Frequently Asked Questions about Living with Arthritis.
Last updated Tuesday, January 04, 2005
Taking charge of arthritisHow do people with arthritis react? Everyone is unique. Personalities, abilities, past experience,
reactions, and concerns vary a great deal from person to person. Some
people appear to handle all of their problems well while others have
difficulty coping with a variety of challenges. Arthritis can be one of
those challenges, both physically and emotionally.
When people find out that they have arthritis, they often feel a
sense of shock, disbelief, or helplessness. After they learn more about
arthritis and its treatment, they may feel overwhelmed or angry. At
some point most people with arthritis realize that the disease is,
indeed, a fact of their lives. With this awareness, they may become
depressed.
In a sense, one could compare this sequence of emotions to the
grieving process. People with chronic diseases actually do "grieve"
over the person they were prior to the time they were affected. In
fact, the grieving process often is necessary in order for people to
accept change and get on with their lives. People with arthritis can
take comfort knowing that the range of emotions they experience is
perfectly normal. What challenges does arthritis pose? People with arthritis experience some changes and challenges that
are different from those of people with other diseases. For example:
- arthritis is usually long-lasting
- the course is often unpredictable
- pain, depression, and excess stress may result
- activities can be limited
- the ability to express and enjoy sexuality may be affected
Adjusting to the changes experienced with arthritis takes time.
However, there are things you can do to better cope with the situation.
With work and understanding, you can learn to deal with the effects of
arthritis. Controlling pain Handling daily responsibilities is not easy when you are suffering from the pain of a headache or toothache. When there is chronic pain because of arthritis, dealing with life's tasks can be even more difficult.
Everyone feels pain differently. Because no one can actually see
pain, other people may not understand how it affects you. And just as
people feel pain differently, they also respond to it differently. Some
simply withdraw from activities because they can't predict when they'll
experience pain and are afraid of making commitments they might not be
able to keep. Others put far too much pressure on themselves by trying
to "tough it out." Still others feel guilty about resting when they
have bad days. A few people seem to get "rewards" for hurting. They use
their pain to get special attention from others or as an excuse for not
doing certain things.
Arthritis medications
work against the body processes that cause pain. Most medications work
well only if taken daily, even when there are few symptoms.
Applications of heat or cold to a painful joint can provide temporary
pain relief. Careful use of your joints can help you avoid pain. Daily exercise can relieve soreness due to stiff, unused muscles and help you maintain your range of motion. You may find activities such as swimming
helpful. Remember not to overdo any exercises or activities. If pain
continues for very long afterwards, cut back on the activity next time.
Listen to your pain. Think of it as a signal from your body to stop,
rest, and relax. Learning relaxation techniques can be helpful for
people who find it hard to totally relax. Physical and occupational
therapists, psychologists, and social workers with special training in
teaching relaxation may be able to help you.
One way to pay less attention to pain is to concentrate on something
else. Stop and consider what happens to the pain when something
interesting is going on. Think about the things that keep your mind off
pain. When you are doing or thinking about something interesting and
pleasurable, you may not be as aware of pain.
If your treatment plan for pain currently does not include
medication, joint protection, exercise, rest, relaxation, or heat/cold
therapy, ask your doctor if any of these might help you. Your doctor
may want to refer you to other health professionals who can help with
your pain management program.
If you frequently experience severe pain, you may want to talk to
your doctor about the possibility of being referred to a pain clinic or
a professional who specializes in pain management. Health professionals
are using many non-medication methods of pain control such as
meditation and biofeedback, with considerable success.
See the article on pain for more information. Dealing with depression and anger Feeling depressed or angry when change occurs is normal, especially
if the change is unexpected and unwanted. You may feel frustrated about
not being able to do a favorite activity, or you may feel angry if you
can't keep up with your friends, housework, or job.
