It's weird that I'm writing a post on this subject. Now.
I've been having a flare for almost a month now. I feel the worst I've felt in a long time. And it's easy to get down about that. Easier to get down than I wish it was.
But as your body rebels and you feel like you're losing control of the physical, it's easy for the mental side to slip away, too.
I wouldn't say I'm currently suicidal. I may be getting more depressed as this flare continues on. But I don't want to die, either at the hands of RA or at my own hands.
I think I was suicidal when I first got sick, when no one could figure out what was wrong with me, and then getting diagnosed with something that I totally didn't understand.
At that time, I didn't know what I needed from myself, let alone other people, so I felt very alone. It is especially hard when you find yourself suddenly needing help, with the seemingly most simple of tasks, when all you want to do is to be independent and dependent on no one other than yourself.
Feelings of hopelessness, and even thoughts of suicide, are common during flares, especially when medical help is sought (Hewlett, et al. 2012). This really isn't all that surprising. When you are feeling your worst, physically, it follows that you may feel your worst, mentally, as well.
But depression is not the only thing. Suicidal ideation is also common in RA.
In one study, it was found that "50% of those with RA, who committed suicide, were female, although only 18% of the whole suicide population were female," meaning that the suicide rate is significantly higher in the population of women with RA than women in general (Timonen, et al. 2003: 289). Further it was found that "Men committed suicide after a shorter duration than women following the first admission [to the hospital] for RA" (Timonen, et al. 2003: 290).
I see a therapist and a psychiatrist, since almost the onset of my illnesses. I've been on anxiety medication since right after I was diagnosed with lupus and RA. But something's are unshakeable. The feeling of hopelessness is unrelenting, despite the fact that I have a boyfriend who loves me and a supportive family and friends.
But they don't understand the pain. They don't know what it's like to see your body transform before your own eyes from a functioning system to a system gone haywire. They don't understand the pain that runs from the top of your head to the tips of your toes. They don't understand the fatigue that you can't shake, no matter how much coffee you drink or how much sleep you get.
But they also don't understand how closely the physical and the mental are tied to each other.
I think the really important lesson here is that while RA causes a lot of physical symptoms, it can cause mental anguish, as well. We would do well to take a holistic approach, especially considering that mental distress can contribute to increased disease activity.
We would also do well to remember that RA doesn't just effect the patient, but the patient's family and friends, as well. Caregivers often go unrecognized, and they can be faced with significant physical and psychological burdens as a result (Gettings 2010).
Whether you're the person suffering from RA or the caregiver of someone with RA, you're never as alone as you feel. And if you don't feel you have in-person support, there are always people in the online community that have been where you are.
If you or your loved one has thoughts of suicide, there is always help. Contact the National Suicide Prevention Lifeline at 1-800-273-8255.
Gettings, Lynda. 2010. "Psychological Well-Being in Rheumatoid Arthritis: A Review of the Literature." Musculoskeletal Care 8 (2010): 99-106.
Hewlett, S., T. Sanderson, J. May, R. Alten, C. Bingham, M. Cross, L. March, C. Pohl, T. Woodworth, and S. Bartlett. 2012. "'I'm Hurting, I Want to Kill Myself': Rheumatoid Arthritis Flare is More Than a High Joint Count - An International Patient Perspective on Flare Where Medical Help is Sought." Rheumatology 2012 (51): 69-76.
Timonen, M., K. Viilo, H. Hakko, T. Sarkioja, M. Ylikulju, V. Meyer-Rochow, E. Vaisanen, and P. Rasanen. 2003. "Suicides in Persons Suffering From Rheumatoid Arthritis." Rheumatology 2003 (42): 287-291.