What challenges does arthritis pose? - Part 4

https://orthop.washington.edu/patient-care/articles/arthritis/frequently-asked-questions-about-living-with-arthritis.html

Taking charge of arthritis

How 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-lastingthe course is often unpredictablepain depression and excess stress may resultactivities can be limitedthe 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 arthritis 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 painfatigueloss of or excessive appetitedifficulty in sleepingfeelings of tenseness anxiety or irritabilitymuscle tightnessdifficulty 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.