Ward off Depression 

When you are depressed, what seemed simple yesterday may seem insurmountable today - even a simple call to your internist or rheumatologist. But it's crucial to get help. In addition to calling your doctor, consider trying a few of these suggestions.

The more the merrier. Spend time with friends or join a support group. Victoria Schomer has been in a monthly women's group for eight years: "It provides an emotional cushion to know that there are women out there who hold me in their heart."

Do what you love. Do things you enjoy doing when you are feeling depressed. If your arthritis prevents you from doing something, such as traveling, enjoy a modified version, such as visiting a local museum or taking in a foreign film.

Try the power of the positive. When you find yourself thinking, "This pain is going to last forever," replace the thought with a more realistic one: "This pain will come and go."

Feel pretty. Self-esteem starts when you look in the mirror. Although you may not feel like leaving the house, don't throw on those ratty old sweats; dress as if company may stop by. When you look good, you can feel good.

Don't berate yourself. Coping with depression isn't a matter of discipline or character. "It's not a case of someone simply 'pulling herself together,'" says Chris Dickens, MD, senior lecturer in psychological medicine at the University of Manchester in Manchester, England.
 

When to See the Doctor 

Feeling down in the dumps is part of being alive. One day you're grumpy and out of sorts, spirits low; next day you're back in the groove, ready to dive into the things you love. Those are the blues. But when, for two weeks or more, you feel like sitting out the rest of your life, you may be clinically depressed, a medical condition that requires treatment - and can be helped - by a doctor. Experts suggest seeking help if:

• Your low spirits persist for two weeks or more;
   
• Your depression is interfering with your relationships and your job; 
   
• You have thoughts of harming yourself;
   
• You have persistent physical symptoms such as headaches, digestive disorders and chronic pain not associated with arthritis that do not respond to routine treatment; or
   
• Your symptoms include any five of the following: sleeplessness or oversleeping; loss of appetite or overeating; frequent tears and feelings of sadness; inability to concentrate; little appetite for things you usually enjoy; fatigue; irritability, restlessness or moving about in slow motion; a feeling of worthlessness or pervasive guilt.

These symptoms are typical of major depression. Less than half of the 10 to 40 percent of people with depressive symptoms have major depression. Other classifications of depression include:

Dysthymia. A less severe form of depression that includes long-lasting symptoms that do not seriously disable a person but keeps one in a constant state of feeling down. Symptoms may include all of the above with the additional feeling of hopelessness.

Bipolar disorder. Also called manic-depressive disorder, it is characterized by extreme highs and lows in mood. The disorder affects thinking, judgment and social behavior. Symptoms include the above as well as racing thoughts, increased talking, unusual irritability and abnormal elation.