Treating depression and anxiety aids in improving arthritis pain
Not only can arthritis make your joints ache, it can affect your mood, too. One-third of arthritis patients ages 45 and older suffer from anxiety, depression or both, a new federal study reports—and half of these patients don’t seek help for their mood disorder.
Anxiety and depression in people with arthritis can have a profound impact on their quality of life. The disorders can contribute to declining levels of physical function, affect the ability and willingness to cope with arthritis and interfere with adherence to treatment.
The Centers for Disease Control and Prevention (CDC) estimates that 50 million Americans have one of several forms of arthritis, including rheumatoid arthritis, osteoarthritis, gout, lupus and fibromyalgia. Together, these rheumatic conditions are the leading cause of disability in the United States. It came as no surprise to CDC researchers who performed the new study that many arthritis patients suffer from depression, since depression is common among people with chronic pain.
But they didn’t expect to see such high rates of anxiety. Anxiety was almost twice as common (31 percent) as depression (18 percent) in arthritis patients. Eighty-four percent of patients with depression also had anxiety—not surprising since anxiety is a risk factor for depression.
Some anxiety may be attributed to the distress caused by arthritis' physical limitations. Lack of confidence to perform certain everyday tasks can contribute to anxiety as well. Consequently, anxiety, as well as depression, can be an obstacle to making lifestyle changes like physical activity, which can reduce pain.
Identifying barriers to wellness
For the CDC study, researchers surveyed 1,793 adults ages 45 and older with arthritis about their emotional well-being and physical function (the ability to walk several hundred feet; wash or bathe; bend, kneel or stoop; and run errands and shop). Among the findings published online in Arthritis Care and Research in April 2012:
- Increasing levels of depression and anxiety led to decreasing levels of physical function and independence.
- People who were depressed had little confidence in their ability to manage their arthritis or joint symptoms.
The study authors say that anxiety and depression are underdiagnosed and undertreated in people with arthritis, so they encourage doctors to screen arthritis patients for both disorders—especially for anxiety, which doctors don't traditionally screen for. If a mood disorder is detected, the appropriate treatment can help reduce joint pain and improve physical function.
What we already know
Anxiety and depression are far more common in people with arthritis than in people in the general population. Moreover, past evidence has already shown that:
- People with rheumatoid arthritis who are depressed are more likely than patients who aren’t depressed to experience a higher level of pain, a greater number of painful joints, more frequent visits to their doctor, more days spent in bed and an increased risk of death.
- Osteoarthritis patients who are depressed report higher pain intensity than patients who aren’t depressed.
- Arthritis patients who believe they can manage or influence their symptoms are more likely to have better outcomes than patients who don’t believe they can control their symptoms.
Depression and anxiety can have overlapping symptoms, such as trouble sleeping or concentrating, nervousness and irritability—and many people who’ve had an anxiety disorder in the past develop depression later. Anxiety isn’t a single condition; it consists of several disorders, including generalized anxiety disorder (constant, excessive worrying), phobias, panic disorder and post-traumatic stress disorder.
Source: Prepared by the Editors of The Johns Hopkins Medical Letter: Health After 50