Arthritis refers to joint conditions characterized by chronic pain, but beyond the physical symptoms, it can also adversely affect one’s mental health. In many cases, this manifests as depression and anxiety, and the comorbidity of these conditions can actually worsen arthritis. As the link between mental health and arthritis becomes clearer, it is important to talk to your healthcare provider about treating anxiety and depression as a part of your care regimen for managing arthritis.
The American Psychological Association defines anxiety as a condition characterized by feelings of tension, worry, and irritability in addition to physical changes like increased blood pressure. Depression is characterized by traits such as sadness, a lack of interest in daily activities, sleep disturbance, fatigue, and feelings of worthlessness. While the rates of anxiety and depression in people with arthritic diseases vary depending on a number of factors including the size of the study and the population, data show that the rates of comorbidity can range between two to ten times greater than the rates of the general population, depending on the type of arthritis.
Many people with arthritis find themselves in a never-ending loop of pain. Anxiety and depression can lower one’s pain threshold, and chronic pain can aggravate anxiety and depression. In addition, those who suffer from both depression and arthritis have functional limitations that can prevent them from adhering to their pain regimens, which can increase their odds of developing other health problems.
Many studies indicate that people with arthritis suffering from the highest levels of pain are more likely to be anxious, though the association between severe pain with depression is not quite clear. Living with chronic pain can be taxing both physically and emotionally. Chronic stress causes changes in stress hormones and neurochemicals, which affect, mood, thinking, and behavior.
While the link between pain and disability to depression in arthritis is clear, there is a developing theory that inflammation also plays a role. In 2016, The Journal of Clinical Psychiatry reviewed levels of C-reactive protein, an indicator of inflammation, in a survey of 10,000 people. The survey found that people with symptoms of depression had CRP levels that were 31% higher than those without depressive symptoms. Dr. Patricia Katz, Ph.D., professor of medicine at the University of California San Francisco, explains that “there is a body of literature recognizing depression as an inflammatory state. There is a well-documented event called cytokine-induced depression, where cytokines are increased and depression occurs.” Specific cytokines are involved in the pain and inflammation process in arthritis.
Furthermore, the pain of arthritis is exhausting. The ensuing health challenges of the condition can cause one to engage in less physical activity, become more isolated, and affect sleep quality, which all contribute to depression. The key to living your fullest life when you are affected by arthritis is to treat both the physical and mental symptoms of the disease.