Coping With Rheumatoid Arthritis and Depression
Mariah Leach and Eric Patterson share advice for dealing with the mental health issues that can accompany RA.
Living with a chronic illness like rheumatoid arthritis (RA) is certain to be physically challenging, but it can also be very emotionally challenging. According to the Arthritis Foundation, as many as 40 percent of individuals living with RA experience significant symptoms of depression. Additionally, recent studies have highlighted high levels of anxiety in RA patients.
Personally, I have experienced both depression and anxiety at various points during my RA journey. The good news is that depression, anxiety, and RA are all treatable. If you live with RA and you are struggling emotionally, know that you are not alone. Here are some ideas that might help:
Treat Your RA
Living with a chronic condition like RA, day in and day out, can certainly take a toll on your mental health. On the flip side, depression and anxiety can make it harder to cope with RA.
In fact, struggling with your mental health can actually worsen arthritis-related pain, lead to more physical function problems, and result in poorer health overall. In order to break this vicious cycle, you need to address both sides of the problem — and that includes addressing the physical symptoms of your RA.
If you are able to work with your rheumatologist to find a treatment that gets your RA under better control, the reduction in physical pain could help reverse the cycle by having a positive impact on your mood.
Treat Your Anxiety or Depression
Since there can be a bit of a stigma surrounding mental health issues, one of the biggest challenges to successful treatment is the reluctance people may have to seek help. However, if you don’t tell your doctor how you are feeling, your doctor won’t be able to help you.
There are many medications that can be used to treat anxiety and depression, including selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and more. These medications can help break the negative feedback cycle by boosting your mood, which will make it mentally easier to handle your RA.
Some antidepressants may even have an analgesic effect, meaning they could also help directly with pain. Because every individual’s situation is different, it’s important to work closely with your doctor to find the best treatment plan for you. If you are seeing multiple doctors — such as a rheumatologist and a mental health specialist — it’s also important to make sure your doctors coordinate treatment to avoid negative drug interactions.
Talk to a Therapist or Counselor
In addition to considering appropriate medications, talking to a therapist or councilor can help you discover other tools to maintain your mental health. For example, cognitive behavioral therapy is a type of psychotherapy that focuses on changing negative thought patterns and behaviors.
CBT and other types of therapy can be done individually or in a group setting. You can also consider taking a self-management or stress reduction class.
Personally, I chose to talk to a therapist in an individual setting and then take a class on mindfulness-based stress reduction techniques. It can sometimes take a while to see results from these types of therapies, so it’s important to make a commitment and stick with it. If you aren’t sure how to find someone to talk to, you can ask your rheumatologist for a referral to a qualified mental health professional.
Try to Exercise Regularly
I know from personal experience that this one is easier said than done, but the truth is that exercise can have positive impact on both RA and mental health. Exercise boosts your body’s endorphins, which are the chemicals that help boost your mood.
So, even if it is a struggle, it’s worth searching for a type of exercise that you may be able to enjoy. For many of us living with RA, it’s better to focus on low-impact exercise so that we don’t increase our levels of pain.
Options include walking, biking, swimming, or even yoga or tai chi. When the weather is nice I like to get out and ride my bike, and when it’s raining or snowing I try to visit my local indoor pool. I often don’t feel like exercising, but once I get going I’m always glad that I did!
Make Good Sleep a Priority
Getting a good night’s sleep is something else that can have a positive impact on depression, anxiety, and RA, though I know this is another suggestion that is easier said than done — especially if you have kids! However, a lack of sleep has been shown to prompt inflammation and make people more aware of their pain, which can initiate that vicious cycle all over again.
Things you can do to promote good sleep include going to bed at the same time every night, avoiding caffeine for several hours before bed, and avoiding screen time too close to bedtime. I find that a warm bath before bed helps me sleep better, and I think adding Epsom salts aids in relaxation as well as reducing my levels of pain.