What Stress Does to my RA
Credit: Eileen Davidson

Living with a chronic illness like rheumatoid arthritis I try to avoid stress as much as possible. Unfortunately, stress is not always avoidable, and the reality of living with RA itself is quite stressful. The impact of stress on my emotional and physical well-being is significant, with the potential to put me into a flare. Considering that RA is progressive systemic autoimmune disease, this is a major concern for me.

Chronic illness itself brings a whole new level of stress that someone healthy wouldn’t fully understand. Balancing medical appointments, overcoming needle phobias or other uncomfortable tests, managing debilitating symptoms, navigating the effects of chronic illness on our social lives, and,of course, the financial burden that accompanies a chronic condition — it’s safe to say the average healthy person wouldn’t understand the unique stress that comes with living with chronic illness.

As a single mother on disability living in one of North America’s most expensive cities, I face the dual challenges of skyrocketing rent and a constantly rising cost of living. Unfortunately, disability pay stays the same, falling below the poverty line. Consequently, finances are always my main stressor, second only to the impact of rheumatoid arthritis on my overall quality of life. I say finances come first because if I had better finances I would more than likely have the ability to live healthier with this disease.

The Mental Impact of Stress on My Life

Stress often leaves me irritable, angry, impatient, overwhelmed, and anxious. I become uninterested in life and lose the ability to concentrate because my thoughts are racing in a million directions. I feel insecure, have difficulty making decisions, my memory worsens, and I find it hard to enjoy life. Stress causes me to eat too much or too little, clench my jaw, become restless, and not exercise as much as I need to. I will often withdraw from friends, family, or any other type of engagements.

Stress is a constant presence in my life, and if left unaddressed, it can consume me, leaving me trapped and paralyzed by intrusive thoughts. What’s worse, stress can cause a lot of uncomfortable symptoms and worsen my arthritis.

What Stress and Chronic Pain Feel Like

Stress is a vicious cycle for our bodies, especially when living with a disease that causes widespread chronic pain. The fact that stress causes more pain is stressful itself.

Stress has an impact on our nervous system. When our nervous system is affected by stress, it leads to feelings of tension, which, in turn, causes our muscles to tense up, often resulting in painful muscle spasms. These spasms further aggravate our joints and contribute to increased fatigue. Let’s not forget that stress also increases anxiety and depression, which worsen perception of pain.

When I am stressed, I notice my breath quickens, my heart rate increases, and my muscles tense up. I can feel my body temperature rising, and a sense of stiffness setting in. This heightened muscle tension can intensify the pain caused by arthritis. If I experience a stressful event, I may encounter a sudden surge in fatigue within hours, impacting my ability to function for several days. I’m left feeling groggy and fatigued. Stress can stop me in my tracks and leave me feeling paralyzed.

Stress has manifested into many symptoms, including hair loss, cold sores, cystic acne, muscle weakness and tension, headaches, increased pain, insomnia, and crushing depression or anxiety that consumes me. Stress has even caused me to gain weight suddenly, either by a chemical imbalance or because it makes me crave unhealthy coping mechanisms, like junk food, cannabis, alcohol, or access shopping. A huge part of my financial stress as someone getting by on disability means I often can’t afford the healthiest groceries to combat my illness, which is not good for my overall well-being either.

Stress doesn’t only affect us physically but also takes a toll on our mental resilience, making it more challenging to deal with the symptoms of your diseases. The longer the stress, the worse the inflammation and impact on your immune system. I don’t need a doctor to tell me this, I’ve felt the physical response to stress firsthand, and it can be debilitating with rheumatoid arthritis.

This is because stress works on a physical level by increasing levels of the hormone cortisol in your body. This triggers immune system hyperactivity, a hallmark of inflammatory types of arthritis, while simultaneously reducing the immune system’s ability to fight off harmful germs. After prolonged stress I can find myself sick and have a difficult time recovering from the illness.

So yes, stress makes our arthritis worse. It makes everything worse. Stress sucks.

How I Deal with Stress

From seeking support and setting boundaries to staying active, here is how I manage stress and prioritize my well-being.

Ask for help

While I can’t control everything, I can control how I respond to things, to some extent. Being proactive, realistic, and productive helps me eliminate some stress as does asking for help from people I know who are supportive and trustworthy. My support network is crucial.

Say no

Learning to say “no” was a lesson to me. I am a people-pleaser but trying to make everyone happy can cause me a lot of stress. If I know it will overwhelm me, put me into a flare, or throw me off my self-care management, I may need to say no. It is ok to be highly protective of your time and energy.

Pace yourself

Chronic illness is bumpy (and I move at an arthritic speed). I remind myself that I am living with a debilitating illness and that I shouldn’t feel guilty if I need to ask for an extension or can’t be present because life is getting too overwhelming. I tell my editors, researchers, clinicians, media companies, or any collaborating I am working with, when I need additional time or gently reminders. I have learned to pace myself.

Stay organized

I make a point to stay as organized as I can possibly be. I write everything down, my thoughts, my concerns, my to-do lists, and so on. This helps me remember them easier and to create an action plan when needed.

Plan ahead

After several years of living with this disease and knowing how stress can impact me I try my best to plan ahead to avoid any surprises. Not always possible, but certainly helpful.

Have a good cry and swear

Sometimes it gets to be too much, and you need to cry and swear out your frustrations. I am a big fan of swearing, and research has proven it does relieve stress.

Let go of guilt

I remind myself that what I go through is not my fault. I do my best to try to remove as many of the emotions of guilt that come with living with a chronic illness. They do me no good. I’m not always successful at this but I do make a point to try to rationalize my negative emotions.

Keep moving and take time to breathe

Even though stress paralyzes me in my tracks, I need to make sure to keep moving as it does help alleviate my pain and how I handle stress. When we exercise regularly, our body releases feel-good chemicals called endorphins.

I don’t just exercise one way, I will hike, swim, use my treadmill, the elliptical at the gym, strength train, or do gardening. When I’m stressed, I try to do the exercise I enjoy the most.

Yoga is a great movement when stressed because it also incorporates deep breathing. When I feel overwhelmed with stress, I make a point to sit quietly for a few minutes and focus on breathing deeply. This helps put my body into a calmer state, even if just mildly.

Eat healthfully

I do the best with what I got, although inflation is making this more and more difficult as prices increase. Avoiding sugar and processed foods when stressed can make a difference.

Get out into nature

Nature has been shown to have remarkable stress-reducing effects by boosting endorphins and dopamine production and reducing that pesky inflammation promoting hormone cortisol.

Cuddle a pet

Cuddling with my four cats brings me immense comfort. Their adorable squishiness provides a soothing and calming effect when I need it most.

See a therapist and your doctor

If stress is consuming, there is no shame in reaching out to a mental health professional for help. You may benefit from cognitive behavior therapy, which aims to help you reframe the issues that are causing your worry and help guide you to deal with them in a more positive light.

Be a More Proactive Patient with ArthritisPower

ArthritisPower is a patient-led, patient-centered research registry for joint, bone, and inflammatory skin conditions. You can participate in voluntary research studies about your health conditions and use the app to track your symptoms, disease activity, and medications — and share with your doctor. Learn more and sign up here.

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