Stressed Out With RA

Patient Expert
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Stress seems to affect every part of our physical and emotional health, and it is no different with rheumatoid arthritis (RA). Stress is linked to triggering the process that starts the development of RA, as well as flares of the condition. But what is it about stress that has this effect and how can you reduce it?


Chronic stress affects your whole body

When the stress is chronic, stress hormones never leave your bloodstream. This impacts your whole body, leading to a number of physical symptoms, such as headaches, depression, a weakened immune system, and deteriorating heart health. Long-term stress increases the number of cytokines (proteins involved in the inflammatory response) and biomarkers related to inflammation. This process can lead to a constant stage state of low inflammation, which may be part of what triggers autoimmune conditions, such as RA.


Does stress cause RA?

Although stress may play a role in the inflammatory process that can trigger the development of RA, at this time there is no evidence to suggest it is a direct cause of the condition. We don’t yet know exactly what causes RA, but every year, researchers find out more about the interaction between genetic and environmental factors that lead to RA.


Stress and RA flares

Many people with RA and other autoimmune diseases report that stress contributes to an increase in symptoms, also called flares. One study found that 86 percent of participants reported that psychological stress and/or mood disorders were common factors in their RA flares. It may even be possible that stress is a factor in the progression of RA.


Having RA is stressful

As anyone with RA can tell you, simply having the condition can be a constant source of stress. You are dealing with a number of unpleasant symptoms, such as pain and fatigue; you are struggling with how RA impacts your ability to live your life, work, and be part of your family. On top of that, you’re trying to adapt to a different reality, juggling healthcare appointments and medication. Having RA is not an easy life.


Stress, RA, and your heart

The physiological response to stress includes increased heart rate, blood pressure, and the presence of stress hormones, mentioned earlier. Chronic stress therefore has a negative effect on your heart health, and can contribute to inflammation of your coronary arteries. Uncontrolled RA inflammation affects not just the joints, but has a systemic impact, including on your cardiovascular health. You might say that untreated RA and chronic stress is a double whammy contributing to risk of heart disease.


Taking charge of your stress

Despite the role stress plays in your RA, how to manage it is not usually part of the healthcare you receive for the condition. If your doctor is not discussing how to manage stress, take charge of this yourself. Ask your doctors for help, such as referrals to counselling to learn effective coping skills, physical therapy for exercise tips to address pain and make you feel more in control, as well as a pain management program. And of course, work with your doctor to optimize your RA treatment.


Acceptance can reduce your stress

One major source of stress when you have RA relates to fighting against it. Working through the grieving process and coming to acceptance can reduce a significant portion of your stress. When you accept that you need to rest more, that pacing yourself can help you have a better experience of your day-to-day life, and that not pretending you are doing better than you actually are releases energy for other things, your stress may be reduced.


Everyday tips to manage stress

Coming to that awareness about cutting yourself some slack and doing what’s necessary to thrive with chronic illness can take some time. Counselling may be useful as part of this process, as can mindfulness meditation, and talking to others in the same situation. Taking a stress management course can also help you learn coping techniques to reduce stress and improve your life.


Where do you start?

As any other endeavor to solve a problem, reducing your stress starts with being aware that you have it. Spend some time thinking about the stressors in your life — things, events, people, and your RA that together or separately make you feel stressed out. From there, think about what you can do to reduce the stress in each area. Sometimes, you can eliminate certain things from your life, at other times, it may be more about addressing your own reaction to your stressors.