Arthritis Rheumatoid Arthritis 9 Ways to Manage Anxiety Caused by Rheumatoid Arthritis By Ashley Olivine, Ph.D., MPH Ashley Olivine, Ph.D., MPH Ashley Olivine is a health psychologist and public health professional with over a decade of experience serving clients in the clinical setting and private practice. Learn about our editorial process Updated on April 20, 2022 Medically reviewed by Anita C. Chandrasekaran, MD, MPH Medically reviewed by Anita C. Chandrasekaran, MD, MPH LinkedIn Anita Chandrasekaran, MD, MPH, is board-certified in internal medicine and rheumatology and currently works as a rheumatologist at Hartford Healthcare Medical Group in Connecticut. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Mental Health and Autoimmune Disease Anxiety and RA Pain Triggers Management Support Living With Anxiety Frequently Asked Questions Rheumatoid arthritis (RA) is a disease that causes painful swelling when the immune system attacks healthy cells. 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. 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. Grace Cary / Getty Images 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 These are long-term health conditions that cause inflammation and physical damage when the immune system attacks healthy cells. As with a long-term (chronic) health condition, people with rheumatoid arthritis and other autoimmune diseases are at an increased risk of mental health challenges. For example, people with an autoimmune disease are at a 45% greater risk of experiencing anxiety or depression. 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. 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. 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. 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. You Are Not Alone Over 1.3 million people in the United States have rheumatoid arthritis, and it is the most common autoimmune disease. Anxiety occurs in about 20% of people with RA. 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. 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. 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. 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. 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 Choosing the Right Therapist 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. 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. How to Find a Rheumatoid Arthritis Support Group 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. 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. Do I Have Anxiety? Frequently Asked Questions Is it safe to take anxiety medication with RA medication? While it is possible to safely take medications for anxiety and RA together, some combinations may cause interactions that are not safe. Talk to your prescribing medical healthcare provider or pharmacist to discuss your medical history, situation, and medications. Learn More: Reducing Your Risk of Adverse Medication Interactions How do you avoid depression with rheumatoid arthritis? Preventing depression with RA can include seeking support for RA symptoms, talking with a mental health professional, such as a therapist, and making lifestyle changes, such as nutrition and exercise. It is important to address any concerns related to possible depression symptoms, such as a decreased mood, sad or hopeless feelings, or decreased interest in activities, with a qualified healthcare provider. Learn More: Do I Have Depression? How do you lower anxiety when you’re in pain? Many of the same things that help to address anxiety without pain, such as setting aside time to relax, talking with someone, or getting enough sleep, can also help those experiencing anxiety and pain together. It is also important to do things that help with the pain, such as following through with taking medications. 12 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Centers for Disease Control and Prevention. Rheumatoid arthritis (RA). Lwin MN, Serhal L, Holroyd C, Edwards CJ. Rheumatoid arthritis: the impact of mental health on disease: a narrative review. Rheumatol Ther. 2020;7(3):457-471. doi:10.1007/s40744-020-00217-4 Global Autoimmune Institute. Managing mental health with an autoimmune disease. Arthritis Foundation. Your RA is in remission! Now what? Harvard Medical School. Understanding the stress response. Liu YZ, Wang YX, Jiang CL. Inflammation: the common pathway of stress-related diseases. Front Hum Neurosci. 2017;11:316. doi:10.3389/fnhum.2017.00316 Machin A, Hider S, Dale N, Chew-Graham C. Improving recognition of anxiety and depression in rheumatoid arthritis: a qualitative study in a community clinic. Br J Gen Pract. 2017;67(661):e531-e537. doi:10.3399/bjgp17X691877 American College of Rheumatology. Rheumatoid arthritis. Arthritis Foundation. How stress affects arthritis. Anxiety and Depression Association of America. Chronic pain. National Health Service. Living with rheumatoid arthritis. Uda M, Hashimoto M, Uozumi R, et al. Factors associated with anxiety and depression in rheumatoid arthritis patients: a cross-sectional study. Advances in Rheumatology. 2021;61(1):65. By Ashley Olivine, Ph.D., MPH Dr. Ashley Olivine is a health psychologist and public health professional with over a decade of experience serving clients in the clinical setting and private practice. She has also researched a wide variety psychology and public health topics such as the management of health risk factors, chronic illness, maternal and child wellbeing, and child development. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit