Just ask Carla Guillory. She's become an expert at what psychiatrists call realistic optimism -- reining in your thoughts, keeping fears and negativity at bay. It's been Guillory's mental way-of-life for upwards of 20 years, ever since rheumatoid arthritis set in.

It's a simple formula: "I just don't think about what might happen, what deformities might pop up. I hold onto positive thoughts," Guillory says. Yet she's no Pollyanna. "I have less strength in my arms and hands. I move slower now. And I know I will get a little slower as I get older. But beyond that, I don't think about the future. I believe that I'll always do pretty well."

Guillory also gets a good bit of support from her family and friends. She stays active. She worked for many years after her diagnosis. She exercises when she can. She wouldn't think of skipping her medications.

All this adds to her quality of life, experts say. By taking care of herself and staying emotionally strong -- taking things in stride -- she's helping her body stay strong, even reducing her own pain. There's good scientific evidence that a positive attitude is necessary for optimal physical health.

It's the mind-body connection. As studies have shown, your state of mind is an essential element in your health and well-being.

The Importance of Optimism

"Optimism is necessary for good health," says Charles L. Raison, MD, a psychiatrist and director of the behavioral immunology clinic at Emory University School of Medicine in Atlanta. "There's growing evidence that, for many medical illnesses, stress and a negative mental state -- pessimism, feeling overwhelmed, being burnt out -- has a negative affect on immunity, which is especially important in rheumatoid arthritis."

Indeed, your brain can create all sorts of tailor-made prescriptions to nurture your body. Raison says these include endorphins -- the natural painkillers; gamma globulin, which fortifies your immune system; and interferon, which helps combat infections, viruses, even cancer.

When depression sets in, we're less likely to take care of ourselves, which means the brain doesn't get prompted to produce those great natural remedies, Raison says. We don't exercise, because we don't have much energy. We don't eat right. We lose sleep -- or we sleep too much.

Even worse, we forget to take the very medications that can help us feel better, Raison tells WebMD. "There's a lot of evidence that when people are depressed, they feel hopeless, they give up on themselves, which affects whether they take medications," he says. "There's also evidence that people who have a positive attitude, what we call realistic optimism, the fighting spirit… they live longer, do better… they take their medications."

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Rheumatoid Arthritis Guide

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Do You Have Fibromyalgia Pain?

Cymbalta is approved for the management of fibromyalgia.

Important Safety Information

Cymbalta^® (duloxetine HCl) is approved for the treatment of depression and generalized anxiety disorder, and for the management of diabetic peripheral neuropathic pain and fibromyalgia.

What should I talk about with my healthcare provider?

Patients on antidepressants and their families or caregivers should watch for new or worsening depression symptoms, unusual changes in behavior, thoughts of suicide, anxiety, agitation, panic attacks, difficulty sleeping, irritability, hostility, aggressiveness, impulsivity, restlessness, or extreme hyperactivity. Call your healthcare provider right away if you have thoughts of suicide or if any of these symptoms are severe or occur suddenly. Be especially observant within the first few months of antidepressant treatment or whenever there is a change in dose.

You should also know that:

Suicide is a known risk of depression and some other psychiatric disorders.
Antidepressants may increase suicidal thoughts or behaviors in some children, adolescents, and young adults especially within the first few months of treatment or when changing the dose. No increased risk has been shown for adults over age 24, and risk decreased for those over age 65.
All patients starting therapy should be monitored appropriately and observed closely for new or worsening depression symptoms, suicidal thoughts or behavior, or unusual changes in behavior.
Cymbalta^® is not approved for use in patients under age 18.

Who should NOT take Cymbalta?
You should not take Cymbalta if:

You have recently taken a type of antidepressant called a monoamine oxidase inhibitor (MAOI)
You have uncontrolled narrow-angle glaucoma (an eye disease)
You are taking Mellaril^® (thioridazine)

What other important information should I discuss with my healthcare provider?
Before starting Cymbalta, tell your healthcare provider:

about all of your medical conditions, including kidney problems, glaucoma, or diabetes
about your alcohol use
if you are taking nonprescription or prescription medicines, including those for migraine, to address a possible life threatening condition
if you are taking NSAID pain relievers, aspirin, or blood thinners. Use with Cymbalta may increase bleeding risk
if you are pregnant, plan to become pregnant during therapy, or are breastfeeding an infant

While taking Cymbalta, tell your healthcare provider:

if you have itching, right upper belly pain, dark urine, yellow skin/eyes, or unexplained flu-like symptoms, which may be signs of liver problems. Severe liver problems, sometimes fatal, have been reported
if you have high fever, confusion, and stiff muscles to address a possible life-threatening condition
before stopping Cymbalta or changing your dose
if you experience dizziness or fainting upon standing, especially when first starting Cymbalta or when increasing the dose. Your healthcare provider may periodically check your blood pressure while you are taking Cymbalta

If you have any questions, talk to your healthcare provider before taking Cymbalta.

What are the possible side effects of Cymbalta?

The most common side effect of Cymbalta was nausea. For most people who had it, the nausea was mild to moderate. Other common side effects included dry mouth, sleepiness, constipation, decreased appetite, and, increased sweating. This is not a complete list of side effects.

Safety Information and Boxed Warning | Prescribing Information | Medication Guide