Living with immune thrombocytopenia (ITP) can feel unpredictable and stressful. In one study, 64 percent of people with ITP reported stress and anxiety about sudden severe episodes, possible daily triggers, and symptoms getting worse over time.

Some people with ITP also notice that their symptoms seem to change during stressful periods. They wonder if unmanaged stress could be a trigger, creating a cycle of stress that causes flare-ups, which in turn create more stress.

In this article, you’ll learn what research says about stress as a possible ITP trigger, along with ways to track and manage stress.

🗳️ Do your ITP symptoms change during stressful times?

Yes, I feel more fatigued.

Yes, I notice more bruising or bleeding.

Yes, I feel more anxious about symptoms.

No, I haven’t noticed changes.

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Can ITP Be Caused By Stress?

If your ITP symptoms seem worse during stressful times, you may wonder whether stress is causing them. Although it’s not clear whether stress directly triggers ITP, there are links between stress and general autoimmune conditions.

Up to 80 percent of people with autoimmune diseases reported unusually high emotional stress before experiencing disease-related symptoms. Autoimmune diseases influenced by stress include rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), which commonly overlap with ITP.

Long-term inflammation caused by stress has been linked with a higher risk of disease, including autoimmune issues. It’s linked to a higher risk of cancers or infections, too.

Autoimmune diseases and infections may trigger secondary ITP — a type of ITP caused by an underlying condition — either due to the illness itself or to the medication used to treat it.

How To Track Potential Triggers

If you believe stress — or something else — is related to your ITP symptoms, start a journal to track how you feel. You may want to note daily activities, including:

• Medications and supplements
• Meals and drinks, including alcohol
• Exercise or relaxation sessions
• Big life events, like moving or losing your job
• Sleep schedule

You’ll also want to reflect on how you feel, including:

• Stress and anxiety levels
• Other emotions, such as excitement or anger
• Energy levels throughout the day
• Interest in hobbies and socializing
• New or changing ITP-related symptoms
• Unusual symptoms, like recurring pain or changes in bathroom habits

When To Talk to a Doctor

Mention any patterns you see to your doctor. They may have recommendations for identifying triggers or improving symptoms and can connect you with the right resources.

Your doctor may also flag symptoms unrelated to your ITP that need to be looked into. For example, joint pain that comes and goes could be a symptom of RA or SLE, so they may want to rule out those conditions.

If you notice new or changing symptoms, you should contact a doctor as soon as possible to control symptoms. These include:

• New or worsening bruises or bleeds
• Unusually heavy periods
• Blood in your urine or stool

Managing Stress With ITP

An ITP diagnosis comes with many unknowns, but you can take back control by managing your stress. Below are a few ways to do so.

Bring Up Lingering Concerns

Don’t be afraid to ask questions or discuss concerns with your care team for peace of mind. If you’re worried about an unexpected severe ITP episode during remission, ask your doctor about making a plan. Establish who you’ll call, which medication you should take, and any other steps to keep bleeds under control in an emergency.

See a Mental Health Professional

Consider seeking support from a professional who can teach you ways to cope with ITP while managing life stressors. Your doctor can refer you to a psychologist to talk about how you feel. Or, if necessary, they’ll refer you to a psychiatrist who can evaluate you and recommend medication.

Ask About Safe Exercise

Physical activity is important for everyone’s physical and mental health, and finding safe ways to exercise should be a priority.

Ask your doctor what restrictions you may have. You may not have any restrictions at all. But if you’re limited because of your bleeding risk, ask which activities you can perform safely. Some ideas of gentle exercise include:

• Walking
• Swimming
• Elliptical
• Stationary biking
• Gentle yoga

Consider Relaxation Methods

Try practicing mind-body therapies, which focus on techniques to promote body awareness and a sense of grounding. Mind-body therapy often involves:

• Meditation
• Breathwork
• Guided imagery
• Positive thinking

If you’re not sure where to start, ask your doctor or a mental health professional. They can share resources they trust to help reduce stress, such as local expert-led classes or virtual classes taught by practitioners.

But be cautious with acupuncture and deep massage. Depending on the severity of your ITP, these activities may trigger bleeding or new bruising. Talk to your doctor about these therapies before trying them.

Gather Support

Talk to your friends and family about your concerns and find others who can relate. You can educate your loved ones about potential triggers and what to do in case of a severe ITP episode, so you’re not problem-solving alone in an emergency. They can also join you during exercise and relaxation sessions to help ease any anxiety over trying new activities.