RA and Isolation – Don't Get Sucked In
Having a chronic medical condition makes you see the world in a different way. Where you once saw hope, promise and endless possibilities, you may now see only rejection, disappointment and fear.
Over time, the negative worldview will make you wonder why you even consider getting out of bed and heading out into the world. Why bother if the space beyond your door is filled with undesirable elements?
People with rheumatoid arthritis (RA) often find themselves in this situation. When your body hurts, simple tasks like driving to the store to pick up a loaf of bread become arduous battles. Getting up, getting dressed, bending over to put on your shoes are all things others take for granted. For you, these monumental tasks diminish your physical and emotional energies. All of this happens before you even leave the house.
Use caution, though. If you give into RA now, it will take hold in your decision making. Little by little, RA will convince you that leaving is too hard and staying put is the only good choice. You will miss doctors appointments, family gatherings and events with your friends.
Before you know it, you will close yourself off and become a prisoner inside your own home.
This scenario may seem extreme, but is actually quite common. People often refer to their “comfort zone.” This comfort in new and changing settings is a very fluid component to your life. It is constantly expanding or contracting based on what you have been doing.
If you have been avoiding people, places and things, it shrinks. If you have been going places and engaging in meaningful activities, it inflates. You are either part of the solution or part of the problem.
Triggers of Isolation
We've looked at how RA persuades you into believing that you are better off staying at home rather than leaving, but there is more happening behind the scenes. People with RA find themselves at a higher risk of depression and anxiety than the typical person because there is added stress and pain from the disease. The added negatives influence your thinking to be hopeless and pessimistic, creating the perfect environment for depression and anxiety to grow.
Both depression and anxiety only care about getting bigger and stronger within you. They take hold by distorting your thoughts and behaviors. They tell you that your best efforts will only lead to more pain and your notions of positivity are faulty and illogical.
People with RA often begin to create tests or challenges for people in their lives. They may go days or weeks without contacting loved ones to see if those people reach out to them. When they do not, the person with RA will feel like no one cares. This is an example of the flawed, over-generalized thinking common with depression and anxiety.
From here, many factors make you think that you would be better off staying in the home including the irrational thoughts that people don’t care about you, they don’t understand your situation, the notion that your life will not improve by leaving and the overriding consistency of RA-related pain. Being withdrawn turns into isolation when you are cut off from the people, places and things in life that bring you joy.
It is impossible for anyone to say that staying active and getting out of the home will make your RA symptoms reduce or will make your life get any better.
What can be said, though, is that isolation always makes your symptoms worse. If you want to avoid isolation and maintain what you have, you must implement coping strategies.
- Assess your comfort zone. Your comfort zone is not something that people usually pay attention to, but if you are reading this, you probably should. Think about the things that you have done over the past weeks. Begin to keep an activity log to track the times you left the house, the times you talk to friends and how you felt during and after doing so. How does your comfort zone look? Avoid editorializing or excusing your behaviors. Let the data speak for itself.
- Assess your mood. Once you gather data, you can begin looking for contributors. Depression is a common explanation for why people withdrawal and isolate. How has your mood been? Have there been any changes to your eating or sleeping habits? Have you been feeling worse about yourself or the people around you without good reason? Has your energy, motivation or concentration been worse than previously? Understanding the role of depression will give you better information regarding ways to fight your isolation.
- Assess your anxiety. Anxiety can exist in the presence or absence of depression so don’t count out its influence until you has evaluated it individually. Like with assessing mood, use the input from your log to compile the impact of anxiety. Have you been worrying more about many things? Do certain situations, places or things make you feel panicky? Do you have a hard time turning off your mind to sleep at night? Do you feel tired and fatigued because your body is so tense and rigid? If yes, anxiety might be a factor in your isolation. In fact, there is a specific type of anxiety disorder called agoraphobia when you are fearful of leaving the house. Doing so typically results in a panic attack. If this is the case, consult with a mental health professional immediately.
- Restart old activities. Assessing the contributors is always a valuable task because it allows you to gain an acceptance of what you are combating. In the case of isolation, there must be behavioral change. Knowing why you are isolating is crucial, but it is only the first step. What did you enjoy before isolation was a part of your life? Where did you go and with whom did you spend time? Where were you on a typical Saturday night? Find ways to motivate yourself into retrying these previously enjoyable activities. With luck, you will slide back into good habits and reap the benefits immediately. Remember, doing nothing ensures that your comfort zone continues to shrink as depression and anxiety rise.
- Find new ones. Do not give up hope if the former activities do not bring back the same level of enjoyment as they once did. After all, you are a different person now than you were back then. You are older, wiser, and have new interests and limitations. Needless to say, there is an infinite amount of places to go and things to do. Stop the self-defeating cycle of listing reasons and excuses to continue your withdrawal. Go and do. Even if the pain is uncomfortable, it is manageable compared to the psychological discomfort isolation brings. Still feeling stuck? Consider this list of 176 pleasurable activities. Surely, you can find a few that pique your interest.
- Bring in the professionals. You are never “too far gone” but you may find yourself too isolated due to depression and anxiety to help yourself effectively. In situations like this, mental health professionals can do amazing work to end the isolation and reintegrate your into society. The great thing about mental health treatment is that you get the beneficial information from the appointment that can be used to lessen the negative influence of depression, anxiety and RA, but you also receive good reasons to leave the home. Weekly appointments help to build consistency and structure to your life. If isolation is problematic enough, may mental health providers have services that can come to your home to assist in getting back into the world.
Being alone is never the best option. People need other people and experiences to challenge and push them into being better versions of themselves. Spending all of your time in your home does not allow you gain from others, and it does not allow others to gain from you. When you choose to give, you choose to gain.