Question: When Does Sadness and Frustration Cross Over Into Depression?
Sadness is a normal emotion that we all feel at times. It's not the same as depression. When does sadness and frustration which may be expected to be associated with chronic arthritis cross over into clinical depression? When are anti-depressant medications indicated? When do you recommend professional counseling? What can an arthritis patient do to help themselves or recognize they need help for depression?
Answer:
Depression: A Common Problem
Depression is common problem for people with arthritis and related conditions. The United States National Health and Nutrition study showed that 16% of people with chronic musculoskeletal pain had depression and other studies have shown an incidence of depression as high as:
Young patients with rheumatoid arthritis may be at an increased risk of depression due to an increase in pain and stress.
Is It Sadness Or Depression?
Two questions that may help determine whether the sadness and frustration many experience with chronic illness crosses over to depression are:
(1) During the past month, have you often been bothered by feeling down, depressed or hopeless?
(2) During the past month, have you often been bothered by having little interest or pleasure in doing things?
If the answer is no to both, you are unlikely to have major depression.
Warning Signs And Symptoms
Even if a patient does not have major depression, it is important to notify your doctor if you have any of the following signs and symptoms including:
Remember, if you experience any of these signs and symptoms, counseling (social worker, psychologist or psychiatrist) and medication are key to feeling better.
More Information
Although depression is often thought of being in an extreme state of sadness, there is a vast difference between clinical depression and sadness. Sadness is a normal part of being human, a natural reaction to painful circumstances. All of us will experience sadness at some point in our lives. Depression, however, is a physical illness with many more signs and symptoms than an unhappy mood.
We all feel sad sometimes. Sadness is a normal emotion that can make life more interesting. Sadness almost always accompanies loss. Learn ways to experience normal sadness in a healthy way and to allow this emotion to enrich your life.
Answers provided by Scott J. Zashin, M.D., clinical assistant professor at University of Texas Southwestern Medical School, Division of Rheumatology, in Dallas, Texas. Dr. Zashin is also an attending physician at Presbyterian Hospitals of Dallas and Plano. He is a fellow of the American College of Physicians and the American College of Rheumatology and a member of the American Medical Association. Dr. Zashin is author of Arthritis Without Pain - The Miracle Of TNF Blockers. The book is useful for anyone on one of the biologic drugs (Enbrel, Remicade, Humira) or considering the biologic drugs. Read our review of the book.
Sources: Hawley DJ, Wolfe F J Rheumatol 1993;20, NEJM Vol 343 Number 26
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