It’s Not Psychosis…

When I saw the headlines about a study finding a link between autoimmune disorders and psychosis, my stomach sank. Sigh. Another co-occurring condition to worry about? Is my mind going as well as my body?

Turns out, no! A meta-analysis of a number of studies did find people with certain autoimmune diseases may have an increased occurrence of psychotic disorders—which is a mental illness severe enough to result in the individual losing touch with external reality (such as schizophrenia). However, this analysis also found that rheumatoid arthritis is negatively associated with psychosis.

They are not sure why some autoimmune diseases may be correlated with psychotic disorders, but advise monitoring for symptoms. In the case of RA, they don’t have any ideas why it may be negatively correlated with these mental illnesses.

RA and it's mental health implications

It is a relief to have a little less to worry about. But I also know that mental health is important to monitor and maintain. People with RA experience a lot of stress, which can contribute to depression and anxiety disorders. It’s important for me to monitor my moods and take care of myself. For me, the mental part of managing RA may be even more important than the physical part. At the very least, I believe the mind-body is strongly connected and taking care of both helps each individually.

I have to laugh, because part of my worry over this study before I read it was how I feel so mad, angry, and sometimes a little nuts about dealing with other people while living with my disease. But after I read the article, I turned to my husband, laughing, and said: “It’s not psychosis, it’s a$$holitis!”

RA and the stigma associated with it

What I mean is that I’m not ‘crazy’, I just get ‘crazy mad’ sometimes by how other people treat me! Whether it’s people trying to sell me cures that don’t work; the pharmacy benefits manager that won’t approve my receiving a new treatment; or people that treat me badly because I use a wheelchair… sometimes it feels like a nonstop assault.

I’ll come home to my husband and say: “Am I crazy or was this situation so wrong that other people are making me crazy?” Thankfully, most of the time he confirms that my frustrations are valid—that it’s not a developing case of psychosis, but instead a lifelong case of having to deal with difficult people who don’t seem to want to understand what life with a chronic disease and disabilities entails.

I’m lucky to be surrounded by supportive friends and family. But they often get shocked too when they are out and about with me. They see the people who jump to get on the public transit elevator before me (hint: if you can run and jump then maybe you can let the people with mobility issues on the elevator first). They see the people who stare at me while I am rolling down the street. And so forth. There’s a lot I don’t even notice anymore because I have learned to block it out! Talk about willfully disconnecting from external reality!

But I know those a-holes are there, and experience them doing their thing. Instead of psychosis, I have developed this strange hopeful attitude that perhaps one at a time, I can teach them a little bit about respecting human variation. Perhaps someday they will be sick or acquire a disability and reflect for a moment on how they have treated others and how they would like to be treated. I know, this hope really is crazy (and I truly do not wish illness on anyone).

In any case, what I’ve come to believe is that there are mental illnesses that we need to manage. There’s also just the concept of good mental health practices, especially for people like us living with a serious chronic condition like RA. But additionally, society and how others treat us can be a bit crazy-making. It’s important to recognize that while we may not be able to alter the situation, it does affect us and require that we be mindful of taking care of ourselves.

So when the world is getting you down, just remember: “It’s not psychosis, it is a-holitis and totally not your fault.”

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