You are not your illness. Unfortunately that can be hard to remember, especially with a diagnosis as chronic and life-altering as arthritis, says Lisa S. Larsen, PsyD, a licensed psychologist in Lancaster, California, who specializes in treating people with chronic illness. “You are not an arthritic, you are a person (first), who has arthritis (second),” she explains.
Dr. Larsen, who also has a chronic illness herself, says this is one of the very first things she tackles with new clients because it’s so important to keep your arthritis from becoming your whole world — a trap she sees too many people fall into. “Once we identify too much with a sick role, it limits our imagination and our feelings of capability,” she says. “There is so much more to you than that illness. Don’t forget to appreciate and love the parts of you that are healthy and comfortable, as well as capable.”
That said, the effects of arthritis on mental health are so often overlooked, she says. Depression, anxiety, obsessive thoughts, and other mental issues can have a huge impact on your health and arthritis management. Your mood and mental state can affect your ability to follow your treatment plan, the way you communicate with medical professionals and loved ones, and even the amount of pain you experience, she says. This is why it’s so important that you address your mental health, a process that a good therapist can help with.
“We are not victims,” Dr. Larsen says. “We just have different health care needs from other people.” And those health care needs should include mental health care just as much as managing your physical symptoms. To help you, we asked psychologists who specialize in chronic illness to share the best advice they give their clients.
1. Accept the Bad Days
This may sound simplistic but many people with arthritis will try to either fight or ignore their bad days, which can turn one bad day into several horrible weeks. “It’s important to accept that you will have days when you feel better or worse than others. The fragility of health is hard for us to accept, especially those of us who are younger,” says Dr. Larsen. “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.”
2. Track Your Triggers
The helpless feeling that comes with an arthritis diagnosis can be one of the most difficult parts for people to deal with, Dr. Larsen says. To help you regain a sense of control over your body and life, she recommends her clients track what triggers flare-ups. “Sometimes you can figure out what made it a good day — or at least a better day — for pain or other symptoms, like a certain medication or exercise,” she explains. “Other days it might be as simple as something like a change in weather or something in the environment that knocks you down. Even if you don’t know for sure if something helped or hurt, write it down because it will help you see patterns over time.” (You can use our ArthritisPower app to track your symptoms and disease activity and share your results with your doctor.)
3. Give Yourself Permission to Mourn Your Old Life
Getting an arthritis diagnosis can change the entire course of your life, affecting not just your day-to-day but also your long-term dreams and goals, your relationships, and your self-image, says Adina Mahalli, MSW, a mental health professional who specializes in trauma and illness, currently practicing in Jerusalem, Israel. It’s important to give yourself the time and space to mourn the loss of the old you, she says.
“Many people have a hard time coping with a chronic illness like arthritis because they are in denial, trying to hold onto their old life,” she explains. “Allowing yourself to be sad about what you’ve lost will help you accept or even embrace your new life.”
4. Tell Your Partner Exactly What You Need
Your partner is not a mind reader. They won’t know what you need when it comes to your arthritis, until you tell them, says Liz Colizza, a licensed professional counselor who specializes in relationships at Lasting, a relationship counseling app. “Be brutally honest and give your partner a realistic idea of what they can expect from you and where they will need to step in and help,” she says. “Tell them exactly what your capabilities and limitations are.” She isn’t just talking about only chores either — be clear about what you need from them emotionally, spiritually, and sexually (oh yes, you need to talk about that).
5. Give Your Partner a Break
Dealing with arthritis is incredibly difficult for patients, but don’t forget that it’s no cakewalk for your partner either, Colizza says. “Caregiver guilt and burnout are a real problem,” she explains. “Let your partner know you appreciate them and that you want them to take care of themselves too.” Encourage your partner to keep up their hobbies, go out with friends, or just create an disease-free zone at dinnertime and focus on talking about other things. “As you walk through this together, keep in mind that your partner can be your greatest ally, and your relationship can still grow in hard seasons,” she says.
6. Make Cheat Sheets
Managing a chronic illness like arthritis can be exhausting — between medications, exercise routines, doctor appointments, battles with your insurance company, and the extra time it takes to get everything done, it can feel like a full-time job. This is why Mahalli recommends creating several cheat sheets to all of her newly diagnosed patients.
Take an index card and write all of your doctor’s names and phone numbers; a second card has all of your meds with their dosages and schedule; a third card contains a list of exercises you’re supposed to do every day; a fourth card has your list of important contacts, including services like Uber or Seamless; another card has a list of all your coping techniques. Then, take a picture of each card with your phone so you have that information at your fingertips no matter where you are, she advises.
