The Emotional Toll of RA
Reviewed by: HU Medical Review Board | Last reviewed: January 2021 | Last updated: February 2021
Living with a chronic (long-term) and painful condition such as rheumatoid arthritis (RA) can take a toll on your emotions. Studies have shown that people with RA are at high risk for depression and anxiety. This risk increases if your RA symptoms affect your daily functions.1-3
Reacting to a diagnosis of RA
People react to a diagnosis of RA differently. However, there are some common feelings that you may have when you learn that you have RA. These include shock, denial, confusion, anxiety, and anger. You may feel relieved to finally get an answer to the pain you have been experiencing.4
Depression is common in people with RA. Up to 41 percent of those with RA will experience some symptoms of depression. This is much greater than the general population, with 7 percent of Americans overall experiencing depression.4
Depression in RA is linked to higher levels of disease activity. Those who report depression have self-reported increased levels of pain, fatigue, and disability.1,2
Living with chronic pain appears to be a difficult cycle to break. Pain can cause depression, and depression can make your pain worse. Chronic stress from pain can change the levels of chemicals in your brain. This can affect your mood, thinking, and behavior. Having depression can make it feel harder to cope with your pain.1,2
Because depression is a dangerous condition that can increase your risk of harming yourself, it is essential to be aware of the signs of depression so it can be diagnosed and treated as quickly as possible. Diagnosing depression can be difficult. If you notice the symptoms of depression in yourself, a friend, or a family member, alert your doctor and ask for an evaluation.
Anxiety can cause physical changes like increased blood pressure, along with feelings of tension and worry. Anxiety typically happens in response to life circumstances, such as living with the uncertainty and stress of having a chronic disease like RA. Different stressors, like financial uncertainty and worry about the future, can trigger or worsen anxiety.2
How are anxiety and depression treated?
Some people never experience anxiety and depression related to RA. But if you do, there are treatment options. Talking to your doctor about your mental health may not be easy. Remember, mental health is just as important as physical health. It may take a team of healthcare professionals to make sure you are getting the support you need.
Counseling or therapy
In counseling or therapy, you can talk to a therapist to help decrease your symptoms of anxiety or depression. Cognitive behavioral therapy (CBT) is the most common form of therapy for anxiety and depression. CBT focuses on changing negative thoughts or behaviors.3
A variety of types of drugs are used to treat anxiety and depression. Depending on your symptoms and medical history, your RA doctor or mental health doctor will decide the best treatment for you.
Mental health drugs work in a variety of ways. Most medications affect the chemicals in the brain to improve mood and behaviors. Some drugs used to treat anxiety and depression may include:3,4
- Selective serotonin reuptake inhibitors (SSRIs)
- Tricyclic antidepressants
Mental health drugs may take weeks to improve your mood. Work closely with your mental health doctor and be prepared to give the process time.4