Depression and RA

What role does depression play in rheumatoid arthritis?


As many as 40 percent of people with rheumatoid arthritis (RA) experience significant symptoms of depression – and studies show those who do are more likely to have poorer health and need more medical care.

That’s especially true for poor people. RA patients with low socioeconomic status are more likely to become depressed, which might explain why they have worse arthritis-related problems and higher mortality rates than financially secure patients, according to a new study, published in the February 2011 Arthritis Care & Research. “Not only does depression increase the odds of developing other health problems, such as heart attack, it may also worsen arthritis-related pain,” says Gary Kennedy, MD, director of geriatric psychiatry at Montefiore Medical Center in New York City. “That’s why you must give as much attention to your mental well-being as you do to your physical health.”

Don’t let financial worries stop you from seeking help for depression. Medicare and Medicaid offer some coverage, and clinics, hospitals and universities often provide low-cost options. Learn how to recognize the signs of depression and about treatments.

Signs of Depresion

  • Apathy, loss of interest in the things you normally enjoy
  • Irritability that’s out of proportion to the situation
  • Sadness, hopelessness, pessimism
  • Difficulty concentrating
  • Sleeping and/or eating more or less than usual
  • More aches and pains than usual

Prescription Treatments

Antidepressants: Newer medications include selective serotonin reuptake inhibitors (SSRIs), such as paroxetine (Paxil), and serotonin and norepinephrine reuptake inhibitors (SNRIs), such as duloxetine (Cymbalta). Older medication classes include monoamine oxidase inhibitors (MAOIs), such as selegiline (Eldepryl).

Combination therapy: Cognitive behavioral therapy (CBT), which focuses on changing negative thought patterns and behaviors, combined with antidepressants

Non-drug Treatments

Psychotherapy: Discussing concerns with a professional, also known as “talk therapy.” CBT is an effective form.

Exercise: Studies have shown regular exercise to be as effective as certain antidepressant medications.

Alternative therapies: Clinical trials have shown acupuncture, massage and yoga can help alleviate symptoms.

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