When to Seek Help
So how do you know when it’s time to talk to your doctor about depression? You should talk to your doctor if:
- Pain or fatigue is limiting your daily activities, such as cooking, dressing, or going out with friends.
- You can’t sleep at night.
- You feel worthless or hopeless about life.
- You’re starting to isolate yourself from people.
- You have trouble concentrating.
Zautra also suggests thinking about your life beyond RA. How are your relationships with your spouse, friends, and coworkers? Do you wake in the morning thinking you can’t get out of bed because of pain or because of the way you feel about yourself?
Once you can get a handle on what’s contributing to your depression, you can figure out what to do. “Think about what has helped you be resilient in the past and how you can apply that to this situation, and perhaps try new things, as well,” he says.
8 Ways to Deal with Depression
It’s important to deal with depression and RA together, experts say. Along with getting effective medical treatment for your RA, these activities -- alone or together -- may help:
Counseling. Psychological therapy or counseling can help you find new methods for coping with pain and stress. Too often, Zautra says, people with RA let pain run their lives. “Chronic pain can narrow your focus, so you’re always thinking about the pain, when it’s there and even when it’s not,” he says. “But you can learn to focus your attention on other aspects of life that are or can be sources of pleasure, value, and purpose. It doesn’t mean the pain goes away, but it becomes less primary in your life.” Ask your doctor for a referral to a psychologist who specializes in pain coping skills.
Support. Having a good support network is important for people with RA. Even if you have a spouse or friends to lean on, support groups can provide tips to make the day go easier and offer camaraderie with other people dealing with the same issues. Check with your local Arthritis Foundation chapter for a group near you.
Meditation. In a 2007 study, researchers at the University of Maryland looked at how a type of meditation called Mindfulness-Based Stress Reduction (MBSR) affected 63 people with RA during a six-month period. They found that it reduced psychological distress by about one-third. Other studies also have shown the benefits of meditation for conditions marked by chronic pain. And meditation seems to help people with RA deal with stress, an advantage because stress may cause RA to flare.
Activity. Exercise may be one of the last things you feel like doing, but it’s one of the most important. “Get some type of physical activity each day, even if it’s just getting outside to get the mail,” says Lin. Substitute new activities for ones you may not be able to do with RA -- like swimming instead of running. Exercise not only helps keep your joints flexible and your heart healthy; it releases endorphins -- the brain’s “feel good” chemicals -- that may ease depression.