Depression often results when a person is unable to express angry
feelings and keeps them buried inside. It also can be a side effect of
certain medications. In addition, depressed feelings can be triggered
by chronic pain, fatigue,
too much stress, fear of losing the interest and affection of a loved
one, a sense of loss about changes in one's body or lifestyle, or fear
of possible future body or lifestyle changes. But in spite of these
many "reasons," not all people with arthritis get depressed or angry,
and many learn to overcome such feelings.
If you are depressed, how does this condition affect your life? Are
you irritable with family or friends? Have you stopped taking care of
your arthritis? Are you withdrawing from activities and friends? Are
you sleeping less or more, eating less or more, or feeling more pain
and fatigue than usual? Are you paying less attention to your personal
appearance? Do you find that life has no value and that your thoughts
tend to be gloomy and negative? These behaviors are possible symptoms
of depression and may require treatment from a professional.
There are many ways of treating depression. The catch is that
depressed people often don't feel like doing the things that will help
them get out of their blue moods.
If you are depressed, you may have to make yourself do things at
first, but it will get easier as time passes. Making the effort to
interact with other people and to leave your house are good starts
toward overcoming depression. Choose activities you enjoy and people
who are cheerful and fun to be with. Talking about your feelings and
moods with family, friends, or clergy also can be very helpful.
Since anger can build up inside you and cause depression, it's
important to learn how to express angry feelings outward in a positive
way. Appropriate ways of releasing angry feelings include exercising,
crying, keeping a journal that includes feelings, speaking into a tape
recorder about your concerns, and talking to an understanding friend.
If the anger is directed toward another person, it may be best to get
the matter out in the open and clear the air rather than to keep the
feelings inside. This does not necessarily mean having an argument. One
can learn how to discuss angry feelings without doing damage to the
relationship.
If the depression persists, discuss the situation with your
physician. Sometimes treatment involves taking medication. If you are
taking tranquilizers or drinking a lot of alcohol, talk with your
doctor about their possible effects on your mood. Also consider a
referral to another health professional such as a counselor,
psychologist, or social worker. Managing stress Stress
is a response the body makes when called upon to make too many changes.
Situations or conditions that can create stress include problems at
work, personal relationships, raising children, paying taxes, the death
of loved ones, and new or frightening experiences. Even happy occasions
such as weddings, births, and vacations can be stressful if there is
pressure involved. You may also feel stressed when you experience one
straw too many--after a series of little things suddenly seem to pile
up and get out of control. People with chronic health problems such as
arthritis can have additional stress because of pain, medical expenses,
and concerns for the future.
Symptoms of too much stress include:
- increased pain
- fatigue
- loss of or excessive appetite
- difficulty in sleeping
- feelings of tenseness, anxiety, or irritability
- muscle tightness
- difficulty in concentrating
Symptoms differ from one person to another and may differ for the same person over time.
People can reduce stress in different ways, although all stress
cannot be removed from life. An important concept in stress management
is to accept what you cannot change instead of feeling constantly
frustrated and upset over situations beyond your control. Have
reasonable expectations for yourself and other people.
Just take one day at a time and try to do something each day that is
pleasant. Improve communication and learn to say "no" without feeling
guilty. Simplify your life as much as possible. Build a daily exercise
period into your life. To counteract some of the stress that cannot be
eliminated, practice relaxation techniques to clear the mind of
thoughts and worries and allow the muscles to release tension.
Stress, depression, and pain are all closely connected, and each
probably affects the other. Sometimes people with arthritis develop a
cycle of these uncomfortable feelings that is difficult to break.
If this cycle should occur, taking steps to solve any one of these
problems can reduce the extent of the others as well. In this way, you
can break the cycle. However, if you feel trapped, talk to your doctor
or ask to be referred to another professional who can help.
See the article on stress for more information. Coping with fatigue People with arthritis often tire easily and may not be able to
participate in all the activities they once enjoyed. As a result, they
may feel frustrated or even guilty for not getting as much done as they
think they should. But with careful planning and pacing, most people
with arthritis still can be very active.
