How to Manage Depression With Rheumatoid Arthritis

From the WebMD Archives

If you've had RA for a while, it won't come as a surprise: A serious case of the blues can sometimes tag along with your achy joints.

But it doesn't have to be this way. The right approach can lift your spirits and keep depression from becoming a regular visitor.

Treat the Arthritis

Your first step is to ease the joint pain that can fuel your depression. Megan Koelzer, a 21-year-old with rheumatoid arthritis, has personally seen how those symptoms are connected.

"When I'm having a bad flare [of arthritis], the anxiety and depression will come on," says the student at Central Michigan University. "In the same sense, if I get a really bad day with the depression and anxiety, the arthritis acts up."

"It's like a vicious cycle," says Ozlem Pala, MD, an assistant professor of medicine in the division of rheumatology at the University of Miami Miller School of Medicine. "When you're depressed, then the sensation of pain will also be increased."

If you hurt less, your mood may get a boost. It's important to follow a medical plan and keep up with your meds to get your RA pain under control, says James O'Dell, MD, chief of the rheumatology division at the University of Nebraska Medical Center.

Talk to Your Doctor

Get his input on more than just your arthritis. Your doctor can also trouble-shoot your emotional health and recommend a therapist who treats depression. He can also suggest a psychiatrist who can prescribe antidepressant medications, if that's right for your situation.

"Letting your doctor know and telling them you are willing to see someone to help deal with depression is critical," O'Dell says.

Get Active

Exercise eases pain and boosts your mood at the same time. Several studies show less depression in adults with rheumatoid arthritis who exercise.

Be careful what kind you choose, though, especially when you have a flare of RA symptoms. Stretching and low-impact activities are a good choice. Try walking, biking, or swimming.

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Stay Connected

Koelzer finds that social media can put her in touch with others who are going through some of the same things she is. When she's awake at 3 a.m., she signs on to the Twitter account she created to follow other people with long-term illnesses. "People are live-tweeting what they're feeling," she says. "[I realize] I'm not the only one. It's comforting."

Koelzer is also a volunteer spokesperson for CreakyJoints, an online, non-profit support community for people with arthritis. It's another way to reach out to people who are looking for ways to manage their RA.

If you're not part of the Twitter generation, try a traditional support group -- one that meets in person or on the phone. They can fill the same role, leaving you feeling hopeful and empowered.

Write About Your Feelings

Koelzer recently treated herself to a fancy leather-bound journal. She's learned from experience that writing about her emotions relieves anxiety.

Other forms of expression might be just as effective. "If it's not the middle of the night," she says, "I can go play some intense Mozart."

Find a Counselor

Studies show that talking with a therapist, psychologist, or counselor can help people with mild to moderate depression. Cognitive behavioral therapy in particular may boost your mood. It focuses on changing ways you think and act.

When you meet with a mental health professional, it can help boost your self-respect and self-esteem, says Jonathan David Krant, MD, medical director of CreakyJoints.

Watch What You Eat

It's extra important to stick to a healthy, balanced diet when you have rheumatoid arthritis. That means you should cut back on fat while you pile lots of fruits and veggies on your plate.

Also look for food with omega-3 fatty acids, like salmon and other fatty fish. They help fight the inflammation that causes the painful joints that are linked to your depression.

You don't have to completely change your eating habits overnight. You can start by making one or two small food swaps at a time. Substitute whole grains for refined products, for example.

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Go Alternative

Consider alternative therapies that might relieve your pain and depression. Acupuncture, massage, or meditation can help.

Whatever route you go, the important thing is not to ignore your emotional health when you're feeling down in the dumps. Depression is treatable, so make sure you take the steps to get back on track.

WebMD Feature Reviewed by David Zelman, MD on October 20, 2016

Sources

SOURCES:

Megan Koelzer, volunteer spokesperson, CreakyJoints.

The Rheumatologist: "Depression in Rheumatoid Arthritis."

Harvard Health Publications: "Infection, autoimmune disease linked to depression."

Ozlem Pala, MD, assistant professor of medicine, division of rheumatology, University of Miami Miller School of Medicine.

Jonathan David Krant, MD, medical director, CreakyJoints.

James O'Dell, MD, chief of rheumatology, University of Nebraska Medical Center, Omaha.

News release, University of North Carolina.

Kelley, G. Arthritis Research & Therapy, February 3, 2015.

Arthritis Foundation: "Best Exercises for Rheumatoid Arthritis," "Antidepressants: OK for RA?" "One-Third of People With Arthritis Have Anxiety and Depression," "Depression Common in Rheumatoid Arthritis."

News release, Hospital for Special Surgery.

Smyth, J.M. JAMA, April 14, 1999.

Gortner, E.  Behavior Therapy, September 2006.

Sloan, D.M. Emotion, April 2008.

National Rheumatoid Arthritis Society (UK): "Depression and rheumatoid arthritis."

Field, T. Complementary Therapies in Clinical Practice, May 2013.

Zautra, A.J. Journal of Consulting and Clinical Psychology, June 2008.

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