What Is Rheumatoid Arthritis
Rheumatoid Arthritis occurs when your immune system mistakenly attacks healthy tissue. This causes pain in your joints and different body parts. Primarily, RA impacts the feet and hands. But it can also affect larger joints like elbows and knees. Moreover, it can produce a variety of other symptoms, such as difficulty breathing and joint stiffness.
With that said, now lets see what patients suffering from it say about what rheumatoid arthritis feels like.
Physical Symptoms And Outcome Measures
In addition to choosing the most appropriate pharmacotherapeutic approach to treating the symptoms of depression, clinical management of depression should include the screening and monitoring of all symptom domains. All symptoms, including physical ones, must be measured in order to be treated fully. The symptoms still present in incomplete remission are important markers of vulnerability to relapse, and if all types of symptoms are not included in assessments, physicians cannot fully assess the treatment response and follow up on unresolved symptoms. Physicians and patients need to become aware of the broad spectrum of symptoms in depression in order to evaluate treatment effectiveness.
Reliable and effective assessment of Axis I disorders often includes utilization of a variety of rating scales used for both diagnostic purposes and follow-up evaluation. Recently there has been a call for including on rating scales all the symptom domains and social functioning/quality of life measures in the requirements for remission, but physicians may not be aware that there are already numerous standardized scales that measure these aspects of depression.
How Is Depression Diagnosed
Depression is usually diagnosed based on your symptoms and behavior patterns. Your doctor may ask you to complete a questionnaire to help them determine if you have depression and how severe it might be.
Debilitating depression, while not an official category of MDD, is more frequently recognized by doctors and mental health experts than before.
The symptoms of major depression include:
- persistent and intense feelings of sadness, anger, or frustration
- thoughts of suicide
- frequent pain such as headaches or backaches
Is It Depression?
While a self-test for depression will not diagnose you, it can help you decide if you should talk to a mental health expert or your doctor. If you answer yes to four or more of these questions, you should make an appointment to speak with a professional to decide the next step.
Do you have difficulty falling asleep or staying asleep at night? Do you sleep more than 10 to 12 hours per day or sleep for most of the day? Have you lost interest in the things that used to bring you joy or excite you, including hobbies? Have you missed work more than once in the last month because you felt too fatigued or too pained to work? Do you notice that youre more irritable and easily upset in recent days or weeks? Have you had thoughts of self-harm or suicide? Has your appetite increased or decreased unexpectedly? Do you have days when you feel as if you dont have the energy to do the things you need to do?
Treatment options include:
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How Emotional Pain Affects Your Body
Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital.
Emotional pain is pain or hurt that originates from non-physical sources. Sometimes this emotional distress is the result of the actions of others. Other times, it might be the result of regret, grief, or loss. In other cases, it might be the result of an underlying mental health condition such as depression or anxiety.
No matter what the cause, this psychological pain can be intense and significantly affect many different areas of your life.
While it is often dismissed as being less serious than physical pain, it is important that emotional pain is taken seriously. There are a number of common feelings that are associated with emotional pain that can have an impact on both your physical and mental health.
Also Known As: Psychic pain, spiritual pain, psychalgia, emotional suffering, psychological pain, algopsychalia, soul pain, or mental pain
Incorporating Physical Symptoms Into Treatment Goals
As with any general medical disorder, full remission should be the long-range objective in the treatment of mood disorders. Many physicians consider a patient to be in remission from depression when his or her acute emotional symptoms have abated, but residual symptoms, including physical symptoms, increase the likelihood of relapse. Physicians should move beyond simple treatment of acute symptoms to a model in which patients are treated until full remission is achieved a virtually asymptomatic state rather than simple response should be the ultimate goal of therapy. Many patients treated with antidepressants fail to achieve full remission, and the costs, both social and economic, of relapse or residual symptoms are high.
Numerous studies have shown79 that patients with major depression who have residual symptoms after treatment have higher relapse rates and they relapse earlier than do those without residual symptoms. In fact, relapse rates are 3 times higher in individuals who have residual symptoms after they have achieved significant improvement than in individuals with no residual symptoms.8 One may infer, then, that the likelihood of relapse is significantly reduced in patients who attain asymptomatic remission.
The Relation of Residual Symptoms to Relapse in Depressiona,b
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Risk Factors For Depression
Depression can affect anyoneeven a person who appears to live in relatively ideal circumstances.
Several factors can play a role in depression:
- Biochemistry: Differences in certain chemicals in the brain may contribute to symptoms of depression.
- Genetics: Depression can run in families. For example, if one identical twin has depression, the other has a 70 percent chance of having the illness sometime in life.
- Personality: People with low self-esteem, who are easily overwhelmed by stress, or who are generally pessimistic appear to be more likely to experience depression.
- Environmental factors: Continuous exposure to violence, neglect, abuse or poverty may make some people more vulnerable to depression.