You can reduce your fatigue
by learning to pace yourself throughout the day. Do the first task on
your list and then rest for awhile before beginning another. Allow
extra time to rest on days when you have big tasks or special plans.
And big jobs can be broken down into smaller, more manageable parts. No
matter what you do, stop and rest before you get too tired.
Develop priorities for yourself. How do you most want and need to
spend your time? Perhaps you could give up some things you wouldn't
really miss doing. Perhaps you are doing something for your spouse or
children that they would be quite willing to do for themselves.
Don't try to hide the fact that you are tired or can't do certain
tasks. If you do try to cover up, not only might you damage your
joints, but your family and friends might develop unrealistic
expectations of you.
If arthritis has affected your ability to do simple daily tasks such
as cooking and cleaning, enjoying your favorite leisure activities, or
working at your job or other desired activities, talk to your doctor. A
doctor, an occupational therapist, or other professional may be able to
suggest aids or devices or ways of modifying activities so that you can
still participate.
See the article on fatigue for more information. Self-image and sexuality Sexuality is an important part of life involving how one feels about
and expresses being male or female as well as the many physical ways in
which one can experience closeness with others. The opportunity to
express and enjoy sexuality can be affected by arthritis. Although
arthritis has no direct effect on the body's capacity for sexual
enjoyment, the disease can indirectly affect sexuality.
For example, pain and fatigue can reduce your interest in being
around others or reduce your interest in sexual activity. Having
inflamed joints or limited joint mobility also can make engaging in
certain sexual activities more difficult. And some drugs that are used
to treat arthritis or other health problems may lower your sex drive or
affect your sexual ability.
Self-image can be affected by body changes caused by arthritis or
certain medications. A disease can change the way you look and feel,
but you still are the same person you were before you became ill. If
physical changes do occur, they will be much more noticeable to you
than to anyone else. How you manage these changes is more important to
your personal relationships than are the actual changes themselves.
Other people "see" you through your personality, posture, voice, and
personal style of dressing and grooming, in addition to your physical
features.
Many of the suggestions already given for dealing with pain,
fatigue, and limited activities can help you enjoy your sexuality.
Also, remind yourself that a great part of how others see you and feel
about you depends on how you feel about yourself. If you don't see
yourself as an attractive person, others might not either.
For those who are not married or enjoying a close relationship,
there may be the challenge of finding a person with whom you can enjoy
life. For a person with a disability or an illness, the usual steps in
making new friends can be more difficult. If you don't feel like going
out, make the effort to maintain contact with friends by telephoning
them or inviting them to your home. Indicate your willingness to try to
participate in whatever is going on.
Fortunately, most people with arthritis are able to get out and
participate in social events. Joining an activity club or an
organization whose efforts are of value to you will put you in touch
with people who have similar interests.
Once you have found someone with whom you wish to be close, you
should tell them about your arthritis in a matter-of-fact way,
explaining that there are some things you can't do but that there are
many more things you can enjoy. Remember that any healthy, long-term
relationship is based on openness. All people risk rejection, not just
people with arthritis. If a person feels too uncomfortable to be with
you after learning that you have arthritis, perhaps that person
couldn't give you the closeness and support you want anyway.
As a relationship develops, there are many ways to communicate with
your partner. You can use unspoken signals such as facial expressions
and touches to get your message across, but you also must be willing to
talk with your partner. Unexpressed feelings can lead to inaccurate
conclusions. You may feel your partner is ignoring you when he or she
may actually just be afraid of hurting you. If you avoid your partner's
touch because you are in pain or are very tired, your behavior could be
misunderstood.
When there isn't enough communication, hurt feelings can build
unnecessary barriers to any relationship. It is your responsibility to
let your partner know how you feel, just as you would like to know how
he or she is feeling about you.
If arthritis does cause problems that can affect your sexual activity, there are many possible solutions. See the article on sex and arthritis for more information.
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