Learn about mood and mental health issues that may accompany pain and other symptoms of rheumatoid arthritis.

People who live with chronic diseases such as rheumatoid arthritis may experience more than physical pain and disability. Their illness could also affect their mental health. While sometimes the illness causes mental health issues, more often than not it’s because of the changes brought about by chronic illnesses.

Managing Chronic Disease May Take A Toll On Mental Health

If you are used to being active and challenging life head-on, it will be difficult to accept that you may not be able to accomplish what you have before. Work may become too difficult; even doing the small pleasurable things, such as hobbies, may become impossible. As the disease progresses, you may end up isolating yourself from others.

“One thing we usually see in anyone with RA is an existing pain syndrome, which then brings on depression, feelings of helplessness, poor self-esteem, irritability, and problems with social interactions,” says Patricia A. Farrell, PhD, a psychologist in Englewood, N.J.

“Pain, caused by the physical damage from RA, is also intensified by anxiety, so as anxiety goes up, the ability to tolerate pain goes down," Dr. Farrell adds. “We need to address these psychological and physical elements, and work with the patients’ other treatment providers.”

Another issue that may cause stress for individuals with chronic illnesses is the fear of the unknown, or of what will happen in the future. With diseases such as rheumatoid arthritis, people know that their pain probably will get worse, that they’ll become more disabled — but they don’t know when or how disabled they may get.

When Mood Disorders Start To Take Hold

It’s important to act quickly to intervene when mental health is an issue. The earlier treatment or management begins, the less likely it is to spiral out of control. It’s important for people with rheumatoid arthritis to understand that it’s all right to ask for and accept help.

Research shows that when people have a chronic illness, the highest risk of developing a problem such as depression is within two years of being diagnosed. This is why it’s important for mental health practitioners to work with the patients’ other treatment providers, Farrell says. Working together, they can address both the psychological and physical elements of rheumatoid arthritis.

“We begin by helping them understand that they do have power in this situation and a variety of self-help techniques will help them,” Farrell says, noting that the team and patient have to work together. “It’s a multidimensional approach to the disorder that works best.”

Maintaining Mental Health

For treatment to be most effective, you need a thorough evaluation by both a psychiatrist and a cognitive therapist (a therapist who helps you recognize and change negative thinking patterns) who are used to working with the chronically ill, Farrell says.

Self-help is also a central part of easing the pain and disability of depression and anxiety. “We teach people how to use relaxation breathing, imagery, and how to manage stressful lives,” Farrell, says. Medication, a necessary treatment tool for some people, is not the answer for all: “The decision to use medication or not is an individual one after careful consideration of the patient’s symptoms and needs.”

Knowing that help is available is a key component to mental health management.