A Symptom Of Depression Could Also Be A New Or Worsened Skin Condition Like Psoriasis Or Alopecia
Depression can cause or exacerbate skin conditions, according to Los Angeles-based board-certified dermatologist Tsippora Shainhouse, MD, FAAD.
Dr. Shainhouse said conditions like psoriasis, alopecia, vitiligo, porphyrias, hidradenitis suppurativa, and acne “are known to be associated with the development of depression.”
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Changes In Your Speech Patterns Might Also Occur
Another lesser-known side effect of depression is slowed or halted speech, said Gasior.
“The ability to speak is closely related to psychomotor function, thinking and concentration, and the speed of information processing, all of which are frequently impaired in psychiatric disorders such as depression,” she told INSIDER.
“This impairment can also impact speech patterns, and recent research has shown that more severely depressed patients tended to speak slower, take a longer time to complete the same number of words, and display longer pauses between words and sentences,” she added.
If you’re dealing with depression, your voice may also be more flat and monotone than usual.
Physical Symptoms You Didnt Realise Depression Could Cause
Many people dont realise that depression can have a very real affect on your whole body – not just your mind.
Most people will agree that depression can cause emotional symptoms feeling sad, low, down, numb But what many dont realise is that depression can have a very real effect on your body as a whole.
We are taking a look at seven common but surprising physical symptoms of depression.
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What Are The Different Antidepressants And How Do They Work
The most commonly prescribed antidepressants cause changes in brain chemistry that affect how neurons communicate. Exactly how this improves mood remains somewhat of a mystery, but the fact that they do often work is well-established.
- SSRIs This category of drug includes Prozac , Celexa , and Zoloft and targets serotonin, a neurotransmitter that helps control mood, appetite, and sleep.
- SNRIs SNRIs include drugs like Cymbalta , Pristiq , and Effexor XR , which block the reabsorption of both serotonin and another neurotransmitter, norepinephrine.
- NDRIs This class of medications includes bupropion.
- TCAs TCAs include such drugs as Tofranil and Pamelor . These drugs were among the earliest antidepressants to come on the market. These days, doctors generally only turn to them when treatment with SSRIs, SNRIs, and NDRIs has failed.
- MAOIs MAOIs, including Nardil and , were the first antidepressants developed. Theyre rarely used today, in part because people who take them require careful monitoring to prevent negative interactions with certain foods and other medications.
All antidepressants can have side effects, but some may be more problematic than others. You may need to try several different medications, or a combination, guided by your doctor, before you find what works best for you.
Symptoms Of Pancreatitis: Pain And Other Complications
The pain of pancreatitis occurs in a specific way and is a key symptom of the condition.
The pain of pancreatitis occurs in a specific way and is a key symptom of the condition.
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Pancreatitis is associated with pain and a handful of other symptoms, some of which can be severe. There are two types of pancreatitis: acute and chronic.
Gallstones and alcohol are the two main causes of acute pancreatitis. With chronic pancreatitis, it’s been estimated that up to 55 percent of cases in the United States are due to heavy drinking or alcoholism.
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Alcohol Tobacco And Other Drugs
The misuse and abuse of alcohol, tobacco, illicit drugs, and prescription medications affect the health and well-being of millions of Americans. SAMHSAs 2020 National Survey on Drug Use and Health reports that approximately 19.3 million people aged 18 or older had a substance use disorder in the past year.
Combining Psychotherapy And Drugs
Patients with anxiety or depression sometimes find that combining psychotherapy with medication offers the most complete relief. A randomized controlled trial, the Stepped Care for Affective Disorders and Musculoskeletal Pain study, suggests that a combination approach might also work for people suffering pain in addition to a psychiatric disorder.
The trial enrolled 250 patients with chronic pain in the lower back, hip, or knee. Participants also had at least moderate depression, as measured by a standard clinical instrument. One group was assigned to 12 weeks of antidepressant therapy followed by a 12-week pain self-management intervention based on principles of CBT. In the “usual care” group, which served as a control, researchers informed participants that they had depression and should seek advice or treatment. Results were considered significant if participants reported at least a 50% reduction in depression severity and at least a 30% reduction in pain. At the 12-month mark, both depression and pain were significantly reduced in 32 of 123 intervention patients , compared with 10 of 127 usual care participants .
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Psychological Theories About Depression
Several psychological theories about the development of depression in chronic back pain patients focus on the issue of control. As discussed previously, chronic back pain can lead to a diminished ability to engage in a variety of activities such as work, recreational pursuits, and interaction with family members and friends. This situation leads to a downward physical and emotional spiral that has been termed “physical and mental deconditioning” .6 As the spiral continues, the person with chronic back pain feels more and more loss of control over his or her life. The individual ultimately feels totally controlled by the pain, leading to major depression. Once in this depressed state, the person is generally unable to change the situation even if possible solutions to the situation exist.
