While there are many controversies and conflicting opinions in the medical world, there is consensus when it comes to stress. Doctors agree that stress can increase blood pressure and the risk for heart problems, lead to shortness of breath, cause stomach distress, disturb sleep patterns, affect sex drive, trigger headaches, and cause muscle tension. In addition, stress can exacerbate existing medical issues by impacting the various systems in the body. For those suffering from rheumatoid arthritis, stress can increase inflammation as well.
I experienced this first hand several years ago. Of course, I had heard all the news stories about the negative impact of stress on our health. I was also aware that I was under stress myself. Yet, I did not realize the full impact it was having on my RA disease activity. From 2005-2008 I had an extremely stressful public school system job that involved providing direct social work services to over 300 homeless children and their families each year, as well as writing and administering the grant that funded the program. It was a big job that tugged on my heart, and I frequently put in 10-12 hour days trying to get as much done for the families I served as possible. I knew I was under stress, but I didn’t know what that stress was doing to me.
In the fall of 2007, my health took a tailspin. My pain and inflammation were becoming harder and harder to bear, and prednisone, which usually decreased my symptoms significantly during a flare, was not having the desired effects. My rheumatologist told me that after seven years on Enbrel, the biologic drug was no longer effective for me. She decided to switch me to infusions of Orencia, a drug that was new at the time. I ended up taking a three-month leave of absence from work while I waited for the Orencia to take effect. This was the most physically painful time in my life, and I was taking painkillers every day. Finally I began to feel the benefits of the new drug, and I returned to work. Yet, six months later I decided to resign from my stressful job before going off of Orencia in order to try to get pregnant.
I ended up being off biologics and off of social work for the next four years, as I was either pregnant and/or breastfeeding the two babies I was able to have. I discovered something shocking during that time: my RA was better off of medications and off of social work than it was on meds while working in that stressful profession. I was amazed. Again, I had heard that stress has a huge impact on the body, but I never would have expected that stress could cause as much change in my symptoms as sophisticated, expensive prescriptions could.
After that discovery, I vowed to work in low-stress jobs as a kindness to my joints. For a time, while I was pregnant and while my babies were small, I did just that. However, that job didn’t pay well, had no prospects for advancement, and was “underwhelming” as far as involving very little mental challenge. A year ago, I returned to a part-time social work job, hoping that a half-time stressful job would be half as stressful as a full-time one. Yet, low and behold, my RA has been worse since making that change a year ago.
Now, on top of worrying about pros and cons involving childcare scenarios, health benefits, financial security, and career advancement, I’m also worried about the impact of stress on my health. Currently, the pain is at manageable, albeit very unpleasant, levels. Yet what is it doing to my joints? Is the stress making future surgeries more likely? Rheumatoid arthritis is a degenerative disease, and I worry that I’m helping pave the path for the condition’s destructiveness. All of these are stressful thoughts, and so I start stressing about feeling stressed. It’s a downward spiral, where stress feeds disease activity, and increased symptoms lead to more stress.
I’ve decided that rather than try to tackle all of life’s major decisions, right now I’m going to focus on tackling the stress. I’ve started doing yoga breathing exercises in the morning, I’m focusing on feeling grateful for the many blessings in my life, I am trying to add more exercise to my daily routine, and I’ve started using an app on my phone that targets stress with activities that focus on mindfulness and positive thinking. Living with rheumatoid arthritis is so complicated, and it’s infuriating that the stress of living with this disease actually makes the disease worse. It requires that much more effort and work to combat this vicious, pernicious beast that is RA.