Practical Ideas to Manage RA and Depression in a Post-COVID19 World

In a post-COVID19 world, it is easier than ever to find yourself sinking into the abyss of depression. Loneliness and isolation are at an all-time high while many of our coping mechanisms fall victim to social distancing and canceled gatherings. Simply getting out of the house is a great way to fight back against depression, but with most of us being immunocompromised, it isn’t always a good idea.

Managing depression with rheumatoid arthritis in a post-COVID19 world can be extra challenging, but not impossible.

Depression is common with RA

Finding yourself saddled with both rheumatoid arthritis and depression isn’t uncommon. In fact, it is a debated topic whether depression itself is a symptom, side effect, or comorbidity. I personally think it is most likely to be a combination of all three. Because in my experience, there is rarely a clear cause-and-effect relationship with anything associated with rheumatoid arthritis.

For example, do you have swollen joints? It could be the result of recent increased activity, failing medications, a storm front coming through, or any combination of these or other reasons. Process of elimination can help, but it is more often that we don’t really know for sure the cause, but we do know that we have to live with the effects.

Depression is a slow leak

Depression is a sneaky a**hole. It is very rare that I use such language, but over the years, depression has definitely earned its nickname. One of the unique things about depression in a post-COVID19 world is the way it creeps into your subconscious. I often liken it to a slow water leak. Drip by drip it infiltrates, dampening and diminishing my ability to feel anything but apathy towards everything. And it takes a very observant friend or family member to spot the changes in me.

I respond to questions with a listless, “I’m fine,” and a slight smile. But my husband can see past the words of my response because he cares enough to. We’ve been down this road before and it is a little easier to see the signposts along the way. But because of the post-COVID19 world that we live in, our options for managing it are limited and we have to get creative.

Manage depression with RA in a post-COVID19 world

Start by finding a small notebook that you can easily keep handy, tucked in a nightstand drawer or on a shelf. With this, you can create a roadmap with small steps to get you back on the right path and patch over that water leak.

On the first page, write one simple thing you can do that day to get back to where you belong. For example, write “Get 20 minutes of sunshine” on the first page. Only that, nothing more. I’ve found that if I write down 10 things in order on the same page, I can easily get overwhelmed by the list and just give up before I even get started.

Don’t undermine the effectiveness of routine

On each of the first 10 pages, write one RA-friendly thing (see a list of ideas to get you started at the bottom of this article) to do that day and literally force myself to do at least that one thing, each day. Before I know it, I’m a few days in and starting to see my way through the fog of depression. And it becomes a little easier to get myself to do that one thing. I cycle through each thing, each day, then start all over again until I find myself in a better state of mind.

Slowly I find my rhythm and routine again. After awhile, I can respond to questions with an honest, “I’m good,” and really mean it. Each time I find myself faced with that same apathy towards something that I would normally find interesting, I pull out my notebook and start the steps again. By now I have them memorized, even though I’ve been forced to change a few because of COVID-19. But, I still go through the motions of getting out that notebook and tackling one page a day.None of it has to be strenuous or difficult to do with RA/RD.

• Take a shower (it seems small, I know, but it is legit)
• Sit outside for 20 minutes
• Take your dog for a short stroll
• Draw, doodle, or color a picture
• Schedule an online get-together (meeting, Zoom, FaceTime, whatever) with a thoughtful friend (and DON’T cancel at the last minute)
• Follow a series of gentle stretches for 15 minutes
• Write an actual letter to a friend and mail it right away
• Meet a quarantined friend or family member for socially-distanced picnic in fresh air
• Make a list of new things you’d like to learn about
• Complete one household chore you’ve been procrastinating
• Cook your favorite meal or bake your favorite dessert (don’t order it, try to make it yourself)

Be sure to check with your doctor especially if your depression worsens or if you have thoughts of suicide.

Editor's Note: Help is available from the National Suicide Prevention Lifeline at 1-800-273-8255. The National Suicide Prevention Lifeline is a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week. You can also visit their website at suicidepreventionlifeline.org.