7. Have Realistic Expectations
Many of her clients with arthritis tend to extremes, vacillating between a Pollyanna-ish blind optimism and thinking their lives are over, Mahalli says. The truth is that for most people the reality is somewhere in the middle. The sooner you figure out what realistic expectations are for your body, the sooner you can start adapting to your arthritis.
“Chronic illness is not fun. It’s not just an ‘inspirational journey’ either. Having realistic expectations will make your pain and the daily inconveniences feel more manageable,” she explains. How to do this? Talking to doctors and others dealing with your same type of arthritis, as well as keeping a symptom journal, can help you shift your perspective.
8. Create a List of Practical Adjustments
Once you’ve figured out what’s reasonable to expect with your particular type of arthritis, it’s time to make a different kind of list, Mahalli says. Be honest about how exactly your life is different now — including medications, appointments, pain flares, exhaustion, chores you can’t manage — and come up with a list of practical solutions for how you can deal with them.
For instance, if you know that brain fog makes remembering things tricky, buy a wall-sized calendar and write everything on it where you can see it first thing every morning. Chronic pain has a way of short-circuiting logical thought processes, she says. Writing this list out will help you feel more in control of your body and your disease, she adds.
9. Separate Your Needs from Your Wants
Everyone has a mile-long list of things they “should” do. For people with arthritis it’s essential to pare that down and decide between what’s essential and what’s optional, Dr. Larsen says. “Make a list of all the things you think you ‘should’ do and cross off any tasks that aren’t really necessary,” she says. “Look at the remaining list and ask yourself why you’re doing those tasks. Is it to make someone else happy at the expense of your own well-being? Consider taking those items off your list too, if you can.”
10. Don’t Overdo It on Good Days
Learning to rest on bad days can be tough enough but learning to take it easy even when you feel great can be incredibly difficult for people with arthritis, Dr. Larsen says. “On the days you feel good, don’t push yourself too hard to get all the things done that you were putting off when you felt lousy,” she says. “Try to pace yourself and check to see your pain levels or energy levels in between activities. Take regular breaks. This is not the time to be macho!” The key, she adds, is to stop while you still feel good. Don’t wait until it hurts.
11. Let Go of Resentment
One of the things Mahalli says her patients with a chronic illness often struggle with the most is a strong sense of resentment and unfairness. Why are you the unlucky winner of the arthritis lottery? Why does your disease progress faster than others with your same diagnosis? Why does your pain not respond to medication like someone else’s? If you look for it, there’s a lot about arthritis that can make you bitter. Learning to let go of that resentment is one of the kindest gifts you can give yourself, she explains. This isn’t something that you can necessarily work through on your own, but a therapist trained in chronic illness management can help you process these intensely painful feelings and see a way forward. “Creating a clear, new path is the best way to try to live happily and without resentment,” she adds.
12. Listen to Your Body
When Kimberly Lackey was first diagnosed with reactive arthritis after a long string of health problems (including cancer), she couldn’t believe her bad luck. Even worse, the immunosuppressive treatment for her arthritis threatened to cause a relapse of her cancer. “I knew that the best thing I could do was listen to my body,” she says. “It took several years but eventually I was able to find the treatments that worked best for my unique situation.” Now she works as a therapist and integrative health coach, counseling others with arthritis. The first thing she always tells them is to learn to trust their bodies, instead of feeling betrayed by them.
13. Celebrate the Little Wins
When it comes to dealing with arthritis on a daily basis, it’s all about embracing the little victories, Dr. Larsen says. Whether it’s getting the kitchen clean, making dinner, or volunteering at your kid’s school, even if you weren’t able to do everything you wanted, doing any of it is still an accomplishment. Instead of beating yourself up for not doing more, acknowledge what you have done. Appreciate that you were able to accomplish that thing, thank your body, and give yourself a little reward or a mental high-five, she adds.
14. Halve Your Schedule
“It is extremely important to discard what you think of as ‘normal’ when you have arthritis,” Lackey says. This is especially true when it comes to your daily schedule. “Some of my clients try to maintain a really hectic schedule, trying to fit in work, social activities, exercise, hobbies, etc. like they did before they were sick,” she explains. “They don’t want their disease to make them miss out on anything, but they end up overdoing it and causing bad flares.” Resist that urge and, at least at first, take half the items off of your schedule. Even if you feel okay, you shouldn’t push it and do more, she adds. Here are some tips for saying no to plans without the guilt.
