People with arthritis often worry about the possibility of losing mobility, being unable to work, or growing dependent on others. But only a very small percentage of people with arthritis ever become severely disabled. Still, the emotional burdens of arthritis are considerable and may result in stress, anxiety, and depression.
Because living with chronic arthritis can be difficult, many physicians use questionnaires to assess your psychological function. Depression and anxiety are of particular concern, as these disorders are twice as common among people with arthritis than people without it.
Your doctor may also ask questions about what type of family and social support you have available, to determine whether you need additional help. For example, if you live alone and have trouble walking, your doctor may refer you to a social worker who can help arrange for someone to handle shopping and other chores. If you are depressed or have anxiety, you may be referred to a psychiatrist.
Depression is common in people with chronic diseases of all kinds. Arthritis specialists have assumed that depression is directly related to the amount of pain and the number of swollen joints a person has, but this isn't always the case. While some people equate a large number of swollen joints with severe disability, those whose favorite pastime is reading or spending time with family might not consider themselves disabled. However, a relatively slight impairment in hand mobility could be devastating for a pianist or artist, and could have a profound emotional impact. Diagnosing and treating depression can be challenging because its symptoms differ from person to person. But effective medications are available, and they often work best in combination with counseling or psychotherapy. A form of counseling called cognitive behavioral therapy (CBT) involves changing people's behaviors by changing their thinking. A 2008 study in Arthritis & Rheumatism suggests that people with rheumatoid arthritis who get CBT early in the course of their disease require fewer additional interventions for the first five years after treatment. The 47 patients in the study had fewer nights in the hospital, fewer injections, and fewer physical therapy referrals, and they used less total health care. There was even a slight reduction in the need for surgery and orthopedic referrals.