Fighting Rheumatoid Arthritis Depression
Often, I get letters from Rheumatoid Arthritis patients struggling with depression. I always encourage them to consider the options of counseling or medication since there’s no way to know how serious their depression may be. It’s heartbreaking. We hope that most of the time we can avoid serious depression, but patients with Rheumatoid Arthritis or any chronic pain are more likely to deal with depression.
Can we avoid the pitfalls of Rheumatoid Arthritis depression? We can try…
- Not keeping it to ourselves. We’ve talked about the tendency to be private about our pain. However, I think there is only so much that a person can hold inside. We can let out our feelings by writing them down or tell them to God in prayer. We still might need another human.
- Knowing there is not an easy answer. We know that RA is a lifelong battle. In an earlier depression post, I wrote how I learned that it helps to “stop being surprised” at our suffering. I’m not sure why, but it helps me to have realistic expectations.
- Finding other patients make special friends. It’s so helpful when we find a friend who gets it. It could be a support system or an online discussion, but no one understands RA like someone who has been there.
- Getting our doctors’ help. Our doctors can help treat the pain that can cause depression. When RA patients have symptoms under control, they often return to doing normal things and feeling better emotionally. Most of us may not ever find our pre-RA normal, but we can strive for the best treatment possible.
- Considering professional help. I know I already mentioned it, but counseling or medication should be considered an option that might be part of treatment for RA patients.
Since we are the ones know what we deal with every day, what ideas do you have for keeping depression in check with Rheumatoid Arthritis?
Neither the blog nor comments are professional medical advice; see disclaimer here.
Recommended reading
- Rheumatoid Arthritis Anger
- Rheumatoid Arthritis and Depression
- Be Your Own Counselor with Rheumatoid Arthritis
- List of posts about Emotions and Rheumatoid Arthritis
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Thank you for posting this. I have been fighting depression for a year now. Thankfully I am on really good antidepressants (Cymbalta). Unfortunately prior to these meds I was seriously depressed, so much so that I was extremely close to suicide. Thankfully I got the help that I needed through hospitalization and counseling. I now understand what causes my depression and how to keep it from happening if I can. Not everyone understands why those of us who have a disease such as this can be depressed. Unfortunately when I was asked once why I was depressed and I explained I received the response, “There’s no reason to be depressed.” I know it was well-wishing but unfortunately it was not the best thing to say.
Thanks for voicing the concerns of others who might not feel able, Alecia. Many believe there are organic causes to depression with these harsh diseases that attack the whole body such as RA. But like you we can fight to have the best life possible even if it is still a struggle sometimes.
“Many believe there are organic causes to depression with these harsh diseases that attack the whole body such as RA.”
I’ve always thought that made sense. After all, the brain and nervous system are composed of “soft tissue.” I’ve also often wondered if the diabetes may not have been triggered by the RA attacking my pancreas. The doctor said it was entirely possible.
For me dealing with depression is a constant struggle. I was dx’d with it even before my RA diagnosis. I also deal with anxiety in several different flavors and OCD. The anxiety makes it difficult for me to reach out to others for help. This blog and the Facebook community surrounding it have been a Godsend.
“3.Finding other patients make special friends. It’s so helpful when we find a friend who gets it. It could be a support system or an online discussion, but no one understands RA like someone who has been there.”
<3 – That says so much.
so many times we can just nod & say mm-hmm. we know.
Depression unfortunately runs in my family…my sister is severely bi-polar, and all over the map. I cover my depression with a thin shield of humor, and usually cope well. Sometimes the shield cracks, or shatters and I have relapses. I do take some minor anti-depressants, and some days are better then others.
I do better in a online environment, then in a “real-life” one (is that bad?), perhaps because I have always been a geek.
My faith in God, family, and a few close friends keep me going. The online support and perspective of others help so much.I do some visiting to a retirement home, where a family friend is…helps keep me in perspective, and to see him and other residents react to visits cheers the soul.
My Black Lab is my constant companion, and her deep licorice all-sort eyes, always cheer me on. I highly recommend, a pet as a major anti-depressant 🙂
I know there are better days ahead, and my final destination is worth the trip.
Russell, good ideas all. Thank you.
