Overview of Rheumatoid Arthritis and Your Mental Health
Rheumatoid Arthritis (RA) is known to manifest through several physical symptoms. However, people who are living with Rheumatoid Arthritis are also known to experience many mental health issues that are not physically visible, but are deeply connected to the condition. When we say mental health, it refers to a person’s psychological and emotional well-being.
While scientists are still unsure about what are the connections involved between Rheumatoid Arthritis and a patient’s mental well-being, new research suggests that many of the same processes of inflammation that is known to cause Rheumatoid Arthritis are also directly associated with depression.
Rheumatoid Arthritis is known to take a toll on your mental health because the disease is known for causing severe pain, fatigue, and stiff joints. It is common for many patients of Rheumatoid Arthritis to experience depression. In fact, people who have Rheumatoid Arthritis are two to four times more likely to have depression as compared to someone who does not have Rheumatoid Arthritis. It is especially true in cases where Rheumatoid Arthritis makes it difficult to enjoy the simple things in life.
The problem that arises is that this becomes a vicious cycle. Depression makes the pain and fatigue related to Rheumatoid Arthritis worse and also increases the risk of heart disease, which is already on the higher side in people who have Rheumatoid Arthritis.
A person’s emotional and mental state of health are essential factors to consider when doctors look at the overall well-being. Paying attention to your emotional and mental health is also going to have an impact on how well you manage your condition. If you have been diagnosed with Rheumatoid Arthritis and you notice any changes in your mood, if you feel depressed or anxious, then you should immediately inform your doctor. Upon learning about your symptoms, your doctor is likely to ask further questions and then suggest options for therapy, treatment, or simple and dietary lifestyle changes.
Living with Rheumatoid Arthritis and Mental Illness
Anxiety and depression are the two most common mental disorders that people who have Rheumatoid Arthritis experience. In 2017, a study carried out in the United Kingdom found that within five years of receiving a diagnosis of Rheumatoid Arthritis, nearly 30 percent of all patients ended up developing depression.(1)
Another study also done in 2017 carried out by the Keele University in the United Kingdom found that people who have RA experience a higher rate of anxiety as compared to those who do not have Rheumatoid Arthritis.(2) In fact, the anxiety rate is almost 20 percent higher. This study was published in the British Journal of General Practice, and it also reported that the rate of depression in people with RA was 39 percent higher than those who did not have Rheumatoid Arthritis.
While depression and anxiety do not manifest themselves with the same physical symptoms that are commonly associated with Rheumatoid Arthritis, they still come with their own set of challenges. Living with even one of these long-term health conditions, without having Rheumatoid Arthritis, can itself prove to be highly challenging, so imagine the difficulties faced by patients who experience anxiety, depression, and Rheumatoid Arthritis all together.
Why is it Important to Seek Treatment for Mental Illness If You Have Rheumatoid Arthritis?
According to research by the Mayo Clinic(3), not treating depression is going to make it more difficult to treat Rheumatoid Arthritis.
A 2017 study carried out by the University of Bristol and published in the Psychosomatic Medicine journal, discovered a strong link between depression and Rheumatoid Arthritis that goes both ways. This means that pain that stems from Rheumatoid Arthritis is known to make depression worse, which, in turn, is only going to make it tougher for a person to manage their Rheumatoid Arthritis symptoms.(4)
This happens partially because pain is known to cause stress, and stress leads to the release of chemicals in the body that directly affects your mood. When there is a change in mood, there occurs a domino-like effect. It becomes harder to sleep, again increasing the stress levels. So anxiety and depression are going to worsen Rheumatoid Arthritis pain and also make it more challenging to manage this pain.
On the other hand, though, if you focus only on treating Rheumatoid Arthritis, without addressing the mental health conditions such as depression or anxiety, then this will eventually lead to a lower quality of life. You might notice a steady decline in the many aspects of your day to day life, and you may also experience an increase in your pain levels. It also increases the risk of heart disease. In many cases, productivity at work and personal relationships also get affected.
Is There a Biological Link Between Rheumatoid Arthritis and Depression?
Research carried out by the University of Cambridge, and the Maurice Wohl Clinical Neuroscience Institute in the UK in 2018 has found a potential biological connection between Rheumatoid Arthritis and depression.(5) According to the researching team, joint damage, and pain that is associated with Rheumatoid Arthritis are known to stem from inflammation, and there is now sufficient evidence to prove a link between inflammation and depression.
One of the primary methods in which researchers’ measure inflammation is by testing the levels of C-reactive protein (CRP) in the body. It is known that CRP levels are usually higher in people who have depression, and the study also found that CRP levels were also significantly higher in those people whose depression was hard to treat.
While it is yet too early to say for sure that inflammation is the reason behind why many people experience both Rheumatoid Arthritis and depression together, but this new research has definitely opened up a new line of thought that is worth exploring further.
Depression Might Go Underdiagnosed
It is a well-known fact that mental illness often co-exists with many forms of arthritis. However, it often happens that people who are living with Rheumatoid Arthritis do not get screened for any psychiatric disorders. This causes many patients to live with untreated mental health conditions.
The study that was done in 2017 by the Keele University and published in the British Journal of General Practice(2) found that over time, people start thinking of their anxiety or depression as being a normal part of living with Rheumatoid Arthritis. Some people also believe that doctors will place more stress on the treatment of their Rheumatoid Arthritis symptoms rather than giving importance to the mental health symptoms.
Many are also nervous or embarrassed to bring up their mental health or may be concerned that the doctor might simply dismiss the psychiatric symptoms and focus, instead, on the physical symptoms of Rheumatoid Arthritis. However, it is vital to your overall health that you find the right resources to help you manage your mental health properly.
Be it discussing with your doctor or finding a mental health professional by yourself or even a support group, there are many options available today that help you address any type of mental health issues.
If you are living with Rheumatoid Arthritis, then it is essential that you keep a close watch on your mental health along with your physical health. It is believed that there is a link between Rheumatoid Arthritis and many mental health conditions, especially depression and anxiety. Seeking treatment for any mental health condition you might be having will help you manage your Rheumatoid Arthritis symptoms also more effectively. So if you are concerned about any aspect of your mental and emotional health, you should discuss the same with your doctor at the earliest so that you can avail the proper treatment.
- Jacob, L., Rockel, T. and Kostev, K., 2017. Depression risk in patients with rheumatoid arthritis in the United Kingdom. Rheumatology and therapy, 4(1), pp.195-200.
- Machin, A., Hider, S., Dale, N. and Chew-Graham, C., 2017. Improving recognition of anxiety and depression in rheumatoid arthritis: a qualitative study in a community clinic. Br J Gen Pract, 67(661), pp.e531-e537.
- Mayo Clinic. (2019). Is depression a factor in rheumatoid arthritis?. [online] Available at: https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/expert-answers/rheumatoid-arthritis-depression/faq-20119780 [Accessed 14 Aug. 2019].
- Euesden, J., Matcham, F., Hotopf, M., Steer, S., Cope, A.P., Lewis, C.M. and Scott, I.C., 2017. The relationship between mental health, disease severity, and genetic risk for depression in early rheumatoid arthritis. Psychosomatic medicine, 79(6), p.638.
- Chamberlain, S.R., Cavanagh, J., de Boer, P., Mondelli, V., Jones, D.N., Drevets, W.C., Cowen, P.J., Harrison, N.A., Pointon, L., Pariante, C.M. and Bullmore, E.T., 2019. Treatment-resistant depression and peripheral C-reactive protein. The British Journal of Psychiatry, 214(1), pp.11-19.
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