Everyone has bad days. But when you have chronic illness like arthritis, a “bad day” can take on a whole new meaning. Part of learning to live with your condition is learning healthy ways to deal with these bad days, whether they are due to mental or physical reasons, or likely a combination of both, says Lisa S. Larsen, PsyD, a licensed psychologist who specializes in chronic illness in private practice in Lancaster, California. She points out that physical pain can lead to depression, anxiety, and other mental health symptoms, which in turn can lead to more physical pain, a vicious cycle that can turn one bad day into a string of bad days.
“It’s been two years since I was diagnosed with ankylosing spondylitis (AS) and I’m still trying to find how to cope on these hard days,” CreakyJoints member Elena K. shared on Facebook.
“It is important to accept that you will have days when you feel better or worse than others,” Dr. Larsen says. “Sometimes you can figure out what made it a good day, or at least a better day, and sometimes you won’t know. That fragility of health is hard for us to accept. Acceptance doesn’t mean you have to like it. It just means that you don’t fight it and waste your precious energy trying to make reality fit what you think it ‘should’ be.”
This starts by being honest with yourself and others when you’re having a bad day and being open about your pain and limitations, says Jen Douglas,PhD, a psychologist and clinical assistant professor at the Stanford University School of Medicine who also has rheumatoid arthritis. You don’t have to spill your guts to the stranger on the train but trying to pretend you’re fine when you’re not is hurtful psychologically and physically.
“Don’t try to hide a bad day,” Dr. Douglas says. “The more you try to hide it and bear it all on your own, the more stressful it is and that can make your chronic illness worse.”
Okay, so you’ve established you’re having a bad day. Now what? We talked to experts for their advice and also got tips from arthritis patients themselves on how to cope.
Mental Health Tips to Get Yourself in the Right Headspace
Managing a bad day starts with your mindset, Dr. Douglas says. Here are some experts’ tips about how to handle the negative thoughts and mental anguish that can come with a terrible flare-up.
Make a bad day plan
The first thing when learning how to manage bad days with arthritis is to plan for them in advance, Dr. Larsen says. Having a plan in place can help keep you from getting surprised by these days and help you feel in control of your situation.
“Your attitude and resourcefulness will be key to how you live the rest of your life,” she says. “Your arthritis doesn’t define you or how your life has to be. A proactive approach will help you from feeling defeated by the bad days.”
A plan could include practical things like letting your manager at work know you might need to call out sick so you feel less guilty about last-minute schedule changes, having child care options lined up if you need help with young children, or keeping easy-to-prepare food in your pantry or freezer for days when you don’t have the energy to cook, shop, or even order in. It could also entail just mentally knowing that there will be days when you need to stay in best and rest so they’re less surprising or frustrating.
Find a good therapist
There’s a grieving process you go through when you’re diagnosed with arthritis. A therapist, social worker, or other mental health professional who specializes in chronic illness can be instrumental in helping you manage those difficult feelings, Dr. Larsen says. Even after you’ve overcome the initial hurdle, feelings may pop up again and your therapist can help you work through your grief, anger, despair, and other issues.
Many people with chronic illness consider ongoing mental health care as critical to their well-being as managing physical symptoms with medication or physical therapy.
Involve your partner
If you’re in a relationship, don’t be afraid to ask for help from your partner — they love you and want the best for you. “I often have to come back to this myself, as I have rheumatoid arthritis and am also very independent and struggle to ask for help,” Dr. Douglas says. “But my best advice to anyone is to have their partner get involved early and often so they understand the illness as well as you do.”
If you don’t have a partner, there may be family members or friends you can count on more than you think or would like to. Consider how you would respond if these people asked you for help in a similar situation — of course you’d be there for them. Chances are, you have some key people in your life who would welcome the chance to be there for you — if you let them.
