The Emotional Health Complications of Rheumatoid Arthritis
Having a long-term illness like RA is emotionally demanding. After overcoming the initial shock, daily challenges increase your risk for depression and anxiety and bring stress to your life.
In fact, according to one report in the International Journal of Clinical Rheumatology, up to 42 percent of people with RA experience significant depression, which leads to worsening symptoms and pain, higher disease activity and poor overall health.
Inflammation and pain are triggers to depression, but so are feelings of worry and fear about your health and how you will live with RA for the rest of your life.
Managing and Coping with RA
Despite the difficulties RA presents, it is a manageable condition, and it is possible for you to live a good quality life with this disease.
It is also possible to slow down the progression of RA and treat the symptoms, with a combination of drug treatments, lifestyle changes, and physical therapy.
For some people, surgery might become necessary to restore function in joints that have become severely damaged and causing extreme pain.
You can also manage your emotional health by practicing a positive attitude and having a network of support that includes family and friends and even a therapist to help you cope with RA challenges and pain.
While there is no cure for RA, newer biologic and disease-modifying antirheumatic drugs (DMARDs), help many people continue to live healthy and active lives.
The goals of RA treatment are to:
- Stop inflammation and potentially put the disease in remission
- Relieve symptoms
- Prevent joint damage and disability
- Improve function and quality of life
For these goals to be possible, your doctor will want to focus on:
- Early and aggressive treatment to manage inflammation
- Targeting remission – RA remission means little or no signs of the active disease inflammation
- Getting disease activity to low levels and keeping it there
The medications your doctor will recommend for treating RA depend on the severity of symptoms and how long you have had the disease. Some RA medications treat and ease RA symptoms while others slow down or stop the disease from damaging joints and causing other complications.
But these rheumatoid arthritis medications come with side effects, and for many of us with RA, we begin to realize the benefits outweigh the risks.
- Disease-modifying antirheumatic (DMARDs). DMARDs slow down the progress of RA to save joints and other tissues from permanent damage from inflammation. The most common DMARD is methotrexate, which has been used to treat RA since 1985.
- Methotrexate. One of the safest RA drugs, but it has side effects, including elevated liver enzymes. Taking folic acid can help relieve some of the side effects. Complications of methotrexate and other DMARDs include severe lung infections and liver damage.
- Biologic response modifiers. Biologic response modifiers, or biologics for short, include a newer type of DMARDs. These drugs target parts of the immune system that trigger inflammation. The medications are most effective when paired with non-biologic DMARDs, especially methotrexate. Because these medications suppress the immune system, they are associated with an increased risk of infection.
- Nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs are designed to relieve pain and inflammation. Some of these are available over the counter and doctors can prescribe stronger NSAIDs. Like other medications used to treat RA, NSAIDs come with long term side effects, including possible kidney and liver damage and heart problems.
- Corticosteroids. Prednisone is the most commonly prescribed corticosteroid drug for reducing inflammation and pain and slowing down joint damage. But because these drugs pose very harsh side effects, including thinning of bones, doctors prescribe them in the short term.
Making appropriate lifestyle changes offers you an opportunity to take a proactive role in your health and overall quality of life.
Here are some of the ways to do that:
- Healthy Eating. There is no particular diet to follow with RA, but research has identified certain foods that can help reduce inflammation, including fatty fish, fruits, and vegetables. Moreover, some foods, especially processed and junk foods, promote inflammation and you can benefit from removing these from your diet.
- Activity. It can be difficult to be active when you hurt most of the time, but exercise is an important part of RA treatment. A physical therapist is in the best position to work with someone with RA and help them to find an exercise program that helps and won’t cause injury.
- Rest. When RA symptoms are active, and your joints feel painful, stiff and swollen, rest contributes to bringing down inflammation and fatigue. It is also important to take to conserve energy and protect joints even on the days where you feel better and stronger.
- Ditch the bad health habits. Smoking, drinking alcohol in excess, not being active, and missing doctor’s appointments are all things that will make living with RA harder.
Why You Need to Ditch the Bad Habits
One 2010 study from Japan finds the risk for RA is doubled for smokers and the heavier of a smoker you are, the higher your risk is. And smoking is associated with higher disease activity in people who already have RA, this according to one 2014 report in the International Journal of Molecular Sciences.
If you take medication for RA, regularly drinking can further worsen your health. RA drugs already increase your risk for liver problems, and adding alcohol can strain your liver even further.
Regular activity is an important part of your RA treatment plan, but only half of people with RA get enough exercise. If the pain is keeping you from being active, it is time to have a conversation with your doctor about getting your pain and inflammation under control.
Make sure you are seeing your rheumatologist several times a year and getting routine blood work done. You should also let your doctor know how treatments are going and if you have any active stressors in your life.
Next page: Tips for managing emotional health because of the complications of rheumatoid arthritis.