Online learning for today’s arthritis patient
Lesson 1 - Understanding the connection between arthritis and mental health
Welcome to Arthritis Consumer Experts’ online course to help optimize mental health and emotional well-being for people living with arthritis. In this first lesson, we explore the intricate relationship between arthritis and mental health. Understanding this connection is necessary to better managing both aspects of your well-being.
Key Points
- Chronic pain, physical limitations, and the ongoing need to interact with healthcare systems can lead to emotional distress, feelings of helplessness, frustration, irritability and a loss of independence.
- Depression, anxiety, and stress symptoms are often higher in people living with arthritis.
- The relationship between arthritis symptoms (pain, fatigue, disability) and mood (stress, anxiety and depression) is a two-way street where each can intensify the other.
- Education and awareness play a vital role in dispelling stigma and misconceptions. It can also allow individuals to feel more comfortable discussing their mental health with friends and family, and as part of their overall arthritis care with their rheumatology care team.
Arthritis and mental health
Fifty years of research has proved the close association between arthritis and mental health and the importance of addressing physical and emotional health together. Arthritis is a chronic disease characterized by pain, fatigue, and disability which can significantly impact daily life. Beyond the physical symptoms, it is essential to recognize how your arthritis impacts your mental health and everyday life. Chronic pain and reduced mobility can lead to stress, fatigue, and low mood including feelings of helplessness, frustration, and irritability. Fatigue and “brain fog” that result – both from living with the disease, but also from medications you may take to control symptoms – can make it harder to function. Social isolation can result from cancelling plans and avoiding activities that used to be fulfilling. Further, the high levels of inflammation that characterize diseases like rheumatoid arthritis, lupus, and psoriatic arthritis, among others, can directly alter brain chemistry.
It is not surprising that individuals with arthritis are more likely to experience depressive symptoms, with 20-40% reporting clinically significant levels of depression.1 People with arthritis are 3-5 times more likely to experience a major depressive episode compared to the general population.2 Similarly, people with arthritis are 2-3 times more likely to report anxiety and stress.1 It is important to recognize the relationship between arthritis symptoms and mood (stress, anxiety and depression) is a two-way street where each can intensify the other.
Impact of arthritis on mental health
Things that contribute to poorer mental health in people with arthritis include the chronic nature of the disease, the uncertainty of living with arthritis, the frustration of dealing with the healthcare system, and the toll arthritis can take on daily function.1 Pain and depression also share common biological and neurochemical pathways which explains why they often co-occur. Arthritis causes ongoing pain and makes it hard to move around, which can make people feel less in control, independent, and less good about themselves. 3 For example, not being able to move freely or always being in pain can cause feelings of frustration, sadness, and a feeling of loss. How much pain a person experiences and how often pain interferes with daily life are important predictor of depression. Additionally, financial burdens and difficulties in accessing appropriate and timely care can further worsen mental health.4
Overall, the impact of arthritis on daily activities, work, and social life can contribute to feelings of isolation and poorer quality of life.4
Recognizing the emotional toll of arthritis is an important first step to addressing mental health needs and ensuring holistic care for people with arthritis. By understanding the impact arthritis can have on mental health, health care providers and their patients can work together to develop appropriate strategies for support and intervention.
Addressing stigma and misconceptions
There are often misconceptions and a sense of shame surrounding mental health and arthritis. Some individuals may view arthritis as purely a physical condition, disregarding the emotional toll it can take. Others may perceive the toll on mental health resulting from arthritis as a sign of weakness. Such misunderstandings can lead to feelings of isolation, shame, and reluctance to seek help.
Awareness and education play a vital role in dispelling the stigma and misconceptions and encouraging individuals to speak openly about their mental health. Arthritis support groups, online forums, and patient advocacy organizations can provide valuable platforms for sharing experiences, combating stigma, and fostering a supportive community.
Challenging stigma and promoting open dialogue are important steps to creating an environment where individuals feel comfortable seeking help for their mental health, ensuring comprehensive care for both their arthritis and mental well-being.
References
- Arthritis Research Canada. Anxiety and Depression in People with Arthritis https://www.arthritisresearch.ca/arthritis-research-education-series/anxiety-depression/
- Guglielmo, D., Hootman, J. M., Boring, M. A., Murphy, L. B., Theis, K. A., Croft, J. B., Barbour, K. E., Katz, P. P., & Helmick, C. G. (2018). Symptoms of Anxiety and Depression Among Adults with Arthritis – United States, 2015-2017. MMWR. Morbidity and mortality weekly report, 67(39), 1081–1087. https://doi.org/10.15585/mmwr.mm6739a2
- Bair, M. J., Robinson, R. L., Katon, W., & Kroenke, K. (2003). Depression and pain comorbidity: A literature review. Archives of Internal Medicine, 163(20), 2433–2445. https://doi.org/10.1001/archinte.163.20.2433
- Zhao, X., Shah, D., Gandhi, K., Wei, W., Dwibedi, N., Webster, L., & Sambamoorthi, U. (2019). Clinical, humanistic, and economic burden of osteoarthritis among noninstitutionalized adults in the United States. Osteoarthritis and Cartilage, 27(11), 1618–1626. https://doi.org/10.1016/j.joca.2019.07.002