For this week's blog entry, I will be talking about Rheumatoid Arthritis and Mental Health. When thinking about an autoimmune disease that affects your joints, people don't always associate that with mental health.
It has been shown that RA patients are more prone to have anxiety, depression and cognitive impairment compared to the general healthy population. This is because RA can cause inflammation and damage to the joints. It can also present with extra-articular manifestations, affecting other major organs in the body. Those mental health conditions contribute to less responsiveness to treatment and higher disease activity in RA mainly due to fatigue and bodily pain.
What is Anxiety and Depression?
Anxiety is characterized by feelings of tension, worry and irritability along with physical changes like increased blood pressure.
Depression is characterized by sadness, a lack of interest in daily activities, weight loss or gain, sleeplessness or excessive sleeping, lack of energy, inability to concentrate, feelings of worthlessness or excessive guilt, and recurrent thoughts of death or suicide.
The Facts
According to The Arthritis Foundation, depending on the type of arthritis, rates can be between two and 10 times greater than the rates in the general population. Studies also show that anxiety and depression can lower your pain threshold, and then the chronic pain aggravates your anxiety and depression. Furthermore, people with arthritis and depression tend to have more functional limitations, are less likely to adhere to their treatment regimens, and have increased odds of developing other health problems.
Depression makes pain worse. Depression weakens a person’s ability to deal and cope with pain. A person’s perception about their condition, for example back pain, might become more negative when compared with individuals who are not depressed. RA may cause mental health conditions, but those mental health conditions can also worsen RA.
One study found that among people with RA, the incidence of anxiety was 24% higher, depression was 46% higher, and bipolar disorder was 21% higher than in the general public.
How do they connect?
Pain causes stress, and stress causes a release of chemicals that change mood. When mood changes, there is a domino effect. It’s harder to sleep and stress levels may rise. Simply put, anxiety and depression appear to worsen pain or make it more difficult to manage pain.
IMPORTANT: Focusing only on RA, without addressing mental health conditions like anxiety or depression, can lead to lower quality of life. People may see a decline in various aspects of daily living. They may have higher pain levels and greater risk for heart disease. Personal relationships and productivity at work may also be affected.
Treatment/ management
Stress reduction techniques, such as mindfulness or meditation
Taking medications on schedule (both RA and mental health)*
Regular physical activity, such as an arthritis-approved physical activity program
Education or workshops in self-management of RA
* Your healthcare provider may also recommend medication, psychotherapy, or other lifestyle changes to help manage your mental health.
My experience
IMPORTANT: As I've said in previous entries... each person's personal RA journey is different. These are things I've found that helps when it comes to my RA, whilst your experience may be different.
Personally, I struggle with anxiety and depression. I was diagnosed around 5 years ago (17 years old), which is significantly later than my RA diagnosis (9 years old.) Although I have figured out my own personal tips and tricks to manage my RA, learning to manage my mental health is still a learning process. I have found some things that can help me when I am struggling with my mental health, but i have found that my RA sometimes can make those things difficult to do.
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