If rheumatoid arthritis is making you depressed, Patricia Doyle’s experience may sound familiar.
Doyle used to love to take long walks near her home in San Francisco and went dancing three nights a week. But four years ago, she was diagnosed with rheumatoid arthritis at the age of 58. As the pain got worse, she reluctantly gave up those activities. And when she was laid off from her job about two years later, depression hit her hard.
“I didn’t want to get out of bed,” Doyle says. “Nothing mattered to me. It was a horrible feeling.” Thinking that she should be able to fix it on her own, she tried walking every day. That helped, but not enough. So recently she “gave in” to the idea that she needed professional help. “I finally told my doctor how depressed I really was, and he started me on an antidepressant,” Doyle says.
Doyle’s story may ring a bell with you. Depression can develop from living with chronic pain or from the feeling that RA has limited your independence, social activities, and mobility. It often leads to a downward spiral: Giving up an activity you enjoy because it becomes too painful can make you depressed, the depression makes you focus more on your pain, and then you become more depressed. You may start to lose sleep, feel more fatigue, and become isolated.
But experts say that treating depression can set you on an upward spiral. It can help reduce anxiety, stress, and even some of the physical pain of RA.
RA and Depression: The Psychology of Pain
“Depression and pain go hand in hand,” says Elizabeth Lin, MD, a family practice doctor and scientific investigator for the Group Health Research Institute in Seattle. Not only can pain bring on depression, but depression can make pain worse, Lin says. “It has been found to lower the threshold of how we tolerate pain -- how easily pain registers in our brain.”
No one should feel embarrassed or stigmatized by depression. “Pain is depressing; there’s no doubt about it,” says Alex Zautra, PhD, a professor of psychology at Arizona State University in Tempe who has conducted several studies on arthritis and well-being. “It’s really a mind-body problem. What happens in the body affects the mind, but the mind affects how much energy people have to be resilient in the face of pain.”
How Treating Depression Can Ease RA Pain
The upside of the link between pain and depression: Studies show that alleviating depression can also help relieve arthritis pain.
In a 12-month study of 1,001 people with arthritis, people who received psychotherapy or took antidepressants had fewer symptoms of depression and reported less pain, and were able to take part in daily activities more than those who did not.
Another study in 2007 found that counseling and coping skills, such as relaxation techniques and pacing activities, not only lowered anxiety and depression but also reduced joint swelling and increased physical abilities. Two-thirds of the people in the study were women.