Mental Health and arthritis: a complex relationship
In the latest issue of JointHealth™ insight, Arthritis Consumer Experts (ACE) reports on the important relationship between mental health and arthritis. People with inflammatory arthritis are more likely to experience mental health conditions such as depression, anxiety, and “brain fog” than the general population.
This issue of JointHealth™ insight will cover the following:
Relationships between depression, “brain fog” and inflammatory arthritis
Burden of depression
Recognizing and managing depression and anxiety
Prevent depression and anxiety
Love, sex, and arthritis*
*Please be advised that the content in this section contain graphics of “joint friendly” positions during sex and may not be appropriate for you or others in your household. The graphics are excerpted from the book, “Rheumatoid Arthritis: Plan to Win”, by Cheryl Koehn, Dr. John Esdaile and Taysha Palmer published by Oxford University Press, 2002.
Much has been said and written about the importance of exercisefor our health and wellbeing. However, for people with arthritis, it also can help manage symptoms. While people with arthritis may be reluctant to exercise fearing joint damage, exercise is especially crucial for people living with all forms of arthritis disease. In fact, exercise is a vitally important part of a well-rounded arthritis treatment plan.
For people living with arthritis, pain, body weight, age and lack of knowledge about appropriate types of exercises may be hurdles to getting started on an exercise program. Another barrier is the lack of recommendation and referral for exercise by physicians. A Canadian study of osteoarthritis patients showed that only one third had been advised to exercise by their doctor. However, exercise has numerous physical and mental health benefits and there are no specific exercises that should be avoided by people with arthritis.
One of the most important benefits of exercise is weight management, which helps to improve body image and can improve the symptoms of arthritis, especially of osteoarthritis. If a person is heavier than their ideal body weight, even a small amount of weight loss can help reduce both the risk of developing certain types of osteoarthritis and the chances of osteoarthritis worsening with age.
For everyone, exercise helps to improve heart and lung function, but for people living with arthritis, a variety of types of exercise can help to reduce joint pain and control joint swelling. These include:
Range of motion exercises help to keep the joints mobile and are also useful for helping to prevent injuries.
Weight bearing exercises can decrease bone loss, keep weak joints stable, and reduce the risk of osteoporosis.
Aerobic exercises, such as walking, help with weight loss. As well, exercise can help make it easier to fall asleep and to sleep more soundly.
In addition to improved physical health, exercise has many psychological benefits. Pain can seem more pronounced when we are unhappy or upset and exercise can help reduce depression. Additionally, it can improve self-esteem and self-confidence, improve the ability to relax, improve mood and wellbeing, and promote a good body image. Exercise also provides a good outlet for dealing with stress and anxiety.
Research suggests that most types of physical activity do not cause or worsen arthritis. In contrast, a lack of physical activity is associated with increased muscle weakness, joint stiffness, reduced range of motion, fatigue and overall reduced physical fitness.
Once a regular pattern of exercise has been established, it is important to maintain this pattern.
In order to get the benefits of exercise, it is vital to stay active.
Research shows that in people with osteoarthritis, once exercise stops, the reduced pain and disability they were experiencing ends.
To ensure that you keep up with a routine of exercising, consider joining a group program or bringing a friend or family member along to motivate you.
Eight ways to get started exercising:
Try to choose a type of exercise, or an exercise program, that you enjoy. It will be much easier to stick to the program if you like what you are doing. Most types of activities are helpful for people living with arthritis, so feel free to do your favourite things such as walking, swimming, golfing, or gardening. Exercise doesn’t have to be strenuous or boring to be good for you.
Community centres can be a terrific resource. Flip through the lists of classes offered at your local community or aquatic centre to find activities that best suit your interests and physical abilities.
You may find that having a partner to exercise with will be more motivating. Research tells us that people are more likely to stick with exercises if they bring along a friend or family member.
Sometimes, having a detailed list of activities and realistic goals will help motivate you, so it may be useful to get a referral to a physical therapist to create an appropriate exercise regimen that suits you and your body. Also, keeping an exercise log can help you and your therapist monitor your progress.
For some, assistive devices such as splints or orthotics may be helpful for protecting your joints while you exercise. An occupational therapist can be a good resource.
Before beginning a new exercise program, it is a good idea to speak with your doctor or health care provider to determine the most appropriate exercise or activity for your needs and capabilities. Also, be aware that during flare-ups it is important not to over-stress and over-work joints, which may cause more pain. For this reason it is important to speak to your doctor about exercise and the types of exercises most suitable.
Try setting a firm goal and then rewarding yourself when you achieve it. For example, set a goal of swimming 5 laps. When you reach that goal, reward yourself, and then set a new goal of swimming 10 laps. Rewards can be anything that is meaningful to you: setting aside time for yourself, treating yourself to a massage or a good book, or going out for a meal with friends.
Acknowledge your effort. Be proud of yourself for taking an active role in your health care.
