Growing up in the spotlight can be tough — just ask Disney-star-turned-pop-singer Selena Gomez. The 26-year-old has been candid about the challenges that come with the attention (and has taken a couple of social media hiatuses to deal, as she explained in a 2018 Instagram post preceding one such break).
But Gomez has also embraced her celebrity as a way to educate fans about being diagnosed with and living with lupus, a sometimes debilitating chronic condition.
Lupus is an autoimmune disease that commonly affects the skin, joints, and kidneys. Instead of warding off infection and disease to keep the body healthy, the immune systems of people with lupus attack healthy tissues in the body. The signs and symptoms of lupus aren’t always present. Rather, there are episodes, called flares, when symptoms worsen.
Gomez revealed her lupus diagnosis in a 2015 Billboard article. And she’s spoken up about managing the condition several times since then.
According to the Cleveland Clinic, women in their childbearing years (between age 14 and 45) are at a higher risk of developing lupus compared to the general population, with the disease affecting 1 in 250 women in this age group.
Here, take a look at what the pop star has said about lupus and how she’s raised public awareness of the disease.
1. Kidney Transplant Is a Common Complication
In the fall of 2017, Gomez revealed that she’d received a kidney transplant. Her friend Francia Raisadonated the organ earlier that summer. Gomez shared the news with fans by posting a photo on Instagram of the two women at the hospital.
Gomez told the audience at the Lupus Research Alliance annual gala in November of that year that the transplant was tied to a complication called lupus nephritis, a kidney disease associated with lupus, according to People. “After undergoing so many tests to monitor my kidneys, my doctors told me I have lupus nephritis, one of those complications from lupus,” Gomez told the audience. “They said I would be needing a kidney transplant.”
The Lupus Foundation of America estimates that 15 to 20 percent of people with lupus nephritis need a kidney transplant or chronic dialysis to stay healthy.
This complication is why it’s so important for doctors to routinely screen people with lupus for signs of kidney trouble, such as high blood pressure and swollen legs, explainsMike Katsaros, DO, a rheumatologist and the chair of the department of internal medicine at the College of Osteopathic Medicine of the Pacific at the Western University of Health Studies in Ponoma, California. “We always recommend patients with lupus are seen regularly by a rheumatologist because often they won’t have any signs or symptoms the kidneys are being affected until it’s later on when there’s more and more damage,” he says.
2. Lupus Can Take a Mental Toll
Lupus creates inflammation, which can lead to fatigue, joint pain, and skin issues. And though it’s less talked about, lupus can affect mental health, too.
Gomez told People in August 2016, “I’ve discovered that anxiety, panic attacks, and depression can be side effects of lupus, which can present their own challenges.” And in 2018, she told Harper’s Bazaarthat she considers the depression and anxiety she faces to be an ongoing struggle.
Dr. Katsaros says that chronic diseases involving arthritis, such as lupus, do indeed have the ability to affect mental health because the symptoms can be life altering.
“It can have a tremendous effect on a patient and how they perceive themselves. It affects their work. It affects their relationships,” Katsaros says. “It’s generally a difficult thing to cope with.”
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According to astudy published in 2018 inMedicine, 25 percent of people with lupus have experienced depression, and 37 percent have dealt with anxiety. Still, Katsaros says it’s important to know that while it’s possible for someone with a lot of inflammation to feel anxious or depressed, this doesn’t happen to everyone with lupus.
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3. Stroke Is a Potential Lupus Complication, Too
Gomez took a break from the spotlight in the winter of 2014 and entered a rehab program in Arizona to help her deal with the disease, she told Billboard in 2015. “I was diagnosed with lupus, and I’ve been through chemotherapy. That’s what my break was really about. I could’ve had a stroke,” she said.
According to the Mayo Clinic, lupus can affect the brain and central nervous system, leading to side effects such as headaches and dizziness on the mild end to, more seriously, seizures and strokes. Katsaros says that while Gomez may have been at risk of having a stroke, these serious complications aren’t very common. “Most patients don’t have the most severe manifestation,” Katsaros says. “It’s [a disease] people can live with and live with well.”
4. Lupus Treatment Can Involve Chemotherapy
In the 2015 Billboard article, Gomez revealed that she’d undergone chemotherapy to treat her lupus, though she had a hard time opening up to fans about it at the time. “I wanted so badly to say, ‘You guys have no idea. I’m in chemotherapy,’” she said. “I locked myself away until I was confident and comfortable again.”
Not everyone with lupus will need chemotherapy, but people with serious cases of lupus may be prescribed a chemotherapy medication — such as cyclophosphamide, methotrexate (Rheumatrex, Trexall), or mycophenolate mofetil (CellCept) — which suppresses the immune system.
5. Living a Healthy Lifestyle Can Help Limit Lupus Flares
Gomez told Billboard that her secret to staying healthy is “diet, routine, and medication.” It’s not surprising that a healthy lifestyle has helped Gomez manage her lupus because experts recommend doing the same thing. Regular exercise, eating a healthy diet, and avoiding smoking and ultraviolet sunlight can all reduce flare-ups and symptoms.
Katsaros says that diet is indeed an important part of managing lupus and that avoiding cholesterol and high amounts of fat and sugar can reduce inflammation and minimize symptoms.
As for Gomez’s comment on sticking to a routine, according to Katsaros, there isn’t research to support this claim, but he says it makes sense. “I could see how that would be beneficial for some people because the thing about autoimmune diseases and lupus is there’s always concern about a flare, about what’s around the corner,” he says. “A routine offers some normalcy, some stability, so you’re reducing the unknown as much as possible. You’re as in control as you can be.” (Additionally, both physical and emotional stress have been linked to triggering lupus flares.)