Achieving Remission In Patients With Physical Symptoms
Treating both the emotion and the physical symptoms associated with depression together is an important part of achieving remission. Unlike selective serotonin reuptake inhibitors such as sertraline and paroxetine, the dual-action antidepressants venlafaxine and duloxetine inhibit the reuptake of both serotonin and norepinephrine. This dual action gives them a robust efficacy in combating depression and preventing the persistence of symptoms, which increases the likelihood of achieving remission. Numerous reports have indicated that therapeutic agents that act on multiple neurotransmitters are associated with higher rates of remission than are single agents.1013 The selection of therapeutic agents proven to effectively promote both an elimination of a broad spectrum of symptoms and a return to full social functioning is important to the treatment of depression.
Because a majority of patients with depression initially seek treatment for the physical symptoms of depression rather than for their emotional symptoms, physicians are often aware of patients’ physical symptoms when treatment commences. Primary care physicians may want to consider using dual-action antidepressants as a first line-treatment in depressed patients who present with physical symptoms.
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Depression Is Different From Sadness Or Grief/bereavement
The death of a loved one, loss of a job or the ending of a relationship are difficult experiences for a person to endure. It is normal for feelings of sadness or grief to develop in response to such situations. Those experiencing loss often might describe themselves as being depressed.
But being sad is not the same as having depression. The grieving process is natural and unique to each individual and shares some of the same features of depression. Both grief and depression may involve intense sadness and withdrawal from usual activities. They are also different in important ways:
- In grief, painful feelings come in waves, often intermixed with positive memories of the deceased. In major depression, mood and/or interest are decreased for most of two weeks.
- In grief, self-esteem is usually maintained. In major depression, feelings of worthlessness and self-loathing are common.
- In grief, thoughts of death may surface when thinking of or fantasizing about joining the deceased loved one. In major depression, thoughts are focused on ending ones life due to feeling worthless or undeserving of living or being unable to cope with the pain of depression.
Grief and depression can co-exist For some people, the death of a loved one, losing a job or being a victim of a physical assault or a major disaster can lead to depression. When grief and depression co-occur, the grief is more severe and lasts longer than grief without depression.
Looking After Someone Who Has Depression
If you’re close to someone with depression, their condition can affect you too. Your relationship, and family life in general, can be strained, and you might not know what to do or how to help.
Talking about the situation can help. Finding a support group, or talking to other people in a similar situation, can make it easier to cope. If the condition is causing difficulties in your relationship with your partner, you could contact a relationship counsellor who can talk things through with both of you.
When suffering from depression, men are less likely to ask for help than women. They’re also more likely to turn to drugs and alcohol to cope with the symptoms.
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Depression Feels Like Theres Nothing To Hope For
The loss of hope is a common symptom of depression.
You may feel like youre always taking one step forward and three steps back. This may lead you to wonder, So why try?
Or maybe you look at your calendar and see nothing to look forward to.
A sense of hopelessness can also manifest as guilt or shame for something youve experienced.
Frequent Headaches Or Migraines Can Be Another Symptom Of Depression
“Individuals with depression often struggle with headaches specifically, they may report symptoms of what is frequently characterized as a tension headache,” explained Dara Gasior, who has a doctorate in psychology and is the director of assessment and training at High Focus Centers, a New Jersey-based treatment facility.
“These headaches are believed to be caused by sustained or tightened muscle contraction of the scalp and neck muscles. As people struggle with depression, feeling overwhelmed, sad, tired, lethargic all of this has an impact on the body.”
Read More: 11 things that could be causing your frequent headaches
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How Long Do Anxiety Relapses Last
If a person remained on the antidepressants for 44 weeks, about 16% of them would have a relapse compared to 36% who stopped after 20 weeks. People with anxiety disorders can have problems with their work, family and social life. Treatments for depression and psychological therapies are the main ones.
Causes And Risk Factors
While some illnesses have a specific medical cause, making treatment straightforward, depression is far more complicated. Certain medications, such as barbiturates, corticosteroids, benzodiazepines, opioid painkillers, and specific blood pressure medicine can trigger symptoms in some peopleas can hypothyroidism . But most commonly, depression is caused by a combination of biological, psychological, and social factors that can vary wildly from one person to another.
Despite what you may have seen in TV ads, read in newspaper articles, or maybe even heard from a doctor, depression is not just the result of a chemical imbalance in the brain, having too much or too little of any brain chemical that can be simply cured with medication. Biological factors can certainly play a role in depression, including inflammation, hormonal changes, immune system suppression, abnormal activity in certain parts of the brain, nutritional deficiencies, and shrinking brain cells. But psychological and social factorssuch as past trauma, substance abuse, loneliness, low self-esteem, and lifestyle choicescan also play an enormous part.
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