Rheumatoid arthritis (RA) is a disease that causes painful swelling when the immune system attacks healthy cells.¹ It is classified as both an autoimmune disease and an inflammatory disease.

There is a link between rheumatoid arthritis and mental health, as people with RA are at an increased risk of conditions, such as anxiety and depression.² Additionally, mental health plays a role in RA outcomes and quality of life.

Learn more about anxiety and rheumatoid arthritis and how to cope when they occur together.

What Is Autoimmune Disease?

A category of diseases that occurs when the immune system attacks healthy cells in the body instead of unhealthy cells.

What Is Inflammatory Disease?

A category of disease that involves the immune system attacking healthy tissues in the body and it leads to inflammation, which is increased swelling, redness, stiffness, pain, or a combination of these symptoms.

Mental Health and Autoimmune Disease

Autoimmune disease is a category of physical health conditions with over 80 diseases, including:

• Rheumatoid arthritis (RA)
• Systemic lupus erythematosus (SLE)
• Type-1 diabetes mellitus
• Crohn's disease
• Thyroid diseases
• Multiple sclerosis (MS)
• Celiac disease

Chronic RA Is Overwhelming

Being sick is unpleasant. The symptoms are uncomfortable and often interfere with daily life. Pain and fatigue can mean missing out on fun activities and lost time from work, which can translate into less time spent with friends and family and lower-income.

Chronic disease means the symptoms are long-term, and so are the adverse effects. There is no cure for rheumatoid arthritis, which means it is a lifelong condition.⁴ Living with a lifelong condition, especially when the symptoms interfere with daily life, can be overwhelming.

Inflammation and Stress

Psychological, physical, and environmental stress can activate the brain with a fight-or-flight response, which involves chemical and physical changes in the body.⁵ This can lead to an over-active immune system and long-term inflammation in the body, and stress increases the risk of 75-90% of diseases.⁶

Addressing Anxiety With Your Doctor

Physical and mental health are linked. However, healthcare providers don't always address mental health when treating physical health conditions. Although depression and anxiety are more common among people with RA, mood is often not assessed during routine appointments and these conditions are under-diagnosed and under-treated.⁷

You Are Not Alone

Over 1.3 million people in the United States have rheumatoid arthritis, and it is the most common autoimmune disease.⁸ Anxiety occurs in about 20% of people with RA.⁷ Anyone facing RA and anxiety together is not alone, and support is available to cope with both conditions.

Can Anxiety Make RA Pain Worse?

People with anxiety and rheumatoid arthritis together can experience worse pain than people with RA alone. This is partially because the stress response can increase inflammation and tension in the muscles, and both of those effects can intensify the pain.⁹ Additionally, pain tolerances may be lower among people who have both chronic or long-term pain and anxiety together, which means they are more sensitive to the feeling of pain.¹⁰

Anxiety-Provoking Triggers for RA Patients

People with rheumatoid arthritis face unique challenges that can lead to anxiety. For example, just the symptoms of RA, including pain, fatigue, and difficulty sleeping can increase stress levels.⁹ There are other stressors in addition to the symptoms that go along with RA.

Here are some things people with RA may face that could provoke anxiety:

• Symptoms: Constantly feeling tired, fatigued, or in pain can be extremely unpleasant and interfere with daily life
• Financial burdens: People with RA may not be able to work, or may miss work due to symptoms, and have difficulty making money or paying for treatment
• Medication schedules: Having multiple conditions simultaneously, such as anxiety and RA, increases the chances of being on multiple medications and needing to keep track of taking them when needed.

9 Ways to Manage RA Anxiety

Living with either anxiety or rheumatoid arthritis alone can be hard. Facing both at the same time can be even more challenging. However, there are things that can be done to manage both conditions separately and to address them together. For example, exercise can help reduce psychological and physical stress simultaneously, which can help with both painful joints and anxiousness.¹¹

Here are nine tips for managing anxiety due to RA:

• Eat a well-balanced diet
• Exercise regularly
• Stick to a regular sleep schedule
• Keep up with medication schedules
• Set goals and follow-through
• Learn and practice stress relief and relaxation exercises
• Take part in relaxing activities
• Talk with trusted friends and family members
• Seek support from a mental health professional

Emotional Support Outlets

Many people with long-term health conditions, such as rheumatoid arthritis, face feelings of anger, fear, frustration, and resentment related to their health, symptoms, and how their life is affected.¹¹ It is important to connect and talk with others to manage emotions. This can include talking with other people who have RA or similar health conditions.

People with RA may consider the following options to talk about feelings and emotions:

• Friends and family may be able to provide empathetic support, even if they do not have RA or anxiety.
• Social media can serve as a way to connect with others who face the same or similar challenges, but it is important to make sure the benefits of this option outweigh the potential drawbacks.
• Organizations and foundations, such as the Arthritis Foundation and Anxiety & Depression Association of America, are available to help support people with RA, anxiety, and other health conditions
• Therapy, also known as psychotherapy or talk therapy, can be used to treat and help people cope with anxiety and RA, and both conditions together.

Day-to-Day Anxiety Management

People who have rheumatoid arthritis and anxiety tend to have worse outcomes than people with RA alone, such as increased difficulty taking their medications and lower quality of life, making it more important for them to address their mental health.¹² In addition to treatment and coping options, there are things that can be done to help overcome some of the daily challenges related to anxiety and RA.

Day-to-day anxiety management options for people with RA include:

• Making work arrangements, such as a flexible schedule, the option to work from home, or extra breaks to help accommodate needs.
• Asking for childcare help to be able to focus on self-care and reduce stress when needed.
• Planning ahead and having options available in case changes need to be made to reduce stress or manage symptoms.
• Communicating with friends, family, and coworkers so they are aware of your needs and can provide better support.

Summary

Rheumatoid arthritis, or RA, is an autoimmune and inflammatory disease that involves long-term joint pain. People who have this medical condition are at an increased risk of anxiety, and anxiety can make the symptoms of RA worse. Although there are unique challenges associated with experiencing RA and anxiety together, there are things that can be done to manage and cope with the symptoms to improve outcomes.

A Word From Verywell

Facing rheumatoid arthritis and anxiety together can be challenging. If you or someone you know is experiencing these two conditions at the same time, help is available. Reach out to a healthcare provider for support, such as a rheumatologist or mental health professional. There are options to treat and cope with both conditions at the same time, such as talk therapy and lifestyle changes.

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https://www.verywellhealth.com/anxiety-and-rheumatoid-arthritis-coping-strategies-5222598