Many people who suffer from chronic long term conditions like arthritis have symptoms like pain and weakness, and may one day experience disability. People with long-term health conditions are alsolikely to suffer from depression and anxiety. For anyone who has been diagnosed with these conditions this may come as no surprise. Research shows there may be a link between inflammation from arthritis causing or contributing to depression. There are ways you can manage arthritis and depression/anxiety while learning to live with them successfully. First, let’s look at why the two conditions appear to be linked.
Why do arthritis and low mood occur simultaneously?
The main reason that arthritis and low mood appear to be linked is the level of a particular chemical in the bloodstream. This chemical is called TNF-a (Tumor Necrosis Alpha Factor). TNF-a is naturally much higher in patients with arthritis. This chemical has been identified as the link for an increased number of people who suffer from both depression and arthritis. Some people are treated by their doctor with drugs called TNF Blockers. TNF Blockers naturally counteract the signs of depression. Some doctors believe the use of TNF Blockers can be a reason why some people suffer from low mood and others do not.
If you are suffering from chronic pain, it is likely your sleep, mobility, and general way of life may be affected. Pain that is at moderate to high levels for long periods of time can become tiring and can cause low mood. Treating the pain is only part of the story. Pain management will help, but many people find a two-way attack is needed, such as treating both the pain and the depression at the same time. For some, depression can mean not wanting to leave the house. For others, it could mean not wanting to exercise to improve the ability to move around. Not exercising can make pain and perception of pain much worse in the long run.
People who are depressed might find it harder to stick to and regulate the treatment plan set with their doctor. They may go for long periods without pain relief or without medicines to control their condition(s). Depression symptoms may be lessened quickly once a person returns to their prescribed dosages. It is always recommended to talk with your doctor when starting or stopping your medications.
It is possible for people to feel the pain and their low mood is too much to manage.* A study, conducted into arthritis, depression and suicide in Finland between the years of 1988 and 2000 with around one thousand six hundred participants, showed that there was a need for more understanding towards patients with these two conditions. Researchers felt people who suffer pain from arthritis who have depression/anxiety might be more likely to attempt suicide. The researchers found the rate of suicide or attempted suicide was higher amongst females. Males were more likely to make a suicide attempt after a shorter period of suffering. For people who overdose on medications, a recovery from overdose is completely possible. The recovery can lead to both conditions being treated thoroughly and successfully with the right help and support being put into place.
What can be done to help ease the problems of arthritis and depression?
First, if you’re reading this and thinking that you may be suffering from depression alongside arthritis, the most important thing you can do is to open up and speak to someone. This can sometimes be difficult for a lot of people. The more people who share their feelings allow for more understanding to be gained. A study, conducted by PAIN in 2001, showed that people who were newly diagnosed with arthritis got great benefit from counseling. This study also showed benefit in treatments like Cognitive Behavioral Therapy (CBT). CBT can help manage pain and to aid in relaxation. In some instances, patients found that over a period of six months, CBT also helped with symptoms like joint inflammation.
For some people, a short or longer term course of anti-depressant medication can help with the symptoms of both depression and pain. Certain medications (SSRIs) can help people relax more. This may mean that intense pain can be dulled and seem less intrusive. Many anti-depressants can be taken along with other arthritis medications. Your physician will be able to help you make the right choice for your lifestyle and your needs.
Sleep can be one of the biggest areas of concern for anyone with pain. Pain can greatly affect the amount and type of rest you’re able to get. Feeling constantly tired can impact your life. It’s important to adopt good ‘sleep hygiene’ practices. Some examples of good ‘sleep hygiene’ practices include:
· set a time every day for going to bed and getting up and stick to it
· have a good daily routine you can stick to as much as possible
· enjoy a warm calming bath with essential oils. Particularly useful for treating arthritis are blends which include lemon, tea tree, lavender and frankincense – these will help relax, calm and ease joint pain when used either in warm water as a relaxing soak or as part of massage therapy.
· drink a hot milky beverage before bed
· keep your room at the right temperature. This can vary from person to person and a degree of trial and error may be needed to find the right ‘sleep hygiene’ routine for you.
· don’t watch television, listen to loud music or use a computer in the bedroom (if possible)
Exercising aerobically can be positive for pain control as it not only helps with joint pain, but can aid relaxation and help to keep the cardiovascular system in good shape. Aerobic exercise also increases the body’s endorphins and serotonin. These hormones not only help with chronic inflammation, but also can improve one’s mood. Doctors recommend exercise like walking, swimming or even gentle movement (Tai-Chi classes). These types of exercise may be extremely beneficial in keeping the joints flexible and free from pain. Doctors often encourage proper rest, relaxation and calming the mind in addition to exercise. The Missouri Arthritis and Osteoporosis Program offers several types of exercise. To find out more about classes available for persons with arthritis or any other chronic health condition, including a walking program, please visit their website.
*NOTE: If you are having difficulty managing your pain or feelings, please talk with your doctor and share your concerns. If you are thinking about suicide, please call 1-800-273-TALK (8255) or visit http://www.suicidepreventionlifeline.org/.
This article was written and provided for the Missouri Arthritis and Osteoporosis Program by Lisa Davies.