Rates of Depression, Anxiety, and Bipolar Disorder Are Higher in People with Rheumatoid Arthritis
Researchers in Manitoba, Canada, studied more than 60,000 people with RA and healthy individuals. The incidence of depression was 45 percent higher in the RA group, anxiety was 25 percent higher, and bipolar disorder was 20 percent more common. While incidence rates for psychiatric disorders declined over a person’s life regardless of their physical health, episodes of depression and anxiety were more frequent and lengthy in the RA group. “We need to learn more about how mood disorders like anxiety, depression, and bipolar disorder are connected,” says study author Carol Hitchon, MD, an associate professor of medicine at the University of Manitoba in Winnipeg.
3 Ways Rheumatoid Arthritis Contributes to Mental Health Conditions, and How to Deal With the Risks
Here’s what experts understand about the connection between rheumatoid arthritis and mood disorders, and what you can do to sidestep or minimize symptoms.
1. Living With a Chronic Disease Like RA Causes Chronic Stress
Fighting the pain and expense of a long-term health problem can be a significant burden to carry. In fact, the rate of depression among people living with rheumatoid arthritis is estimated to be anywhere from 13 to 42 percent, according to some research. “Certainly pain with RA is one factor, but we know from studies — including ours — that there is more depression and anxiety in people with RA even before the RA is diagnosed,” says Dr. Hitchon. “This suggests that other factors may link these conditions, including genetics, environmental exposures, and health habits.”
2. Inflammation Is a Common Thread in RA and in Mood Disorders
Inflammation is a popular topic in a variety of different disease discussions these days. Scientific researchers speculate that chronic inflammation, which is when your body’s immune system goes into overdrive and stays there, contributes to many diseases beyond rheumatoid arthritis, including heart disease, cancer, diabetes, stroke, and depression. “There is evidence that depression is an inflammatory disease, and there is also evidence that people with high levels of certain inflammatory biomarkers in their system are more likely to develop depression. Some of those markers are the same ones that are elevated in rheumatoid arthritis,” says Patti Katz, PhD, a professor of medicine at the University of California in San Francisco, where she studies adults with chronic health conditions.
3. RA Pain Leads to Depression; Depression May Worsen Pain Perception
Depression and pain are akin to the proverbial chicken and the egg: Chronic pain can lead to depression, and feeling down in the dumps can worsen the perception of pain. In a study published online in April 2016 in BMC Musculoskeletal Disorders, researchers asked 56 people with rheumatoid arthritis to complete a questionnaire designed to assess their depression and anxiety levels. A year later during follow-up, researchers found a strong association between the number of sore joints and scores on how participants were feeling in general. As it turned out, the worse they felt emotionally, the more significant they considered their pain to be. The authors of that study speculated that perhaps depression and anxiety simply worsen the sensation of pain. But they also thought it possible that depression and anxiety lessen the motivation to keep up with medication and healthy behaviors, like exercise and eating healthy, which are known to help minimize the more debilitating aspects of the disease. RELATED: 4 Ways Spending Time in Nature Boots Health
Recognize Early Signs and Symptoms of Mental Illness When You Have RA
If you have RA and you’re worried about the state of your mental health, “it’s best to see your doctor about your concerns,” says Hitchon. “Experts have developed questionnaires that can assess the risk of having one of these conditions. Signs of depression can include a change in your level of interest in things you normally like to do, feeling down, having difficulty sleeping, or changes in appetite or concentration.” Anxiety may be present if the level of worry you have about your life interferes with your regular activities. “Hyperactivity, racing thoughts, needing less sleep, or doing things that are not usual for you, especially if they interfere or cause problems with your work or family life, may be a sign of bipolar disorder.” RELATED: Overcoming Sleep Problems and Rheumatoid Arthritis
Practice Self-Care to Help Protect Your Mental Health When You Have RA
Seeing a doctor to discuss mood changes and possible treatments is a great start, but taking steps to live healthier can help manage mood symptoms too. “Eating healthy food, keeping physically active as best as you can, and getting enough sleep can help,” says Hitchon. She also says that some people find activities like meditation and practicing mindfulness helpful. And if medication is needed, “make sure your doctors are aware of all medications, both prescribed and nonprescribed, that you are taking so they can determine if there are any concerns with the interactions between the medications,” she says. RELATED: Breaking Records With Rheumatoid Arthritis: Traci’s Story