Arthritis Consumer Experts (ACE) releases a special edition of JointHealth™ insight for Arthritis Awareness Month in Canada: “Where is arthritis? – Everywhere.” Arthritis is everywhere and can affect patients’ jobs, financial resources, academic studies or relationships with family and friends. There are now more than 6 million people of all ages, living with more than 100 separate types of arthritis and musculoskeletal diseases in Canada. Arthritis can generally be categorized into two types: osteoarthritis and inflammatory arthritis. This issue of JointHealth™ insight provides evidence-based information on strategies to help change, overcome or manage the challenges arthritis patients face, including:
A guide to living well with osteoarthritis including information on the disease, diagnosis and self-care
Back-to-school tips for students living with inflammatory arthritis
How to participate in our #WhereIsArthritis social media campaign
Arthritis affects people of all ages and can cause stress, and in more serious cases, depression and anxiety. 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. Arthritis Broadcast Network believes people living with arthritis deserve extra relaxation on National Relaxation Day and hope that the following tips will help you relax!
Rhythmic breathing and deep breathing can help release tension from everyday life. The former involves inhaling and exhaling slowly while counting to five; the latter can be accomplished by filling your abdomen with air, like inflating and deflating a balloon.
Harvard Health summarizes the benefits of exercise as follows: Exercise reduces levels of the body’s stress hormones, such as adrenaline and cortisol. It also stimulates the production of endorphins, chemicals in the brain that are the body’s natural painkillers and mood elevators. Endorphins are responsible for the “runner’s high” and for the feelings of relaxation and optimism that accompany many hard workouts — or, at least, the hot shower after your exercise is over.Continue reading →
According to the “Psychological well-being among US adults with arthritis and the unmet need for mental health care” published in the US National Library of Medicine National Institutes of Health, the prevalence of mental health conditions such as depression, anxiety, and serious psychological distress (SPD; a nonspecific indicator of mental health problems) is higher among adults with arthritis compared to the general population.
The study finds that in individuals with arthritis, mental health issues interact with other health conditions and symptoms of arthritis (e.g., pain, fatigue, and disability) such that a decline in one area can directly or indirectly affect the others. Mental health issues can increase the severity of disability, interfere with disease management, and increase disease severity and mortality. Providing mental health support for arthritis patients can improve their overall wellbeing. It has been documented that treating depression can improve medication adherence, and improve both psychological and physical outcomes for patients.
An important strategy for reducing the pain of arthritis is treating your depression. Two approaches can be used, non-pharmacological and pharmacological, together or individually.
Separate from improving mood, antidepressants have been shown to reduce pain in many different chronic conditions, including arthritis, and they work even when depression is not a factor. How these drugs work to reduce pain is not fully understood, but may have to do with improving sleep, relaxing muscles, or increasing neurotransmitters in the spinal cord that are responsible for lessening pain signals.
Please consult your doctor to discuss your treatment options.
Battling rheumatoid arthritis – American Ninja Warrior style. #WeAreAllAbel
The TV series American Ninja Warrior (ANW) is a show where contestants compete to win the grand prize by finishing an obstacle course requiring strong, agile and determined athleticism. Contestants must have faith that they can conquer any obstacle put in front of them – the same type of faith some have when battling rheumatoid arthritis. In ANW contestant Abel Gonzalez’s case, this was true in the literal sense.
Abel grew up in Chicago with a rough childhood. His parents married young and had little financial means. In an interview with EverydayHealth, he said: “My dad was abusive. He sold tires at a flea market to try to help us get by. When I was 10, my mom and dad’s fighting escalated.” His parents eventually split up and Abel and his brothers were forced to split up. Abel and his brother were sent to live with family members in Texas, while his two younger brothers stayed behind to live with his mother in Chicago.
“I can remember my younger brothers sitting on the steps as Matthew and I drove away for good. It devastated me to be apart from my younger brothers. I was only 10. I thought that maybe I had caused my parents to get divorced,” Abel added.
The Aboriginal Children’s Hurt and Healing Initiative wanted to answer one simple question: What does pain look like? Not what it feels like, but what pain would look it if you had to express it on paper, or in this case, canvas.
In an interview with CBC News, John Sylliboy, community research co-ordinator with the Aboriginal Children’s Hurt and Healing Initiative, said: “Aboriginal children feel and experience pain just like anyone else. It’s just that they express their pain very differently. They don’t necessarily verbalize their pain, or they don’t express it outwardly through crying or through pain grimaces. A lot of kids, they just suck it up. That’s what they say all the time. ‘We just suck it up.'”
The research study spawned in 2008 when Margot Latimer, a clinical scientist at the Centre for Pediatric Pain Research at the IWK Health Centre in Halifax, observed there was no First Nations youth being referred to their pain clinic at the IWK hospital.
“My painting is about pain and the black represents how she feels inside. But she has like this white kind of atmosphere and it separates it from her pain.” – Artist, 16-year-old Source: http://www.cbc.ca/news/health/aboriginal-youth-art-pain-hurt-healing-1.3852646?cmp=rss
Today is the 5th annual Bell Let’s Talk Day, with Clara Hughes leading the campaign inviting all Canadians to talk, text and tweet and share on Facebook about mental health and help build a Canada free of the stigma of mental illness.
In a press release yesterday, Clara, Canada’s 6-time Olympic medalist and national Bell Let’s Talk ambassador since the launch of the initiative in 2010, said: “I’m really looking forward to kicking off the national conversation about mental health with Bell Let’s Talk Day 2015! Join us in the fight against the stigma that makes most who struggle with mental illness reluctant to ask for help.”
Mental illness is associated with other diseases, one of which is a type of arthritis called fibromyalgia. Fibromyalgia is characterized primarily by chronic widespread pain (CWP) in the muscles, ligaments and tendons, and a heightened sensitivity to touch resulting in pain that can last for months.