, magnesium is POSSIBLY UNSAFE. Large doses might cause too much magnesium to build up in the body, causing serious side effects including an irregular heartbeat, low blood pressure, confusion, slowed breathing, coma, and death. Magnesium strengthens bones; maintains nerve and muscle function; regulates heart rhythm and blood sugar levels, and helps maintain joint cartilage.http://www.arthritis.org/living-with-arthritis/treatments/natural/vitamins-minerals/guide/magnesium.php
I know some people apply magnesium oil directly to their skin. But I don't know about the safety of it.
After you have considered all of the other ingredients, don't forget the sunscreen. You need an SPF of at least 30. I happen to think people with Lupus SLE and Sjogren's should use the highest they can get. If it isn't in your moisturizer, you may have to use a separate one. I have some for sensitive skin that I use and that have pretty high SPFs.
If you have ever given birth then you are probably familiar with Palmer's Cocoa Butter products for stretch marks. But they make products for your face now and they are excellent. If they can help with stretch marks they have got to be doing something right. If you compare the ingredients to the ones listed above, you can see that they are very good for your skin. And I have some of them and they worked pretty well. I used the serum and day cream in the day and the night cream, obviously at night during a time that my face was super dry.
They have an SPF 15. Some of them say they promote collagen production and they contain antioxidants, a peptide complex, and vitamins A, B1, B2, B3, C and E. It depends on the individual product. Among other ingredients they contain, Hydrogenated Palm Glycerides, Theobroma Cacao (Cocoa)Seed Butter, Dimethicone, Butyrospermum Parkii (Shea) Butter, Oenothera Biennis (Evening Primrose) Flower Extract, Aloe Barbadensis Leaf Juice, Hydrolyzed Milk Protein, Glycerin, Triethanolamine. The night cream contains Natural Cocoa Butter, Retinol and Antioxidant Vitamin E.
Last but not least I just discovered a new moisturizer line that sounds interesting. Garnier SkinActive Moisture Bomb “WATER-LIGHT FORMULAS. ANTIOXIDANT-PACKED HYDRATION.
Including formulas that feature goji berry and pomegranate, our refreshing gel cream, SPF 30 lotion, and all new super hydrating sheet masks blast dryness away, flooding skin with long-lasting hydration for a softer, healthier-looking complexion.”
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