Rheumatoid arthritis (RA) is an autoimmune disorder that attacks your body’s tissues. It affects the joint lining causing joint pain and swelling. One in six people with arthritis suffers from depression, and studies suggest that depression may worsen this disorder.1 There is some overlap with arthritic and depressive symptoms so both must be assessed and addressed to help enhance patient treatment and recovery.
The Connection Between Arthritis & Depression
Rheumatoid arthritis is a chronic illness with no cure. There are treatments designed to reduce the damage to joints. Pain is a frequent symptom related to arthritis. Consequently, it directly impacts the quality of life for diagnosed patients. These dynamics can lead to depression.
Arthritis patients are not always screened for signs of depression. There is ongoing research being done to determine the relationship between arthritis and depression. Currently, it is unclear whether depression is caused by arthritis’ physical symptoms or is a symptom of the disorder itself.2
How Pain Affects Depression
Rheumatoid arthritis is a chronic disease causing ongoing inflammation and pain. Arthritis can limit mobility, increase disability, and negatively impact people’s ability to function on a daily basis. Rheumatoid arthritis can also limit participation in activities that you enjoy and create stress that can contribute to depression. This becomes an unhealthy cycle. The greater the pain, the higher the possibility of depression. A higher level of depression can result in more intense pain.
Experts in rheumatology research have concluded that those with arthritis and depression may have a harder time coping with and managing their depression through medication.3 Ongoing chronic inflammation and pain can inhibit mobility, decrease movement, and enhance social isolation contributing to depression.
Ten Signs of Depression in Those With Arthritis
Researchers examining links between depression and arthritis discovered that depression increases the risk of mortality in those with arthritis as well as cardiovascular disease, suicidal ideation, and death.4 Depression can also lower your ability to tolerate pain.
There are specific signs to watch for that may indicate you or your loved one may be developing depression related to rheumatoid arthritis. Note there is some overlap in symptoms of arthritis and depression such as complaints of fatigue and pain.
Here are some examples of depressive symptoms:
- Fatigue
- Sexual dysfunction
- Increased social isolation
- Increased feelings of helplessness and hopelessness
- Loss of energy
- Increased complaints of body aches and pain
- Loss of appetite/ increase in appetite
- Suicidal ideation
- Loss of attention or ability to focus
- Loss of interest in things that previously brought joy
How to Get Help for Depression
When pain occurs, it causes both physical and emotional stressors. Both inflammation and pain create physiological changes in the body that can cause depression. It is important to get help for both the psychological symptoms as well as the physical symptoms caused by rheumatoid arthritis.
When seeking help for the psychological reactions to arthritis, find a mental health professional who has experience with chronic illness and chronic pain. A directory is a good place to start looking. Find out about their philosophy on working with patients with chronic pain and chronic illness. You may want to also inquire about how many sessions your chosen therapist anticipates you will need.
The fees for counseling/therapy vary depending on the license, certification, and specialty of the practitioner you see. Find out what your insurance covers. Ask about the type of insurance the therapist you selected takes. If finances are an issue, inquire if your therapist accepts a sliding scale fee. This means your fee is based on your income level and what you can afford.
Nine Ways to Cope With Arthritis & Depression
The American Journal of Managed Care describes the challenges of coping with the symptoms of rheumatoid arthritis and depression. They describe it as a “bidirectional relationship”–arthritis impairs effective coping mechanisms which can worsen depression.5
There are ways to help improve your depression and emotional health while also managing rheumatoid arthritis:6
1. Practice Self-Care
Practicing self-care can keep negative emotions at bay. Some self care options include mind-body practices, music and art therapy, exercise, a healthful diet, massages, and activity pacing.
2. Socialize
Getting involved in social activities can help distract you from pain and feel less isolated. Even something as simple as taking a walk with a friend can make a big difference in how you feel.
3. Find a Support Group
Find a support group that focuses on chronic illness or arthritis. Support groups help you feel less alone and can offer information, comfort, and support through the relationships and connections made with other members and facilitators.
4. Contact Your Doctor
If you find increasing feelings of depression that remain or get worse, reach out to your rheumatologist to discuss treatment options or referrals for additional counseling and support.
5. Talk About it
Find a trusted friend, mental health professional, partner, or family member you can candidly discuss your feelings with. Conversations like these are a great way to vent, express yourself,
6. Educate Yourself About Arthritis
Talk with your doctor about medications and treatment options that will help alleviate your pain and functionality. Be an active participant in your own care. This can help empower you.
7. Engage in Gentle Exercise
Consult your physician about what exercise options are safe and available for you. Exercise can help with joint mobility, improve muscle strength and flexibility which can all reduce pain. It can also help you feel more control over your body.
8. Keep a Gratitude Journal
Gratitude journals help you to recognize and identify things in your life you are grateful for. It helps to understand and articulate your feelings. It also helps you to identify your strengths and ways you are able to cope with challenges.
9. Practice Stress Management Techniques
Other examples of stress management techniques include deep breathing, muscle relaxation, and controlled breathing exercises. These techniques are designed to help you regain control over your body and your mind.
Final Thoughts on Dealing With Arthritis & Depression
Having the dual diagnosis of rheumatoid arthritis and depression does create numerous challenges for patients. Experts have concluded that mental health and autoimmunity may have a connection.7 If you work in tandem with the proper mental health and medical professionals you can gain the knowledge, proper treatment, and coping skills to manage these challenges. Treat both diagnoses actively and seriously in order to create the best possible outcome for yourself or a loved one.
