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Anxiety and depression are common among people with arthritis. One study showed that people with rheumatoid arthritis (RA) are twice as likely to suffer from depression as those without RA. We know that as many as 40 percent of people with RA have significant symptoms of depression, and according to the CDC, one in three adults with arthritis also has anxiety or depression. This is not surprising given the chronic pain and physical limitations that often come with RA; however, many people don’t realize that depression can actually worsen arthritis pain. One 2011 study showed that among people with osteoarthritis, depression can have as much of an impact on knee pain as physical joint damage.
One reason for the link between pain and depression has to do with lifestyle changes that may be caused by depression and that can increase pain. These include poor sleep, lack of exercise and reduced socializing. Another theory suggests that if you have depression, you are less able to cope with chronic pain and may perceive your condition more negatively than those who are not depressed. There are also biological factors shared by both depression and chronic pain – specifically, the neurotransmitters serotonin and norepinephrine – that can cause the brain to register more pain from certain stimuli, such as a stiff joint, in people with depression.
Anxiety can be just as big of an issue in arthritis as depression. In fact, a CDC study found that anxiety was even more common in RA patients than depression. People with arthritis may become anxious about their pain and disability or worry that they will be unable to work, take care of their families or perform other daily tasks in the future. People with arthritis may also be hesitant to go out and participate in activities like exercise or social functions, which can increase their sense of anxiety.
Anxiety and depression not only contribute to arthritis pain, but can also lead to poorer health outcomes and reduced treatment response. Research shows that people with RA who also have persistent anxiety or depression have reduced odds of achieving RA remission at two years.
Unfortunately, mental health problems in people with arthritis are underdiagnosed because many patients do not feel comfortable mentioning mental health symptoms to their doctor, and often doctors do not ask. If you are experiencing depression or anxiety, it’s important to talk to your doctor so that you can receive the best treatment for you.