Osteoarthritis and Depression

Depression has been linked to certain types of arthritis but it is not usually associated with osteoarthritis—at least not in most people's minds. But osteoarthritis can cause physical limitations that restrict people's lives so significantly it can lead to depression.

While osteoarthritis may only affect a single joint, it can affect mobility or the ability to remain independent, and in turn, stir feelings of depression. Researchers have actually pointed to certain factors that predict the severity of depression in osteoarthritis patients (from the strongest predictor to the weakest):

• the patient's perception of their pain level
• having few social contacts
• physical limitations of the lower body
• physical limitations of the upper body
• the patient's age
• body mass index (overweight)

While a patient's age cannot be changed, the other factors should be targeted by a comprehensive treatment plan. Pain must be well-managed, social isolation must be avoided, weight must be controlled, and physical limitations overcome with appropriate treatment.

Social Impairment Greater Than Physical Impairment

Researchers have also compared the effect of physical impairment to social impairment caused by osteoarthritis. You may be surprised to learn that physical limitations were not linked with increased depression, but social consequences were linked to increased depression.

Think about it—if you have knee osteoarthritis that makes it difficult to walk—is the difficulty with walking more depressing or the social consequences of not walking normally? Meaning, it can become difficult or impossible to:

• walk around the block and talk to neighbors
• go to the shopping mall with friends
• cook dinner for friends
• go out with a moment's notice

It's hard to plan activities because you feel anxious—unsure of how you will feel. If this is the case with you, you're letting pain control your life—at least your social life.

You should discuss how osteoarthritis affects your social life and social activities with your doctor. Be open and disclose feelings of depression, if you have them. Ask for your doctor's help with this aspect of living with osteoarthritis. Remember, don't just talk about your pain—talk about how that pain is affecting your life.

Changing Seasons May Provoke Depression in OA Patients

Worsening osteoarthritis symptoms typically occur in spring and autumn, the season's which are most changeable. Worsening osteoarthritis symptoms have long been tied to rain and high relative humidity—peaking in April/May and September, October, November.

Spot the Signs of Depression

Don't ignore signs of depression just because you think it doesn't match up with having osteoarthritis. If you're depressed, know when to seek help.

• Do you wake feeling the glass is half-empty and has that feeling persisted?
• Have you lost interest in work or activities you typically enjoy?
• Have you been restless at night and not getting sufficient sleep?
• Have you been staying in bed longer and oversleeping?
• Do you have a poor appetite or do you overeat?
• Have you been crying, sad, or irritable?
• Do you have persistent headaches or stomach aches?
• Do you have a sense of worthlessness?

Talk to your doctor, if you experience several of the above signs of depression. Your doctor can evaluate your medications to see if depression is a known side effect. Or, your doctor can refer you to a mental health specialist if needed. If you choose to ignore your symptoms, you will perpetuate the pain—physical limitation—depression cycle. Stop the cycle.