My Rheumatologist explained this to me recently as a process – we are losing a part of ourselves so it is natural to “mourn”. Mourning may turn to anger/frustration and finally acceptance. Unfortunately, because of the hills and valleys of this disease, we may go through this cycle continually. For me, just hearing this from her was encouraging (daunting maybe, but encouraging). Knowing that this is a process and that there is no easy “fix”, I try to stay positive and focus on the blessings in life and know that help is available if things become too overwhelming. PS I agree about pets being an anti depressant – my little furball is in my lap as I write 🙂
I agree about the mourning & I know I did that process with a counselor. Your rheum doc is wise. Yet it’s different than most grief which can be over in a few weeks or months. RA can come back again and again for some patients or be a permanent visitor for others. So the grief can come back.
Even though I’m such a positive happy person, sometimes it’s a struggle to keep dark feelings at bay when there is so much pain every single day & it’s so constant & unrelenting & always new losses with the disability. And you’re right – I really miss my dog. ♥
I really think most people don’t understand how defeating the pain is day after day when it is not managed. I can tell you though that communities like this help me deal with this disease day in and day out. It is just like you said Kelly, no-one understands better than another RA patient. I know the problem most of us face is keeping everything inside. We must have a place where we fell safe and can communicate. If you don’t have that it is my opinion you will have problems. Most chronic illnesses can lead to depression because they are with us for life. We need our families, but if we don’t have them then we need to look elsewhere. Thank God for Kelly and rawarrior, twitter and facebook as they have lead to a great group of new friends and support!
Thanks David. I must say I’ve received the same benefits as many others. God is good.
Yes. God is good. He has to be to listen to me everyday, several times a day. And so are you Kelly and all the contributors on this site. I don’t run anymore, but this is one place i hurry to when I’m not so happy. So i thank God and you for giving me a place to come and know that someone truly does understand where I’m coming from.
Finding people to talk to on the web, since I don’t know anyone with my illness around me. Has realy help me.
The best thing againts depression ? Not to feel alone.
I have experienced mood swings more than normal, thinking it is a side effect of medication. Depression, think myself lucky to be alive and getting well, better again. Looking into the chemistry of Inositol: http://www.bipolar-lives.com/benefits-of-inositol.html. Self experimentation, looks like it is benefiting, confident. Could blog more chemistry if anyone really interested.
I found that when the constant pain caused by my RA and treatments that were disappointing, I fell into a depression. Before my diagnosis, I was dealing with OCD-compulsive cleaning which was also therapeutic (anyone who understands OCD knows that the behaviors we exhibit releases anxiety).
When I could no longer release my anxiety through my OCD (the RA had robbed me of the ability to clean, clean, & clean some more)and the frustration, fear, & anger because of the RA spiraled out of control, I had to seek professional help.
I went to a psychiatrist who in addition to behavior modification therapy, psychotherapy and medication, helped me lift myself out of the depression. While it has been 1 1/2 years since my therapy, I would have no problems of seeking therapy again if I felt the depression returning (the OCD is blog-worthy, LOL).
We have to be willing to seek whatever help we need. This is a very unpredictable disease and we need all of the support we can get.
Tonia, you are such a champion to fight both and not give in. Thanks for putting your testimony out there to encourage others.
I was only just diagnosed with RA at the beginning of January 2011. I find it reassuring that I’m not alone in my intermitant depression. It just seems really unfair that god would let Someone who is only 18 to get sick like this. Does anyone know how to find a good counselor for chronic illness?
It is unfair to get sick. I’m sorry it happened to you. Personally, I believe that God loves us and this is a fallen world and He sends help by his love & through other people. That’s my belief.
The best idea I have about finding a good counselor is asking others – asking doctors and friends if they know someone they trust is what I’d do.
Sangichan, I am so so sorry that you have this demon called RA!!! I too have often wondered and asked why God let this happen to me and anyone else. Then when my mind is right (from days of less pain) I realize that God did not “give” me RA!! I really think that illness is enviromental, something in the air we breathe. Some bodies can handle enviromental factors and some can’t. I also have a constant nagging in the back of my mind that those of us that do endure such illness are here to help and or show others something…..to help them with their day to day living in this ever fast moving and changing world. Why do I think this? My late husband passed away from a very rare for of Cancer, he being the 3rd person to ever have this form of Cancer. During his illness and day to day suffering, a friend gave me a book to read that helped me in his illness and in his passing on. “Enbraced by the Light” by Bettie J. Eadie. In this book is a chapter that explains why these things happen and it made a lot of sense to me. I think maybe this book may help you with your present feelings of your newly diagnosed condition. It is okay to be angry. Heck, I was diagnosed in 1999, and I still get angry….especially when my treatment plans stop working and I have to begin the process all over again with a new plan. Just yesterday, I considered suicide! I felt totally helpless and useless to myself and my family! Thankfully for me, I reached out to my RA Warriors and thy got me through a very low and deep hole that I was slipping into. Please now that God loves you! And he would never “give” you a disease. Disease is man made….from the evils of the world. I pray that you seek some counceling, and if you don’t, please reach out to the Warriors on RAWarriors……they will never give up on you or let you down. I also pray that your Doctors begin aggressive treatment and it stops the destruction that no treatment will cause.
