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, many individuals living with RA and other types of severe arthritis can experience significant symptoms of depression and anxiety.
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.
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.
Now Eric Patterson will share his insights for dealing with depression accompanying RA.
Consider Other Alternatives
There are many alternative therapies that may also be useful in treating anxiety and depression. Acupuncture or massage may have an impact on both physical and emotional symptoms. Meditation, mindfulness, and other relaxation techniques can also be useful.
Writing about your feelings may also be helpful — I chose to write about my feelings in a blog, but you could also write in a private journal. Even just getting some fresh air and sunshine may help rejuvenate you.
No one should have to endure RA, depression, or anxiety alone — particularly since feeling isolated can trigger or worsen that vicious cycle. I find that one of the most effective ways to endure the emotional impacts of life with RA is to talk to other RA patients.
Whether you join an in-person support group or connect with other patients through online platforms like this one, interacting with people who truly understand what you are going through can be invaluable.
Whatever you choose to do to address your depression or anxiety, the important thing is that you address it. The truth is that caring for your mental health is a fundamental aspect of managing your RA symptoms and your overall health.
Counselor Eric's Guide to RA and Depression
Rheumatoid arthritis (RA) is a chronic medical condition that takes its toll on a person’s physical health. Pain and stiffness limit your daily functioning. You skip the activities and events you used to enjoy because attending is not a pleasurable experience. Fatigue zaps your energy and motivation. Now, lying on the couch is all you have the energy to do. Your exercise regime is nonexistent and the medications you’re using are increasing your weight. You nap during the day and get poor sleep at night, never feeling really rested. Each day is physically challenging.
Regrettably, the challenge overlaps with your mental health. You will notice the symptoms; isolation, lack of energy, lack of interest in pleasurable activities, poor sleep and weight gain. Do these sound familiar? These are all symptoms of depression; it is easy to understand why people with RA have higher rates of depression than the general population. Physical consequences trigger low moods and feelings of helplessness.
RA and Depression Busters
You are up against a formidable opponent with RA, but there are answers to managing your mental health. Here are some mood-boosting tips:
- Accept and acknowledge - Before you can get better you need to accept your medical situation. Check out information on RA and understand your limitations. Expecting your life to go on unchanged is, sadly, unrealistic. Don’t try to fool yourself. Once you accept your state you can begin to move forward. Be aware that some level of sadness is expected. Have no fear, though; this is a healthy part of the grieving process.
- Modify – Life has changed and your expectations of yourself need to change as well. You may not be able to cook a holiday dinner by yourself anymore. You may not be able to plant a grand garden in the spring. Instead of focusing on such losses, consider some measures to modify your life for success. Asking family and friends to bring the side dishes to dinner and planting a smaller garden will yield the same benefits with less stress. Modifying your life will maintain your motivation and interests in other activities.
- Fun – There is no better depression buster than good old-fashioned fun. With RA, like other chronic medical conditions, people become focused on symptoms rather than solutions. It is far easier for you to add positives to your life than to remove the negatives. It is common that your former leisure activities are no longer an option. Don’t give up! Seek fun out and the benefits will be worth the effort.
- Supports – With more stress, you will need more support. You should not have to care for yourself alone. Others in your life will happily help because they love you and want what’s best for you. Be willing to accept help.
- Therapy – Seeking mental health treatment is always a good idea when confronted with a significant change in your lifestyle or you notice changes in your mood or energy levels.
When it comes to RA and depression, the worst thing to do is nothing. The tips in this article work well to repair damage that has already been done, but they work best as prevention. Do not wait until symptoms present themselves. Be active and anticipate issues before they come.