Depression and rheumatoid arthritis: link, treatment and prevention

rheumatoid arthritis (RA) is an autoimmune inflammatory disease in which the body’s immune system attacks the joints and certain organs. These biological factors, along with the effect of RA on quality of life, can lead to depression. People with RA are twice as likely to suffer from depression as the general population. This is due to a complex relationship between the two conditions.

In this article, learn more about the relationship between rheumatoid arthritis and depression, and why it’s so important that depression be diagnosed and treated alongside it.

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Rheumatoid arthritis and depression

Scientists don’t fully understand the relationship between rheumatoid arthritis and depression, but they believe it’s two-way. This means that rheumatoid arthritis can cause depression, and depression can also make rheumatoid arthritis worse.

Prevalence

About 17% of people with rheumatoid arthritis are diagnosed with depression, but due to limited mental health screening, this statistic is likely higher.

How rheumatoid arthritis can lead to depression

When a person suffers from rheumatoid arthritis, they experience pain, fatigue, joint damage and deformity, etc. Often they cannot do the activities they are used to, such as writing, cooking, knitting and dressing. All of this affects the quality of life and can lead a person to develop depression.

Additionally, the chronic inflammation and defective immune response of rheumatoid arthritis may play a biological role in depression.

How Depression Makes Rheumatoid Arthritis Worse

Studies have shown that people with rheumatoid arthritis who suffer from depression have worse outcomes than those who do not suffer from depression. This includes:

  • Increase in pain
  • Lower quality of life
  • Reduced remission rates (when symptoms improve)
  • Higher death rates

This is thought to be partly due to the impact that symptoms of depression (such as fatigue, listlessness, low mood and difficulty concentrating) can have on coping mechanisms.

People with depression may have poorer adherence to medications or therapeutic exercise regimens, which may then lead to poorer outcomes for rheumatoid arthritis.

One study found that people who had depression at the start of biologic treatments for RA had a significantly lower chance of having a good treatment response and reduced improvement in disease activity by one year.

How to deal with depression

It is essential to manage depression at the same time as rheumatoid arthritis in order to achieve the best results. Some of the treatments for depression and rheumatoid arthritis overlap.

First, you should talk to your healthcare provider about your depression. They can prescribe antidepressants, if needed, or refer you for counseling or psychotherapy.

There are many proven ways to deal with depression, and a therapist can guide you to the best tools for you.

Some depression management techniques include:

  • Meditation
  • mindfulness
  • Improve sleep quality
  • Eat balanced and nutritious meals
  • Exercise regularly
  • Social interaction or support groups
  • Avoid alcohol, drugs and nicotine

Interestingly, a 2021 study found that there was no association between rheumatoid arthritis activity and symptoms of depression, while there was been a relationship between higher levels of physical disability and depression.

The authors recommended that treatment goals therefore focus on improving physical and mental functioning and well-being rather than solely managing the medical activity of the disease.

Occupational therapists often work with people with RA to manage symptoms and adapt to activities of daily living. Your health care provider can refer you to occupational therapy if recommended.

How to Prevent Depression

Depression is not entirely preventable, but learning to identify depression or a depressive episode early is key to getting a diagnosis and treatment. It is not only the responsibility of the patient, but it is also the responsibility of health care providers to screen people with RA for depression.

Some signs and symptoms of a depressive episode include:

  • Loss of interest in previously enjoyed activities
  • Fatigue
  • Feelings of sadness, apathy, hopelessness or pessimism
  • Difficulty concentrating
  • Appetite changes
  • Sleep disturbances

A therapist can also work with you to identify your personal triggers and develop an action plan or routine to help prevent these symptoms from worsening.

Support someone with depression

If you have a loved one with rheumatoid arthritis and depression, learning more about their conditions and how they interact is a great first step. Some additional things you can do to support them include:

  • Provide encouragement and patience and listen to their concerns and worries.
  • Don’t take their attitude personally, acknowledge that they have a health problem.
  • Help them stick to their medication regimen, such as setting alarms or filling out pill planners.
  • Keep inviting them on low-pressure outings, even if they’ve already said “no.”
  • Motivate them to stick to their home exercise program, like exercising alongside them.
  • Make sure they have transportation to get to their health care and therapy appointments.
  • Help them clean or organize their living space.

Summary

Depression in people with rheumatoid arthritis is twice as common as in the general population. This may be due to RA symptoms, such as fatigue, affecting overall quality of life. Leaving this depression untreated can worsen the results of RA treatment.

It is essential that health care providers identify depression and provide appropriate treatment alongside all existing treatments for rheumatoid arthritis to achieve the best results.

A word from Verywell

It’s natural to feel weak if you experience pain, exhaustion, and lack of mobility. These things can easily lead to a lack of motivation to get through your day. If you have rheumatoid arthritis and feel this way, you may be suffering from depression. Depression occurring alongside RA should be treated. Talk to a trusted healthcare provider about getting treatment for your depression and rheumatoid arthritis.

Frequently Asked Questions

  • How Does Rheumatoid Arthritis Affect Mental Health?

    Rheumatoid arthritis can lead to depression and anxiety in multiple ways, including reduced quality of life, increased physical disability, immune dysfunction, chronic inflammation, and other social and socioeconomic factors related to the disease.

  • How can you minimize your chances of becoming depressed from rheumatoid arthritis?

    Research shows that higher physical disability is correlated with depression in people with rheumatoid arthritis. Therefore, it is recommended to address both physical and mental functioning and well-being.

  • What are the signs of depression?

    Signs of depression include loss of interest in hobbies or activities, feelings of hopelessness, pessimism, sadness or emptiness, and changes in sleep, weight and appetite.

About Antoine L. Cassell

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