Reframe bad days
How you think about a bad day can go a long way in how bad it really feels, Dr. Larsen says. Learning how to reframe negative situations can help you deal with them better. “Don’t beat yourself up for having a bad day. Instead look at it as an opportunity to take care of yourself,” she says. “Instead of thinking you’re ‘weak’ for not being able to do what you used to do, focus on how strong you are for handling your illness on top of everything else.”
Ditch the fear
A lot of what makes a bad day bad is fear and anxiety about the unknown, Dr. Larsen says. For instance, you may be afraid of how long a flare will last, how much pain you will have, if this means your illness is worsening, or how this setback will affect other aspects of your life. Instead of ruminating over these things, do your best to get some answers, she says. This may include calling your doctor about your symptoms if they’ve changed, keeping a journal of your symptoms so you can look for patterns, calling your boss and making arrangements for your work, or researching medication or other treatment options. (You can use our ArthritisPower app to track your symptoms and disease activity and share your results with your doctor.)
“Anything you can do to take action, within reason, will help you feel like less of a victim to the bad days,” she says.
Make a happy goal to look forward to
It can be easy in the midst of a bad day to forget about all the good things you have going on, so it’s important to remind yourself that this bad day or flare up won’t last forever. One way Dr. Douglas does this is by thinking of a happy goal — for her it’s focusing on her child and her plans to add to her future family.
Be open to trying new things
Things you used to not enjoy or that you’d never tried, you may find helpful now, so it’s important to be open to new experiences, Dr. Larsen says. For instance, taking up a creative skill like painting or music may be a great way to manage a bad mental health day. “Don’t worry about being ‘good enough’ to do it, as long as you enjoy it, that’s all that matters,” she says.
Know, and accept, your limits
A common problem Dr. Larsen says she sees is thinking you can force through the bad day if you just try hard enough. “Don’t push yourself too hard or you’ll make the bad times last longer,” she says. “Be honest with yourself about your pain levels and energy levels and allow yourself to rest. Don’t try to be macho.”
Sometimes, getting deep into your head can be the best way to get out of your head and away from the negative thought spirals that can sometimes plague people with chronic illness.
“When I’m having a bad day, I like to do a guided meditation,” says Susan Blum, MD, MPH, chronic disease specialist, assistant clinical professor in the Department of Preventive Medicine at the Icahn School of Medicine at Mount Sinai, and author of Healing Arthritis: The 3-Step Guide To Conquering Arthritis Naturally. Dr. Blum also has arthritis herself. “It distracts me and helps me calm down. Meditation also has proven pain relief benefits.”
How People with Arthritis Get Through Their Bad Days
Once you’re more mentally prepared to deal, there are a lot of little things you can do to take the sting out of a rotten day. We asked people with arthritis for the top ways they manage.
I drink a mug of golden milk
Golden milk is a traditional Indian drink made with turmeric and other spices and is becoming very popular for its health benefits. “Everything about it is relaxing to me, I find it soothing to my hands to just hold the warm mug and the smell makes me happy,” says Abbie D., 24, who has rheumatoid arthritis. “Plus the turmeric is an anti-inflammatory so it helps reduce some of the swelling, at least I hope it does.” Abbie says she buys a premade golden milk spice mix from her health food store, adds one scoop to coconut milk (you can substitute any type of milk you like), and microwaves it for two minutes.
I do yoga
“The worse my flare is, the more I know I need to move but the less I want to,” says Abbie, who also has fibromyalgia. “So on my worst days, I do a yin yoga class. It’s in a warm room, which is super relaxing, and we move slowly through very basic poses. We also lay in different positions while supported by yoga blocks and covered with a blanket.” The combination of warmth, gentle movements, meditation, and the calming environment of the yoga studio is a magic bullet for nixing a bad day, she says. Here are some gentle restorative yoga poses you can try.
I get a massage
There’s just something so soothing about human touch — especially when it comes in the form of a relaxing massage. “I’m in grad school and on a budget so this isn’t something I do often but on my really bad days I go get a massage,” Abbie says. “I don’t talk, I just lie on the table and try to focus on how good it feels. I always feel better after.”
