Rheumatoid Arthritis and Depression
Depression can be a normal part of living with rheumatoid arthritis. Whether it is depression that comes attached to a diagnosis or the worry and sadness that accompanies a flare, chances are you may become acquainted with this state of mind. The topics of depression and suicide prevention have previously been covered on MyRACentral by both Lisa Emrich and myself. Today's interview with Merely Me, the Community Leader on HealthCentral's MyDepressionConnection rounds out our discussion about this important topic.
You have yourself experienced depression in connection to a chronic illness. Please tell us a little about that.
First of all thank you for talking about this topic. I think that a lot of people who have been diagnosed with a chronic illness may also experience symptoms of depression. It is good to talk about it in the open and to be aware so that you can get the help, support, and treatment that you need.
Three years ago I was diagnosed with Multiple Sclerosis. It was a total shock to me as I had very little experience with illness. I was one never to even catch colds. I was, however, very experienced with battling depression. I would not say that my MS caused my depression but it sure didn't help things. I did go through all the typical grief reactions of shock, denial, anger, sadness, and I have to say that I am still in the process of acceptance. Anytime I experience a relapse or have a lot of MS symptoms, my feelings of depression increase.
Some of the symptoms of depression and autoimmune diseases are similar (e.g. fatigue, fuzzy brain, etc.). How do you tell the difference between the symptoms of RA and the symptoms of depression?
This is an excellent question! It is like asking which came first, the chicken or the egg. Symptoms caused by an autoimmune disease can exacerbate the feelings of depression. And likewise, depression can worsen the symptoms of your illness. In researching my own medical condition I was somewhat startled to find that Multiple Sclerosis can cause depression because the brain lesions associated with MS can affect the mood centers of the brain. It made me realize how very organic depression can be. It is my opinion that depression is more than a result of coping with life stressors. It is a biological disease. And I think in time, research is going to show more of a link between such things as autoimmune diseases and mood disorders.
If you are experiencing five or more of the symptoms of depression listed below for two weeks or more, it may be time to seek help from a mental health professional:
1. Depressed mood on most days for most of each day -- irritability may be prominent in children and adolescents
2. Total or very noticeable loss of pleasure most of the time
3. Significant increases or decreases in appetite, weight, or both
4. Sleep disorders, either insomnia or excessive sleepiness, nearly every day
5. Feelings of agitation or a sense of intense slowness
6. Loss of energy and a daily sense of tiredness
7. Sense of guilt or worthlessness nearly all the time
8. Inability to concentrate occurring nearly every day
9. Recurrent thoughts of death or suicide
People talk a lot about grieving in connection to getting a diagnosis of chronic illness like rheumatoid arthritis. What does that mean?
When you have been diagnosed with a chronic illness such as rheumatoid arthritis or multiple sclerosis it is normal to go through a period of grief. You may grieve over anything you feel you have lost, such as a life without this disease, certain abilities, or your self-image. You may even grieve over an uncertain future, not knowing what this disease will do if it progresses. For me, I grieved over losing my lack of worry over my health. Now my MS is a constant reminder as if it were telling me, "I am here and I am not going away." I can tell you from my experience that time and knowledge of your disease helps. Talking to others who also have your disease can give you the inspiration to realize that you too, can manage and learn to live with your chronic illness.
Cognitive therapy can be especially helpful in adjusting to life with a chronic illness. What is cognitive therapy?
Cognitive behavioral therapy (CBT) is a form of psychotherapy which proposes that if we change the way we think, we can change the way we feel. There is much research to show that this type of therapy is effective for a variety of conditions including dealing with chronic illness. You can read more about CBT on My Depression Connection.
If money is tight, are there inexpensive or free options for counseling?
In this economy many people are faced with the situation of either not having insurance or not having the funds to pay for mental health services. There are other options for receiving both services and/or medications. I have written a couple of articles to assist people to find help which you may find here. Remember that you may have to be persistent and make many phone calls. But don't give up trying.
What are some of the other ways you can get support?
One way to find support is right here on sites such as MyRACentral or on MyDepressionConnection. In addition Health Central has other mental health sites including AnxietyConnection and BipolarConnect.
There may also be local mental health support groups in your area. The National Alliance on Mental Illness lists local state organizations on their website.
Living with illness and pain and their effect on your life can make you very depressed, even suicidal. What can you do if you start having suicidal thoughts?
Talk to someone. Share your thoughts with a loved one, family member or friend. This is the time to reach out for help. If this is an emergency you need to get yourself to the nearest emergency room or call one of the suicide hotlines. Here are some numbers you can call. They are free, available 24/7, and you can remain anonymous if you choose.
National Suicide Hopeline
National Suicide Prevention Lifeline
The one thing you need to know about depression is that it is treatable. There is hope. You don't have to go through this alone. Please reach out. There are people who understand and who will listen.
Arthritis Introspective is a grassroots organization that offer support and support groups for people living with RA and other forms of arthritis.