RA and Depression

I’ve had depression since I was 14. It’s something that has colored every aspect of my life and how I perceive the world around me. So has RA, even though I have only been officially diagnosed since October 2018. The two diseases go hand in hand; they feed into and contribute to each other. As time tumbles forward, I have picked up on the cyclical nature between the two and want to explore that nature in detail.

Exploring depression and chronic disease

First and foremost, receiving an RA diagnosis is life-changing. In my own experience, the diagnosis was charged with negative emotions: it was life-shattering. I cradled the life I had previously lived in my hands like a white-blue porcelain bowl; the diagnosis pushed that bowl through my hands, shattering into a million pieces on the cold, sterile floor. Along with all the physical symptoms of RA —the most pernicious being fatigue and unrelenting joint pain— I had to begin cultivating and figuring out this new life. My depression entered my life in the same manner as a shadow swallows the remnants of sunshine when a strong thunderstorm passes through. I was thrust into a maelstrom of confusion and panic, worry and dread, fear and loathing. I had no idea what to do.

Coming to terms with my RA diagnosis

After first being diagnosed, I would wake up in the morning and sit at the edge of my bed, my head falling heavily into my hands. I would look down and think, “this is not happening to me, there’s no way I have rheumatoid arthritis.” But as I shuffled around my apartment and turned over the Rx bottles, the boxes of Humira in my fridge, the wrist splints littering my vanity, I recognized that this is my reality, now. That, although I am incredibly privileged and thankful to have medications that help me, RA will never go away, as much as I want it to.

Managing the mental and physical symptoms of depression

But, it’s not enough that RA can worsen depression; depression can conversely affect RA. Any mental illness can cause physical pain, including headaches, fatigue, muscle pain, and more, which only complicates and compounds the pain of RA. In addition, depression can exacerbate pre-existing feelings of dread, anxiety, and fear about having RA: “Will I have another flare soon? How much are my medications going to affect my health in the long run? What am I going to do if I’m always feeling pain throughout the rest of my life? Why is my life so different now?”

Focusing on what I can do

Because these questions have now entered my life, I’ve been trying to figure out ways to answer them. What has worked for me is focusing on things that I can do. After working a full day, if I find myself asking “why can’t I study more today?”, then I say to myself “my fatigue limits me, and I’m proud to have completed a full day’s worth of work.” After writing all weekend, if I find myself complaining that “I should have made time to see my friends,” I remind myself that it is impractical to believe that I can accomplish everything, especially now with RA.

In all honesty, having depression and RA has forced me to make taking care of myself a priority, something I had never been able to do before. More importantly, realizing this has allowed me to mitigate the pain and tension I feel. I’m slowly learning that listening to my body is the only way I will be able to make sense of this life.

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