Cindy.
Sangichan: please know you are not alone. I agree with what Cindy and Kelly both said. I was young also when diagnosed, with a husband and a young child. I saw that although i didn;t know the reason why I got the disease, that God has been with me every step of the journey. There have been periods of depression though ;through this long journey(i am 49) and I was helped by talking to my doctor who also gave me a referral to a counselor. Also, I have been helped by antidepressants.
What you are experiencing and feeling are so very normal , as part of the grieving process in response to this diagnosis. It is hard to say how your disease will affect you physically. Hopefully, you will have milder disease, Please take care of yourself. I hope it is a comforting thought that much better meds are being researched and developed all the time. There are many more meds now than when I was first sick. And the existence of a website, like RA Warrior, and the support and information i found there, would have been so welcome by me, when I first became sick.I hope you find the same to be true, and that you know you are not alone.
Kelly,
First of all ~ I’m new here ~ and so glad I found your website.
Thank you for providing a forum in which this issue can be discussed. I was diagnosed last year ~ am on a cocktail of drugs that really aren’t working too well ~ and recently fell into a deep depression. Thanks to the reading I have been able to do I am realizing that what I am going through is like grief….denial, anger, et cetera. On top of all that I now have to be treated for latent TB before they can try starting me on any of the biologic drugs. My rheumatologist and my family doctor have been wonderful. I started on an anti-depressant a few weeks ago and start counselling tomorrow.
I am looking forward to participating in your conversations!
(It’s nice to have something to look foward to!)
Take care
I’m glad you found us too & I hope tomorrow goes well. Grief was exactly what I went through the first couple of years and it helped to have someone to talk with. Welcome. 🙂
Welcome. I, too, understand the emotions you are going through. I think I found Kelly before I was officially diagnosed. She and her site are simply amazing. I am proud of you for taking control and good luck.
As a Christian woman, prior to the sudden onset of my RA in December, I never believed I would ever have to be on any sort of mood altering or antidepressant drugs, because I had Jesus in my heart so it could never be necessary due to the joy that he brings me.
About 10 days post onset, and during the diagnosis phase, while only on mobic and prednisone, I found myself having to pray hard throughout the day, knowing that the severe pain and fatigue of RA was causing my moods and brain to be out of control, and that the thoughts, impatience, anger and frustration the disease was causing, were not coming from the true me.
I was so grateful when a week later I was given Cymbalta, along with other meds I am currently on. I wouldn’t have believed it if I hadn’t experienced it personally, but within an hour of my first dose, I was able to calmly and logically process and handle things. I believe that pride could have kept me from taking the pills had I not been so desperate for help, and I know that God appoints doctors and scientists to perscribe and formulate the medicines that will help us. While RA continues to be a daily battle, struggling with pain and fatigue, at least I can deal with it logically now:)
I think we have to be very careful not to turn down medicinal help due to stigma, fads, or current popular belief. I believe that God is in control of everything including appointing us with this disease. Our witness throughout it with be to his glory if we allow it to be.
Heather, this is such a beautiful post. Thank you for sharing. I hope it encourages others.
Heather, Cymbalta is an amazing anti-depressant. That is what I am on now. I was also on it 4 years ago, I only stopped because it cost a lot of money.
I am glad you came to the realization you did. Thank you for sharing.
I am also a Christian and at a crossroads with my Ra treatment. This past winter has played havoc on me I am not rebounding like I have in past years. The exhaustion and chronic ache has taken its toll culminating in overwhelming depression. While I think I am over the stigma of using medication as a Christian….long over after dealing with my RA for 6 years, I am hestitant about taking another med but the depression isn’t lifting. Thanks for you post. I gives me courage.
