Rheumatic diseases can be particularly challenging for patients who have them. Besides affecting the physical body, energy levels and the ability to perform daily activities, these conditions can also affect emotional health.
Rheumatic conditions are different from other diseases, while many diseases can be cured; rheumatic diseases require an ongoing process of adaptation to maximize each patient's ability to function and well being over a long period of time.
Knowledge of the causes of rheumatic diseases and their impact on the body, as well as new approaches to treatment of these conditions, is expanding rapidly. The following information are provided to help patients manage the condition most effectively.
How Rheumatic Diseases Affect Your Life
The chronic pain, recurring flare-ups and disabling effects on joints and the ability to cope with the demands of daily living can take an emotional toll, as well as a physical one. This toll may take the form of depression or emotional distress, stress or impact on relationships with family and friends. It may involve changes to career plans, roles and relationships with other people. Therapists or behavior psychologists may be able to help you put things in perspective. They can also help you develop coping skills, including relaxation techniques.
More than 30 years of research has shown that a patient's beliefs about illness, ability to cope with the challenges of rheumatic disease, confidence in coping abilities and support system all have an impact on health. The good news is that attitudes, coping skills and confidence can be learned to enhance physical and emotional health. The ability to cope with pain and attitude about coping ability are influenced by:
- Level of independence and reliance on others
- Resourcefulness in solving challenges
- Knowledge of the specific condition
- Coping skills
- How family, friends or support groups respond to difficulties
The medical, emotional and behavioral aspects of a rheumatic disease are linked. Adjustments in each area will be unique and individual. Over the course of the disease, the elements that cause or maintain certain feelings, quality of health and behavior in response to the disease will vary. Any approach that developed by the patient and doctor to manage the condition should be broad enough to cover a range of issues that affect both physical condition and emotional and psychological responses.
Chronic Pain
Ongoing pain that gets worse from time to time is a primary source of emotional distress for persons with rheumatic diseases. One study based on data from the National Institutes of Health found that over the span of their lifetimes, more than 60 percent of those with arthritis became depressed or developed a psychological or emotional disorder. This rate is higher than that found in person with cancer, diabetes or stroke.
The more pain a person has, the more likely he or she is of having depression. For many people a feeling of being powerless to do anything about the pain - or feeling that the pain will never end - makes depression or mood disturbance even more likely
Strategies for Emotional Health
Despite the challenges that a rheumatic disease presents, much can be done to improve physical and emotional health, such as to:
- Become a partner with the doctor in managing the condition. Be sure to communicate with him or her.
- Develop a more positive attitude towards the disease and symptoms and the challenges they create
- Learn about the disease and ways of managing it
- Learn about treatment and management approaches, such as drugs or complementary medical approaches
- Manage life through good nutrition, proper exercise, getting enough rest, etc. to maintain the best health possible
- Enhance problem-solving and coping skills
- Develop role models and support group contacts to share coping strategies with
- Set goals and get feedback from others about progress and successes
Anything that makes patients feel more powerful, more in control and better able to manage the condition will be helpful. Patients should not forget to enlist the assistance of family, spouses or others who are important in their lives. The more they know about the condition and managing it, the more support they can offer.
Approaches to Managing Depression
A number of approaches can be used to manage the depression or emotional distress associated with chronic pain or a rheumatic condition. These include:
- Reducing stress related to the disease or its treatment or to environmental demands
- Managing your lifestyle to avoid stress, fatigue or activities that strain the joints or increase pain
- Managing your thought processes to reduce negative thinking and to give you better control. Called cognitive behavioral therapy, it also includes using imagery or distraction to create a more positive and powerful attitude toward your condition and your ability to manage it.
- Scheduling pleasant events to put you in a better mood, reward positive behaviors and reduce depression
- Learning problem-solving skills
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