“The pain is killing me.”
This may seem like hyperbole, but for some people with arthritis it can be true.
The rate of suicide among people with arthritis is notably higher than in the general population, researchers say.
According to a study from the University of Toronto published in the medical journal Rheumatology International, one of out 26 men with arthritis has attempted suicide.
This was in comparison with one in 50 men who did not have any form of arthritis.
The study also found that the rate was higher among women with arthritis. Researchers said 5.3 percent of women with arthritis have attempted suicide, compared with 3.2 percent of women without arthritis.
The study looked at a total of 21,744 people in Canada, out of which 4,885 had arthritis.
The results of the Canadian study showed an increase in suicidal behaviors among people with arthritis, even when adjusting for other factors such as a history of mental health disorders, chronic pain, age, and socioeconomic status.
In fact, those with arthritis still had a 46 percent higher risk of suicide attempts than people without arthritis.
People with arthritis who had a history of substance abuse, anxiety disorders, or a traumatic childhood had higher odds of developing suicidal tendencies than people with arthritis who weren’t affected by those factors.
Also at an increased risk of suicide among the arthritis population were people who had lower incomes, were less educated, and were younger.
Nonetheless, the results of the study seemed to indicate that arthritis was a primary contributing factor in suicide attempts, although a direct link could not be proved, the researchers wrote.
Stephanie Baird, study co-author and doctoral student, wrote in a press release, “Due to the cross-sectional nature of this survey we cannot establish causality. We do not know when the arthritis began nor when the suicide attempts occurred. It is possible that other factors that were not available in the survey may confound the relationship. For example, childhood poverty has been strongly linked to both the development of arthritis and suicide risk.”
The abstract of the study states, “Younger adults with arthritis were more likely to report having attempted suicide. Future prospective research is needed to uncover plausible mechanisms through which arthritis and suicide attempts are linked.”
Depression, serotonin, pain
Various forms of arthritis, such as rheumatoid arthritis (RA), are also linked to depression and serotonin deficiencies.
Some studies have shown that depression makes it more difficult for RA patients to cope with their symptoms.
This may play a role in suicide attempts as well, even though in the University of Toronto study there were adjustments for mental health factors.
A 2002 study published in the journal Rheumatology said that suicidal thoughts and tendencies needed to be taken seriously in the RA population, especially among women.
The researchers concluded, “Attempted suicides and especially depression in female RA patients should be taken more seriously into account than previously in clinical work so that the most appropriate psychiatric treatment can be provided for such patients.”
However, the topic of suicide still carries a stigma. Suicide often isn’t discussed or even studied. It is frequently attributed to mental illness, but unrelenting pain or illness can also be a trigger.
Some U.S. reports state that chronic pain or sickness can contribute to up to 70 percent of suicide cases. A 2011 study in Great Britain found that about one in 10 suicides were due to terminal or chronic illness.
Maria Marino of Georgia, an active member of many online communities for people with RA and chronic pain, said, “We have had three people commit suicide, and one person attempt suicide while hurting themselves the process, just in the past 7 years alone in some of the RA Facebook groups I've been on. This is an epidemic in our community.”
A letter written by several doctors, and published in the British Medical Journal stated, “Rheumatoid arthritis, the most prevalent chronic inflammatory musculoskeletal disease, has been associated with several negative psychological outcomes, including depression. Our ongoing studies indicate that almost 11 percent of hospital outpatients with rheumatoid arthritis experience suicidal ideation.”