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    Rheumatoid Arthritis: Keeping a Positive Outlook

    Realistic optimism fuels the body's immune system and triggers natural painkillers.
    WebMD Feature

    The stress of waging a constant health battle can get to you. Day after day, week after week. It's easy to get down, depressed.

    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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