Anxiety & Depression

Anxiety and depression are common psychological problems in rheumatic diseases. Depression is estimated to be prevalent in more than 20% cases of rheumatoid arthritis. Nearly 80% patients of fibromyalgia have associated anxiety and depression. Osteoarthritis, systemic lupus erythematosus and most other chronic rheumatological diseases have associated psychological features. Psychosocial stress is one of the factors responsible for disease onset as well as disease flares. Females and patients with lower socioeconomic and educational status appear to be more prone to develop psychological problems. Although sadness, irritability and pessimism can be considered as normal psychological reactions to any chronic illness, their persistence for prolonged periods indicates a psychological illness. Depression and anxiety can increase pain as well as disease severity and disability. Various factors such as physical appearance, decline in functional ability, social stress, social isolation and dependence on drugs for control of symptoms lead to psychological stress. Family problems and financial stress aggravate the problem. Children with arthritis, too, manifest features of depression especially when parents are distressed. Improved diagnosis and treatment of rheumatologic disorders can reduce psychological stress. Identification and concurrent therapy of psychological problems is an essential part of management of chronic diseases. This may need collaborative care from a psychiatrist. Training in coping, adaptation and stress management skills, relaxation techniques (Yoga, biofeedback), exercise and cognitive behavioral therapies can considerably improve the quality of life in patients with rheumatological diseases. You can easily evaluate your level of anxiety or depression by answering 14 questions in the scoring sheet of Hospital Anxiety and Depression Scale (HADS). You have a problem if your score is more than 11 and, if so, you need to take some measures against it.

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