Arthritis and emotions

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beyondblue: the national depression initiative and Arthritis Australia have put together this information to raise awareness of the risks and impact of depression in people with arthritis. This sheet provides general information about the symptoms of depression and what you can do to manage it.

What is depression?
Depression is common and affects up to one million people in Australia each year. Depression is not just a low mood or feeling sad, but a serious condition that needs treatment. People with depression generally feel sad, down or miserable most of the time. They find it hard to engage in or be interested in normal day-to-day activities. Depression has serious effects on physical as well as mental health.

How do you know if a person is depressed?
A person may be depressed, if for a period of more than two weeks they experience:

1. Feeling sad, down or miserable most of the time, OR
2. Loss of interest or pleasure in most of their usual activities
AND experienced some of the following symptoms:

• weight gain or loss
• disturbed sleep
• feelings of agitation and restlessness
• slowed movement and reactions
• tiredness or loss of energy
• feeling worthless
• feeling guilty for no real reason
• poor concentration, indecisiveness
• recurrent thoughts of death, thinking about suicide
• bodily discomfort or pain in the absence of a physiological cause
• feelings of stress and anxiety
• feelings of confusion
• memory disturbance.

Causes of depression
Depression has a number of causes which are common to people of all ages, including genetic factors, ongoing stress, social isolation, physical illness and drug and alcohol use.

What is the link between depression and arthritis?
Up to two thirds of people with arthritis say their condition has affected them emotionally. Many people with arthritis are frightened by the impact arthritis might have on their everyday life and their future. People living with persistent pain are four times more likely to experience depression or anxiety than people living without pain.

Having arthritis can result in a loss of independence, self esteem, the ability to work and continue social or recreational activities. These losses are risk factors for experiencing depression.

Living with arthritis can place stress on relationships. Pain and tiredness may make connecting with family members and friends seem like an effort. Intimate relationships can also be affected. It is not unusual for younger people to feel especially angry or depressed at being diagnosed with a disease that is mistakenly thought to affect only ‘old’ people.

Depression can make it hard for people to manage their arthritis effectively if they can’t find the energy to exercise, take medication regularly, keep appointments and eat healthily.

What treatments are there for depression and arthritis?
There are effective treatments for both depression and arthritis. A co-ordinated approach to treatment can have benefits for both conditions. For example, people with arthritis and mild depression may find that regular physical activity improves depressed moods and also helps control joint pain and stiffness. More severe types of depression may require different types of treatment, including:

• medication to relieve the symptoms of depression
• Cognitive Behaviour Therapy (CBT) to learn to identify and change negative thought patterns
• Interpersonal Therapy (IPT) to assist with the acceptance of having arthritis and the need forlong-term treatment. This can also help improve relationships with family and friends.

An important part of managing depression and arthritis is seeing a doctor regularly to check that treatments are working effectively.

What can you do to help yourself?
If you think you might have depression:

• seek help as early as possible from a doctor or other health professional (for example, psychiatrist or psychologist)
• get involved in social activities
• do some regular exercise
• learn about depression and arthritis
• eat healthily and include a wide variety of nutritious foods
• achieve and maintain a healthy weight
• limit alcohol intake
• get help and support from family and friends.

Depression is an illness, not a weakness, and people shouldn’t feel ashamed to seek help.

Depression and arthritis are both common and treatable. With the right treatment, most people recover from depression. Seek help early – the sooner the better.

For more information

beyondblue: For more infomation and advice about depression, anxiety, available treatments and where to get help go to the beyondblue website www.beyondblue.org.au or call the beyondblue info line 1300 22 4636 (local call cost).
SANE Australia: information about mental health and where to go for support. 1800 187 263 (Monday to Friday 9am-5pm) www.sane.org
Lifeline: 24 hour counselling, information and referral. 13 11 14 (local call cost). www.lifeline.org.au
Mensline Australia: 24 hour telephone support, information and referral for men. 1300 789 978 www.menslineaus.org.au
CRUFAD (Clinical Research Unit for Anxiety and Depression): information about depression, anxiety and its management. www.crufad.org
To find a psychologist, talk to your doctor, contact the Australian Psychological Society on 1800 333 497 or visit www.psychology.org.au