Arlene, I feel like saying something really silly – I just replied to your other comment – with regard to the incredible pain and the depression that has come as a result: “the disease doesn’t care if you are a Christian.” It will be just as cruel and unrelenting, so if you do need medical care for this, I hope that you will get it before it gets too bad. The stigma is real in certain circles, but not all Christians think that narrowly either. I’ve prayed for you to get whatever medical care would be best for you.
There are so many negatives and difficulties with RA it’s very easy to sink into depression.
A small thing that I have found keeps the black dog (depression) at bay is keeping a gratitude journal. I suffered clinical depression for the best part of three years while learning to live with RA and working with a counsellor used a journal to get myself back to being myself. It was little things like being able to get a carton open, or making it down the steps when my ankles felt like they were encased in cement. It’s so easy to feel defeated with this disease, but looking back on that first journal, I see how much more positive I am now.
Betty, thanks so much for leaving this helpful suggestion – something any of us can try even today to take a small step!
Kelly, I agree with everything you have mentioned. I’m sitting here, struggling with finding words. It’s as if I have so many comments and thoughts and instead of coming one at a time, they are a waterfall.
I find that the people I share with are the friends I’ve made through Twitter and commenting on here. I still tend to keep a lot of it inside. I did start a blog of sorts and it helps to get those feelings out in some form or fashion.
I fluxuate between understanding that this isn’t going away and that I’m just going to have to manage, not cure what’s happening within me. There are other days, when the shots have worn or are wearing off, that I get surprised at feeling the old pain. Then, I try to compare it to before, and see if the meds are helping. So, the “Surprise” factor is sort of, an off and on thing.
I already suffer from depression. Have since High School, but didn’t realize it until 12 years ago. Up until last June/July, I was on some form of anti-depressant and had been to counseling. Both helped, a lot. At the beginning of March, I asked for an anti-depressant from my rheum. She suggested it more for the fibro than the depression. We found one that works nicely for both. I DO notice a difference in my frame of mind. I think the fibro is slowly responding.
Depression in and of itself really is horrible. And yes, adding chronic pain to it. The biggest thing that has helped me is having people whoare like me, and knowing I’m not alone. People like you, Kelly, who open the doors of knowledge and educate us, who educate doctors.
Strangely, it helps me to know that depression is just a part of this health condition. When I am depressed, eventually I remember that it’s like having a flare and I’m not “really” depressed, and it becomes much easier to manage.
It’s amazing to find that I can sympathize with so many of these posts. I too had the diagnosis of depression before the diagnosis of RA. I do think it was in connection to the fact that I was slowly losing the old me and losing the ability to do the things I loved. I also was one of those OCD clean people. My apartment was methodically cleaned each week, laundry done each Sunday and put away immediately. As a teacher, I could wake at 5 and continue to run all day until bed at 10 or 11. So much of that is gone now. I am closing in on a year of RA symptoms and still find it frustrating, and then depressing, that I can’t lead the life I put so much value in. I struggle to understand why I was given the love of teaching and then given this disease that makes everything so difficult to do. I struggle with the lonely feeling because so many around me don’t understand what this disease truly feels like. I have been told by so many that perhaps my depression is because of the meds, or that having a positive attitude might change things. I really struggle when people tell me they understand because their grandma has arthritis or they themselves have a hurt knee when it rains. How do you tell them that they are so far off? That the pain at times is indescribable. That the depression stems from a lonely place of chronic pain and that if I could just “suck it up” and keep going, I would. Luckily, this is at least one place where others can understand.
Depression and a sadness that permeates all my days are things I have learned to live with over the years. I think physical pain is, indeed, one of the reasons for that—but feelings of disappointment in my inability to perform everyday tasks, the little things I once took for granted, is an even bigger reason. More medication is not an option—my RA meds cause a lot of drowsiness already, too much to drive some days, and paying someone to listen to me talk would be a waste of money I do not have anyway, (besides, half the time I am unable to get out the words for what I want to say).Family attitudes will not change, and this is a part of my life I simply must learn to accept, over and over again when I need to remind myself that this illness exists in me for a reason I do not understand, but hope to someday.
