Living with depression and rheumatoid arthritis is a vicious cycle that can take a mental and emotional toll on a patient. Can it take a physical toll too?

A new study suggests that depression can lead to slower healing in RA patients. The study, conducted by Alan Rathbun, Ph.D., and colleagues at the University of Maryland School of Medicine, suggests that depression can make RA remission more difficult. It can also slow the process of symptom improvement.

Depression Affects How Patients Feel, Heal

RA patients with and without depressive symptoms were evaluated over two years. Patients who reported symptoms of depression were slower to show any improvement in their joint pain and in measurable disease activity.


The patients who did not appear depressed had a better overall rate of RA improvement. The conclusion was that symptoms of depression can, in fact, influence RA disease activity.

The study also found that patients whose disease had shown up more recently showed much slower decreases in disease activity than the rest of the group who’d had RA for a longer period of time.

Rathbun said, “Collectively, these data indicated that a prior history of depressive symptoms could affect how patients interpret and perceive their condition, or alternatively, that depression has an impact on the experience of musculoskeletal pain."

Read More: Disability, Depression, and RA: A Vicious Cycle »

How Does Depression Affect the Bodies of RA Patients?

Physical symptoms can often piggyback on mental or emotional strain. They can, at times, overlap with or mimic the pain experienced by RA patients.

“Your body doesn't know the difference between physical, chemical, or emotional stress. Emotional stress or depression can have just as big of an impact on interfering with your body's natural healing abilities as other, more obvious forms of stress. Depression can create physical inflammation that can make all sorts of symptoms worse, including arthritis,” said Mercedes Turino. Turino is a certified holistic health and nutrition coach from Marquette, Michigan.

Dr. David Borenstein, a clinical professor of medicine at the George Washington University

Medical Center, explains how the depression cycle can begin: “Diagnosis can result in depression as part of the realization of the potential difficulties of a chronic disease. The depression itself can be disabling even if the changes of rheumatoid arthritis are mild.”

Nonetheless, he says, there’s hope. “The expectation, with current therapies available, is that individuals with RA will not experience significant disability from their illness with early, effective treatment,” he said. “With effective treatment, individuals can regain control of their lives that helps break the hold of depression.”

Perhaps, as Borenstein suggests, a patient’s best bet is to work with their doctor to treat depression early on. This could help prevent further disability from RA and improve quality of life overall.

Learn More: What Is Migratory Arthritis? »