Do You Have Anxiety or Depression?

By Jennifer Cuthbertson

When you live with arthritis, you also likely live with bouts of fatigue, pain, worry and days where you have no energy or interest in getting out and doing. Unfortunately, these are all things that are common when you have a chronic disease.  And living with a chronic disease can lead to depression and anxiety.

Both are more common in people with a chronic disease than the rest of the population. According to Meghan Beier, PhD, assistant professor of physical medicine and rehabilitation, Johns Hopkins University, “About 25% of people with arthritis experience depression and around 22% will experience anxiety at some point.”

It pays to understand the symptoms and warning signs so you can recognize it and treat it early on.

Anxiety and depression are often under-diagnosed in people with arthritis because symptoms of arthritis overlap can with those of depression and anxiety.

Some of the most common symptoms of depression will look familiar if you have arthritis or a related disease, like fibromyalgia. Those symptoms include:

• Low mood or feeling sad.
• Less interested in activities you normally enjoy.
• Difficulty sleeping.
• Feeling tired or having low energy. 
• Change in appetite.
• Difficulty concentrating.
• Aches or pains, headaches, cramps, or digestive problems without a clear cause or that do not ease with treatment.
• Negative thoughts.

People with an anxiety disorder have many of the same symptoms as people with depression, but they also have excessive worry; feel restless, wound up or on edge; and may be irritable. Some amount of anxiety is normal. But when it lasts a long time and begins to hurt your relationships, job, school or daily activities, it may be a disorder.

The trick is distinguishing between the symptoms that are caused by your arthritis and those that are caused by anxiety or depression. 

“A good rule of thumb is to always first rule out medical causes for the symptoms,” says Beier. “For example, thyroid disorders impact mood and too much caffeine can mimic general anxiety or panic disorder.”
 

It is not uncommon for anyone, whether they have arthritis or not, to be down, frustrated, angry or to have feelings of grief for short periods of time. But most of us are able to pull ourselves out of a bad mood or cheer ourselves up with a favorite activity or by socializing with friends.

“If someone is having a low mood or loss of interest for most of the day for two or more weeks, it is time to seek help,” Beier advises. “Visit your doctor to check out your symptoms.”

A visit with your primary care doctor will help you rule out underlying medical issues. If your symptoms do not have a physical cause, then it might be time to determine if anxiety or depression is to blame.

Beier explains that both medical and mental health professionals will ask nuanced questions to help distinguish medical from mental health symptoms. For example, they will ask about your desire versus your ability to engage in normal day-to-day activities. This is because the desire to get out and be active is a key when deciding if mental health issues are at the root of your lethargy.

If you have the desire to engage in activities, but can’t because of extreme fatigue or pain, then it could be your arthritis causing the symptoms. A person who is depressed or anxious will be indifferent or resistant to taking part in pleasant or mundane activities.

“Early treatment is important to control depression and reduce its impact on pain, ability to participate in activities, sleep disturbances and difficulty with social and work activities,” says John M. Davis III, MD, a rheumatologist at Mayo Clinic in Rochester, Minnesota.

If you have thoughts of death or suicide, please seek help immediately. You can call the Substance Abuse and Mental Health Services Administration (SAMSA) Helpline: 1-800-662-HELP (4357).