Rheumatoid Arthritis - Beyond Physical
Psychiatric disorders, especially depression, are common comorbidities of rheumatoid arthritis. Psychiatric and depressive disorders may be related to the stress of living with a chronic disease, disease activity, and chronic pain. In other words, there is a correlation -- significant depression exacerbates rheumatoid arthritis symptoms -- and vice versa.
Managing Pain and Depression
Pain is the most common physical reason for visiting a doctor -- and depression is the most common mental issue that requires consultation with a doctor. Pain and depression together can interfere with life and they are recognized causes of decreased work productivity. But there are ways to manage the two conditions. According to a study published in the Journal of the American Medical Association (JAMA), a combination of antidepressants and self-management techniques can be effective. Self-management techniques include muscle relaxation, deep breathing exercises, and distraction.
An earlier study in JAMA concluded that a combination of antidepressants and psychotherapy was effective for depression and arthritis. Patients had less pain, less interference with daily activities, and improved quality of life after receiving medications and psychotherapy.
Depression Should Not Be Disregarded
Whatever the course of treatment decided upon, rheumatoid arthritis patients and their doctors should pay closer attention to mental aspects related to the disease. Depression should not be ignored or cast aside as par for the course. It must be addressed. If you experience depressive symptoms, don't hesitate to discuss it with your doctor.
Bottom Line
If patients aren't talking to their doctor about depression and doctors aren't asking their patients about depression -- the communication gap could have a profound negative impact on quality of life.
Sources:
63% of Rheumatoid Arthritis Patients Suffer Psychiatric Disorders. EULAR. June 2009.
http://www.eular.org/congresspressreleases/OP-0227_press_release_Lisitsyna_psychiatric_disorders_in_RA.pdf
Optimized Antidepressant Therapy and Pain Self-management in Primary Care Patients With Depression and Musculoskeletal Pain. Kroenke Kurt, MD. JAMA. May 27, 2009.
http://jama.ama-assn.org/cgi/content/abstract/301/20/2099