I snuggle my pup
Animals can be incredibly comforting, both for the physical pain of arthritis and for the emotional side. “My pupper Mabel is everything to me,” says Kennidee T., 17, who has juvenile idiopathic arthritis. “She just seems to know when I’m having a really bad day and she won’t leave my side and gives me lots of snuggles. She always helps me feel better.”
I vent to my online support group
There are many places online for people with arthritis to bond, get advice, and vent. They’re also great for offering support during the bad days, Kennidee says. “My online friends help me in ways my real-life friends and family can’t because they just get it,” she says. “I’m part of a group specifically for kids with arthritis so they know exactly what I’m going through. We met through Reddit and then set up our own Discord channel where we check in regularly.”
I take a nap
“The best way for me to get through a bad arthritis day, if the pain isn’t too bad, is to sleep it off,” says Daniel L., 60, who has osteoarthritis. A quick nap — he recommends no more than an hour — not only gives his body a little rest but it helps mentally as well. “I always wake up feeling a little more positive and with a better outlook,” he says.
I indulge in a good Netflix binge
Netflix binges were made for helping people get through bad days and that’s especially true for people experiencing a bad arthritis flare-up. “I have my go-to shows, like Parks and Rec and The Office, which always make me laugh and feel better,” says Mike E., 27, who has ankylosing spondylitis. “Sometimes I’ll watch a documentary or biopic if I’m trying to distract myself from going to a dark place mentally.”
I read an inspiring book
“I’ve read Unbroken [by Lauren Hillenbrand] at least 20 times,” Mike says. “It’s my favorite book to read when I’m feeling down about my arthritis. If that guy can make it through 47 days floating on a raft lost in the ocean and then as a prisoner of war for over two years, then I can deal with whatever my arthritis is throwing at me.” Check out more inspiring books about living with chronic illness.
I eat some chocolate
“I shouldn’t eat treats because they make me swell like a balloon, but on a really bad day I just want something comforting and for me, that’s chocolate,” says Mary R., 55, who has rheumatoid arthritis. She adds that she tries to keep it healthy-ish by choosing a Lily’s dark chocolate bar sweetened with stevia.
I call my mom
Is there anything moms can’t make better? “I’m 39 years old and haven’t lived at home for 20 years, but my mom is still the first person I think of when I’m having a bad day,” says Amber S., 39, who has psoriatic arthritis. “There’s just something about talking to her that makes me feel like everything is going to be okay.”
I invite a friend over
When you’re in the midst of a terrible arthritis flare up, going out can feel impossible but seeing loved ones is a simple pick-me-up. The solution? Ask them to come to you. “My best friend lives down the street and she’s so great about coming over and just hanging out,” Amber says. “She catches me up on the neighborhood gossip and tells me jokes and brings me coffee. She’s really the best.”
I get acupuncture
Amber says she used to think holistic treatments were too “out there” but since getting psoriatic arthritis, she’s much more open to trying alternative treatments, especially on bad days. “If it helps, it helps, and I don’t question it,” she says. “I’ve actually found a lot of relief from weekly acupuncture and aromatherapy with essential oils.”
I ask for help
“I’ve learned that when I’m down, I need to stay down,” says Jennifer D., 34, who has psoriatic arthritis. “This means I have to rely on other people, like my husband and my kids, to help me, and that’s okay. I’ve had to get over feeling like I’m inconveniencing them and feeling like I ‘shouldn’t’ need help.”
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Interview with Jennifer Douglas, PhD, a psychologist and clinical assistant professor at the Stanford University School of Medicine
Interview with Lisa S. Larsen, PsyD, a licensed psychologist who specializes in chronic illness
Interview with Susan Blum, MD, MPH, chronic disease specialist, assistant clinical professor in the Department of Preventive Medicine at the Icahn School of Medicine at Mount Sinai, and author of Healing Arthritis: The 3-Step Guide To Conquering Arthritis Naturally