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Depression Can Make Arthritis Pain Worse
Author: Dawn Flemming
July 6th, 2018

Depression has been linked to arthritis but not the way you think. It seems that depression may be involved in making your arthritis pain worse.

By Dawn Flemming

Having arthritis, and I mean any kind (like rheumatoid arthritis) can be a very harrowing experience. It leads to isolation, irritability, breakdown of social relations. It's not surprising when it leads to anxiety and depression.

Depression is not just about sadness. It’s also the opposite of liveliness, where one becomes hopeless and doesn’t have the energy to do anything anymore. “Why do anything? It’s just all going to go to waste anyways” an acquaintance of mine once said.

Depression and anxiety can do something else as well. It lowers one’s pain threshold thereby making the debilitating illness even worse. So you have this circular problem, arthritis pain leads to depression, and in turn depression makes the pain worse.

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Look at what current research is now showing:

Depression makes pain worse. Depression weakens a person’s ability to deal and cope with pain, says Marina B. Pinheiro, a researcher at the University of Sydney, Australia. “So an individuals’ perception about their condition, for example back pain, might become more negative when compared with individuals who are not depressed.”

Jon T. Giles, MD, an assistant professor of medicine at Columbia University and rheumatologist at New York Presbyterian Hospital in New York City, says “Painful sensations are relayed through the brain in a very complex way, and can be modulated up or down.” Stress, poor sleep, anxiety and depression all influence pain levels, he explains.

So what does all of this mean? If depression makes arthritis pain worse, then the good news may mean that anti-depression treatment can help with reducing pain. This is exactly what researchers are suggesting:

People who have RA can safely take antidepressants in addition to other medications, and studies suggest antidepressants improve depression, anxiety, and feelings of helplessness. 

In addition to helping with depression, some antidepressants may have an analgesic effect , says Dr. Bergman. 

"The first thing I would do for an RA patient would be to put them on RA treatment, but if they are also depressed I might put them on an antidepressant...and I wouldn't be totally surprised if they got pain relief from that," he says.

It’s not just antidepressant medications that can help but any mood enhancer, including better sleep, better social relations, and exercise can help alleviate pain.

If you have arthritis and think you may have depression, speak to your doctor and see what options you have to help reduce your pain.

Dawn Flemming is Director of Business Services at Geriatric In-Home Care in Fresno, California.

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