The Interaction Between Emotions and Arthritis
How One Affects The Other
If you have arthritis, you know how painful it can be. What you may not know is that arthritis pain can cause mental health issues like anxiety and depression. These conditions can then make arthritis pain worse.
Depression and anxiety are two of the most common mental health issues experienced by those with arthritis, but there are others.
In 2017, British researchers learned that 30 percent of people who received an arthritis diagnosis developed depression within five years.
What Is Anxiety?
Anxiety is excessive and unjustified worrying. If anxiety escalates to epic proportions, it can turn into a panic attack that puts you in fight or flight mode. Physical symptoms include a racing heart, shaking hands, sweating and a dry mouth. These episodes can last for minutes, hours or even days.
Intense, long-term panic and constant anxiety can give you a headache and make you feel nauseous and dizzy. According to Healthline, "Having a serious medical condition or a substance use disorder can also lead to an anxiety disorder."
What Is Depression?
When you have depression, life doesn't seem worth living. Sadness, sleeping too much, fatigue, isolating, lethargy and changes in weight are common symptoms of depression. You might feel guilty or worthless because you're not getting things done, but at the same time, you might not want to leave the house. In extreme cases you might even feel suicidal.
What's the Connection Between Depression, Anxiety and Arthritis?
A study in the journal Psychosomatic Medicine reported that pain from arthritis can make depression worse. Worsening depression makes it harder to manage arthritis.
Studies reveal a concurrence between mental health issues and arthritis. Researchers found that people with arthritis are up to 10 times more likely to experience depression and anxiety than the general population.
Research also shows that depression and anxiety can reduce your threshold for pain. Worsening chronic pain increases depression and anxiety and makes arthritis harder to treat.
People with arthritis and depression tend to have more functional limitations. They are less likely to follow treatment plans and are more likely to develop additional health issues. These issues, in turn, can significantly disrupt arthritis management.
According to a 2017 British Journal of General Practice study, people with arthritis are 20 percent more likely to experience anxiety and 39 percent more likely to get depressed.
Even though anxiety and depression do not cause the same symptoms as arthritis, they generate troublesome symptoms of their own. Arthritis is challenging enough. When you add mental health problems to the mix, feeling better can seem impossible. Meanwhile, each condition is making the other conditions worse.
Can Pain Cause Depression?
Numerous studies have shown that those with the highest arthritis pain levels are most at risk for anxiety and depression. Researchers aren't sure why, but a significant correlation between anxiety, depression and pain is well-established.
Daily chronic pain is debilitating. It drains your energy. It takes everything you have just to put one foot in front of the other. This is a depressing situation in and of itself.
Chronic pain causes chronic stress, and chronic stress can disrupt the biochemical balance in your brain. Stress releases chemicals that change mood, and when mood changes, all the other variables change as well.
Stress hormones and neurochemicals like cortisol and serotonin can impact your thoughts, emotions and behavior. A severe imbalance in brain chemistry caused by chronic pain can trigger a major depressive episode in some people with arthritis.
Does Depression Make Pain Worse?
Depression makes it harder to cope with all stressors, particularly pain. If you see your life through the black-tinted lenses of depression, you are more likely to feel hopeless and negative about your condition.
Untreated depression, stress, lack of sleep and anxiety can all interfere with arthritis treatment and cause pain levels to rise. According to the Mayo Clinic, failing to treat mental health issues like depression and anxiety can reduce arthritis treatment effectiveness and cause the health of the person to deteriorate.
If you have arthritis, it can be difficult to complete daily living tasks. Increased pain puts you at greater risk for heart disease, while personal relationships and work productivity can suffer.
The Role of Inflammation in Arthritis
Joint damage and pain from arthritis are partially due to inflammation. Studies suggest a link between inflammation and depression. A biological inflammation marker called C-reactive protein (CRP) is generally higher in those with depression. According to a 2018 study, CRP could be even higher for those with severe, treatment-resistant depression.
The Connection Between Inflammation and Depression
It's been shown that depression is connected to arthritis pain and disability. A new theory suggests that inflammation is also involved.
Inflammation is thought to play an important role in the pain, disability, depression and anxiety that can accompany arthritis. Numerous studies suggest that depression is an inflammatory state.
In 2016, a study published in The Journal of Clinical Psychiatry revealed that CRP levels in 10,036 people were 31 percent higher for those with depression.
Patricia Katz, PhD, professor of medicine at University of California San Francisco, tells us, “There is a well-documented event called cytokine-induced depression, where cytokines are increased, and depression occurs.” Certain cytokines are linked to the pain and inflammation present in arthritis.
Effects of Undiagnosed Depression
The connection between mental health and arthritis is well-established. Those with arthritis may be experiencing untreated mental health challenges as a result.
A recent study found that people with arthritis may perceive anxiety and depression as a normal part of their condition. They might hesitate to share it with their doctors for that reason.
Other people are afraid of being stigmatized if they admit they might have mental health issues. Instead, they believe they should be strong enough to overcome these symptoms on their own.
You might be worried that your doctor will dismiss your symptoms as imaginary. However, if these issues are not addressed, your doctor won’t have all the information necessary to give you the best possible treatment.
Getting help with mental health issues can have a positive effect on arthritis. If you're feeling depressed or anxious, talk to your doctor. Treatment options include individual or group therapy as well as a variety of support groups.
The reasons for depression and anxiety may be different for those with arthritis. However, addressing these concerns can change your life or even save it. When you combine mental health treatment with arthritis care, these treatment modalities can each have a positive effect on the other.