This post is very timely for me Kelly. RA in itself is a very isolating disease, and for those of us who live alone, it is even worse. I have been considering suicide for months. Most of the time my thoughts are deliberate, not sad or panicky. Although I have been taking Cymbalta for over 10 years, I don’t think it is effective for me any longer. I have reached out to my family and told them of my thoughts. My sister urged me to contact my states (Georgia) Mental Health Hotline, which I did. I will soon start seeing a Psychiatrist and Therapist at a reduced rate and can get my meds through a patient assistance program. PLEASE, if anyone is reading this and feels that their income or lack thereof is preventing them from getting mental health care, most states offer this service. I have not yet gotten into treatment yet, my first appointment is next week. But I recognize my depression is severe. My life has changed drastically over the last few years and I feel hopeless about my future. I am struggling, but I do have my sister for support. Thank you Kelly for your post.
I was diagnosed in July, and I am still processing my diagnosis and it’s impact on my life. I have found encouragement in the RA Warrior links and articles, so thank you for all of them. Prior to my diagnosis, I had been taking Paxil for almost a year to address anxiety. I have remained on Paxil, which I think helps me from becoming depressed, but it’s not the answer all by itself. Waking up with chronic pain each day can so easily drive anyone’s emotions down the drain. I’m still early in my diagnosis but already can relate to the feeling of having to make a choice each day when I wake up to fight through the symptoms and do the best I can as a working mom. I cannot do it alone-I rely on my faith in God, not hiding it from my family members but sharing with them, and I try to do one thing just for me each day–something to treat myself like heated slippers, going to bed early, etc. As moms, we usually put ourselves last after the needs of everyone else, but I’ve found that I need to stop and take some time for myself each day if I’m going to stand up to this RA and not let it beat me.
Sad,sad comments here regarding depression and anxiety and also some very helpful suggestions about how to cope with the losses RA inflicts upon us. Once a very wise little girl of 10 years and fighting a serious bone cancer told me when I asked her if she often asked …,why me? She was taking a strong course of chemotherapy after a left leg amputation and her prognosis was grave. Her answer was straight forward and simple.. “No… I ask why not me?… Am I so special that only other people should be sick with cancer? I think I am lucky I am ten years old.. some people only get to live 20 minutes.”And she smiled.
I thought about this answer of hers for many years after her death a few months later in
1984 and realized the wisdom in her words.. It doesn’t help with the pain and it doesn’t remove the disease and the deformities and the losses the disease inflicts and I still grieve each time I lose another ability but now I know something that I didn’t know before. Like this little girl I am human. I was concieved and born with the possibility and potential of suffering any number of diseases and conditions. It happens that RA moved in and there may be other illnesses along the way for me to battle but I am still alive and can still fight. I have lived 68 years and I have been fighting this RA since I was 30 years old. I still have both legs, am still walking, talking, painting,reading and very often I am able to welcome the apin for it reinforces the fact that I am still alive. My memory of this little girls strength, reason and love of life keeps my depression under control.. reminding me that I am just simply not so special.
I was officially diagnosed with RA in Oct 2012. I have suffered with serious depression for 20 years. I also have cervical spinal stenosis, which exactly 1 year ago. On January 6,2012, a neurosurgeon rebuilt my neck with brackets and screws. I lived with debilitating pain for 7 years and had steroid shots in my spine every 6 weeks or so just to function. I took asprin, addvi, and lyrics by the handful everyday just to function. I “be taken cymbalta and wellbutrin for years. For me they have helped. My neck surgery was very successful. I am so thankful.
So when one struggle ended, this new one came along. My aunt died due to ra complications. This RA hashit fast and hard. Just having the energy to remain employed full time, has. Become a full time job. I find the exhaustion to be overwhelming, I find myself sinking back into dispare. Thoughts of suicide creeping back. Just like I have read on this blog, I do,nt look sick yet I have trouble walking. I find myself feeling very alone.
With 2013 on the horizon, to keep my feeling of panic under contol I tell myself, one day at a time.
I live near Harrisonburg Va. and can not any kind of support group near me.I have been living with RD for 7years, and sure could use someone who truly understands how alone this disease makes you feel.
Dear Elaine, I hope you have found someone, somewhere, to understand how alone this disease can make one feel. (I personally HATE IT and everything about it.) But please know that I am praying for you every single morning because I do not have anyone either – even my old dog/best friend just passed – and do not live near any groups, just like you. Just remember I am praying for you, Elaine, every morning to have a good day, like a little watchdog nipping at you and wanting you to smile! — God bless you always, Mrs. B