When you have a rheumatologic disorder, life can be a little unpredictable. One day you're feeling great; the next, not so hot. And, well, that can get to even the most upbeat person. If your mood has taken a hit lately, you're not alone: A study in Arthritis Care & Research found that of 1,800 people with arthritis, one-third were depressed or anxious. And 84% of those with depression were also anxious.
Swelling of the Joints
Systemic Lupus Erythematosis
'A high percentage of people with arthritis are in distress and are not getting the care they need," says study author Louise Murphy, PhD, an
epidemiologist with the Arthritis Program at the Centers for Disease Control & Prevention in Atlanta. "Only half of those with depression or anxiety had sought help.'
Yet, she notes there are paths to managing the feelings that come with arthritis. Read on for ways to do just that.
1. Frustrated by the little things?
Lanier S. Lobdell, 57, a customer service employee for the local transit service in Eugene, OR, has had rheumatoid arthritis (RA) since she was 35. Although her RA is well controlled by a biologic medication, she has trying moments. "I get frustrated
trying to open things like jars or when someone hands me change and I drop it because my wrists are fused. I get crabby.'
Laugh it off. "I use humor to get through pretty much everything," says Lobdell. "My RA isn't going away, so my attitude has to change." For instance, when swollen joints cause her fingers to bend, she tells herself, Well, I can wave really well around corners.
2. Feeling anxious? Jessie Jones, PhD, age 63, found herself overwhelmed with anxiety in the first years after she was diagnosed with fibromyalgia in 1998. "Because of fibro fog''difficulty with concentration and memory that can accompany the condition''I couldn't focus on completing tasks, and then I would get very anxious," says Dr. Jones, director of the Fibromyalgia and Chronic Pain Center at California State University at Fullerton.
Take charge of the "controllables." Dr. Jones realized there were a few situations that were adding to her anxiety'and there was something she could do about each one of them. "I decided not to work at night anymore," she says. "And I started saying no to some requests." She also minimized anxiety-provoking situations; for instance, she no longer works with a colleague she found stressful.
3. Feeling depressed? Kat Elton, 43, of Durango, CO, has had RA most of her life. And with it have come some periods of depression.
Rally all the resources. An occupational therapist, health coach and author of A Resilient Life (her memoir on how to thrive with RA), Elton copes by drawing on friendships. "I have one friend who just listens. When I reach out to her, I realize that I'm not alone'we all have challenges." She's also stepped into a psychologist's office. "A trained professional can listen and provide support, and advise about how to handle feelings; if you bottle them up, that just feeds into hopelessness and depression." Another must: "Exercise'it always makes me feel better.'
4. Feeling guilty for letting others down? Lobdell feels guilty when she misses work because of her RA.
Take a preemptive tack. Luckily, her guilt is eased by a simple arrangement she's made with her colleagues: "I cover for other people when they have to be out," says Lobdell. And if the guilt is still getting to her after she's been out sick, she simply apologizes to her co-workers, "and then I have to let it go."
5. Jealous of the rest? An avid tennis player and rock climber before she developed fibromyalgia, Dr. Jones admits she once had moments of envy: "I was jealous of my friends who got to continue being involved with sports."
Find a fun new way.
So Dr. Jones involved herself with a program called Health Rhythms. "It uses drumming, meditation and dancing as a way to help people deal with emotional issues," she says. "So, I've found something much more meaningful that still allows me to be physically active."
Patricia Katz, PhD, professor of medicine and health policy, division of rheumatology, University of California, San Francisco, agrees that finding a replacement is a great idea: "If you can't take a long walk with friends, meet them for coffee afterwards. Or
go for half the walk."
A bad mood'or depression?
If negative feelings last more than two weeks, and they're interfering with your daily life,
you may be suffering from clinical depression. Other signs include:
" Loss of appetite
" Sleep problems
" Poor concentration
" Feeling hopeless
" Memory problems
" Lack of interest in activities that you usually enjoy
If you suffer from any of these problems, seek help right away. "Draw your doctor's attention to your low mood," says rheumatologist Mary Margaretten, MD,
of the University of California, San Francisco, who studies depression and rheumatoid arthritis. "She may refer you to a therapist or psychiatrist who can suggest treatment like antidepressants.'
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