Positive mental health is the capacity of people to feel, think, and act in ways that enhance the ability to enjoy life and deal with challenges, such as living with arthritis. Having a strong social support network can help. Continue reading below to learn the relationship between depression and arthritis and ways to help avoid and alleviate depression.
The Center for Disease Control and Prevention estimates that 54.4 million (22.7%) adults in the United States have doctor-diagnosed arthritis – approximately one-third of them report having anxiety or depression, with anxiety more common than depression.
According to a recent National Health Interview Survey, in adults with arthritis, the prevalence of anxiety is 22.5% and the prevalence of depression is 12.1%. This estimates to about two-thirds higher than those living without arthritis or 10.3 million arthritis patients with symptoms of anxiety or depression – 4.9 million had anxiety only, 1.3 million had depression only, and 4.1 million had symptoms of both anxiety and depression.
The survey also found that anxiety and depression were more common for people who:
- are young adults
- lives with chronic pain or comorbid chronic conditions
- are unable to work due to their disease or medical condition
- have a physical disability
- currently smokes
Click here to learn more about the Center for Disease Control and Prevention report.
The relationship between arthritis and depression
Rheumatoid arthritis can increase the chances of depression; depression may worsen RA symptoms, leading to higher disease activity and disability, which in turn can lead to depression. Several studies have indicated that depression in those with rheumatoid arthritis is linked to greater joint pain and other symptoms of RA such as fatigue and sleep disturbances, decreased immune function, and a higher mortality rate. Untreated depression may cause you to be less likely to take care of yourself, less motivated to stick to a treatment plan, more likely to isolate yourself from friends and family and avoid activities you once enjoyed. For all these reasons depression can affect the outcome of treatment. Click here to learn more.
Additionally, pain is an indicator of the highest chance of experiencing depression. Again, there may be a backwards and forwards relationship between pain and depression, with pain increasing depression and vice versa. A demonstration of the connection between the two conditions is a study that found almost one-third of individuals with RA felt they had a higher level of disease severity than their doctors evaluated. This disagreement occurred most often in RA patients who experienced symptoms of depression, and who had the lowest overall function.
Pain researchers are discovering how emotions, thoughts, and behaviours can influence the level of pain someone experiences and how well they adjust to it. For instance, how an individual responds to stress can predict how well they will recover from hip replacement surgery. Even how a patient feels about whether their coping strategies are working, or not, can affect their experience of the pain itself. Other factors that can influence how well you manage with your disease are whether you feel helpless, tend to spend a lot of time thinking about your pain, whether you decide to accept your pain and carry on in spite of it, and how well you handle stress.
There appears to be no link between severity of the disease and a greater chance of depression; however, there is a link between depression and physical disability. Older patients, even with greater disease activity, tend to adjust better to their disease than younger ones.
How much loss you feel as a result of your disease is likely a large part of how well you cope with it. You may be more likely to become depressed if you have lost your job or friends due to your diagnosis, are unable to participate in previously enjoyed recreational and social activities, or have more difficulty looking after your family.
There are steps you can take to improve the outcome of your arthritis. Untreated depression can lead to a downward spiral of health, so if you think you may be depressed, consider finding help from your doctor or a therapist.
Strategies to avoid or alleviate depression
- Try to find a way to express your emotions, including thoughts or feelings such as anger, in a safe environment.
- Consider taking time to examine your support network. How do you feel about the type of social support you get? Is it sufficient? Are you in a relationship in which you have positive support?
- Try to train your brain to think more positively (focus on positive events no matter how small or rare they may seem), but try to feel less guilty about your emotions no matter how negative.
- Try to find things to laugh about. Laughter can boost your immune system, but it also just plain feels good.
- Try to stay grounded in reality by not personalizing, or feeling responsible for, negative occurrences, and try not to expect the worst.
- If your partner is depressed, that may be affecting how well you cope with arthritis and therefore contributing to your own depression. Consider talking to your partner about also getting treatment and working together to overcome depression.
- When you feel safe to, take control by learning everything you can about your disease without overthinking your symptoms.
- Look for ways to find purpose in your life. If there are activities in your life you can no longer participate in because of your illness, find ones you can do.
- Try to practice mindfulness. Essentially, it means paying close attention to events as they occur in a dispassionate, or non-emotional way.
- Think about joining a support group, for arthritis and/or depression.
- As much as you can, attempt to exercise and eat healthfully.
- Try to do what you can to manage your pain.
The Canadian Mental Health Association provides other resources to help you stay mentally fit and healthy.