15. ‘Double’ Your Sleep
“I can’t overstate how crucial rest and quality sleep are for people with arthritis,” Lackey says. And she doesn’t just mean your normal six or seven hours per night. “People with arthritis underestimate how much sleep they actually need to heal and recover,” she explains. Build in extra time to sleep — say, an extra hour per night plus a nap if your schedule allows. “It can seem daunting to find this much extra time but it is absolutely necessary,” she adds. (If you struggle to sleep because of pain, check out these tips for managing painsomnia.)
16. Involve Your Family in Your Care
“Arthritis may be happening only to you, but that doesn’t mean you’re in it alone,” Mahalli says. “Reach out to the people who love you, and tell them you’ll need a bit of extra help as you navigate this new territory.” It can be extremely difficult to ask for help — especially if your independence is very important to you — but if you can’t do it for you, do it for them.
“Consider how you’d feel if you had a loved one struggling who didn’t tell you,” she says. “Recognize that your loved ones feel the same about you. They will be happy to help you in your time of need.”
17. Do Something Nice for Yourself Every Day
“Self care” looks different for everyone but it’s important that you have some things that you find fun and rejuvenating and do at least one every day, Lackey says. “I recommend my clients try music therapy, mediation, journaling, and getting plenty of sunshine,” she says. Other ideas could include a hot bath, a gentle walk, playing a game with friends, reading a novel, or playing with a pet. Here are more self care ideas to try.
18. Keep Flares in Perspective
“Know this: A flare up is not a setback; it is a reminder to surrender to perfection and stay focused on your overall progress,” Lackey says. This can be hard to remember in moments when the pain is excruciating, but if you see every flare as a failure then you’re just adding more misery, she says. Instead of blaming yourself, make a mental note of what you can do differently next time (in many cases, there may be nothing you can do) and then do your best to get through it, knowing it will end eventually.
“I used to always fear that I would be stuck this way and worry that the pain would never end. I would obsess over all the things I did wrong to cause it,” she says. “Now I counsel people to just repeat, ‘This too shall pass’ over and over again. Because it will.”
19. Break Down Big Tasks into Small Steps
Cleaning your whole house every Saturday morning is a luxury most people with arthritis simply can’t afford, Dr. Larsen says. But while you may not be able to do a cleaning binge like you used to, the house still needs to get clean. The solution? “Make a list of what needs — emphasis on ‘need’ — to get done and then break those tasks into smaller, easier steps,” she says. Consider assigning different steps to different days and check off each step as you go.
20. Subscribe to an Uplifting News Site
“One of the best things you can do is to surround yourself with positive things,” Lackey says. This could include saving healthy recipes, following news reports about people doing good things, or reading stories of survival. And they don’t necessarily have to do anything with arthritis — the point is to help you see the good in the world, boost your morale, and remind you that this pain is temporary. It can be helpful to see other people overcoming really difficult challenges, even if their challenges are completely different than yours, Lackey says.
21. Take a Class in Stress Reduction
If you were diagnosed with inflammatory arthritis, chances are your doctor talked to you about reducing your stress levels, as stress can be an arthritis flare trigger. Take that “prescription” as seriously as you do the prescriptions for medication, Dr. Larsen says. “When you employ the relaxation response, your parasympathetic nervous system helps you rest, digest, and repair because you are not bound up in fear or anger,” she explains. “Learn about stress reduction from books, videos, or working with a psychotherapist. Use prayer, meditation, or whatever else helps your body heal itself while relaxed.”
22. Have a Really Good Cry
“Many people with arthritis feel like they ‘just need to be strong’ but crying is a powerful and healing release,” Lackey explains. “I remind my clients that letting go is not a sign of weakness. In fact, it takes courage to accept the process as is. Tears are healing and detoxifying. Don’t fight them off. Allow yourself to grieve everything you feel because you will find that once you address your fears or feelings of inadequacy and frustration, they become disarmed.”
23. Watch Funny Videos
Laughing might seem the last thing you feel like doing when you’re in the midst of a bad flare but laughter really is the best medicine, Lackey says. Save funny movies, YouTube clips, or memes to pull out when you’re feeling particularly down. “You should find a reason to laugh every day,” she says. “Not only will it instantly raise your mood but laughter is a natural stress and pain reliever.”
