Anxiety, depression & musculoskeletal conditions

Things to remember

Anxiety and depression are common in people living with arthritis and musculoskeletal conditions
There are many treatment options available to help you reduce their impact on your life.

It’s understandable to feel overwhelmed when you’re diagnosed with arthritis or a musculoskeletal condition (e.g. osteoarthritis, back pain, fibromyalgia).

You may feel anxious because you’re not sure how your condition will affect your life. Changes in your condition and your levels of pain can also create anxiety.

If you’re experiencing anxiety you’re not alone. 1 in 4 Australians live with anxiety ¹. Many people living with musculoskeletal conditions deal with some form of anxiety and/or depression due to their condition.

It’s important to recognise signs of depression and anxiety and seek help as early as possible. Together with your doctor you can develop a treatment plan that fits your needs physically, emotionally and mentally. This type of holistic approach has been shown to be most effective.

Anxiety

Anxiety is a normal feeling in response to stressful situations. Everyone experiences anxiety from time to time.

Anxiety becomes a problem when it begins to interfere with your everyday life. If this is happening to you, you may have an anxiety disorder.

There are different types of anxiety disorders with varying symptoms. It’s important to recognise the signs and symptoms so that you can get your anxiety under control.

Symptoms of anxiety

Common symptoms of anxiety disorders include:

shortness of breath
rapid heartbeat
feeling jittery and/or shaky
tightness in the chest
stomach pain
poor memory or concentration
obsessive thinking and/or worrying
nausea
insomnia
panic or anxiety attacks
feelings of impending doom
abuse of drugs and/or alcohol.

Talk with your doctor if you’re experiencing any of these symptoms. If your doctor finds that you do have an anxiety disorder, you can discuss the range of treatment options available and find the best treatment for you.

Depression

Most people feel sad, lonely, unhappy and miserable at times. They’re common, normal feelings when something causes you emotional pain or stress.

However some people experience these emotions frequently and very intensely for prolonged periods of time. They lose interest and motivation in their lives and the world around them. These people may be depressed.

Depression is a serious condition that affects how you think, behave, feel and how you live your life. This can affect your physical health and function. However help and treatment for depression is available and effective.

Symptoms of depression

You may be depressed if you’re feeling sad, miserable or unhappy and have lost interest or pleasure in your life or activities for more than two weeks, as well as experiencing symptoms such as:

feeling miserable, anxious or empty for prolonged periods of time
feeling hopeless or pessimistic
feeling guilty or worthless
feeling irritable, restless or frustrated
feeling unmotivated to do anything
you’ve lost interest in once pleasurable activities or hobbies, including sex
sleep disturbance, either not sleeping well or sleeping a lot
not wanting to get out of bed
feeling excessively tired (fatigue) and/or low energy
difficulty concentrating and getting things done
feeling overwhelmed
difficulty thinking and making decisions
changes in appetite and body weight
suicidal thoughts and tendencies (e.g. being careless of your safety and wellbeing)
abuse of drugs and alcohol physical pain such as headaches, cramps and digestive problems.

What can you do?

It’s important to seek help for anxiety and depression as early as possible so that you don’t prolong your illness and make your symptoms worse. It becomes harder and harder to climb out of a depressive episode the longer you wait.

Similarly, the longer you put off seeking help for anxiety the more anxious you may become about taking that first step. If there are people you trust in your life, talk with them and ask for their support.

There are many different types of treatment options available for anxiety and depression. The important thing is to find the right treatment and health professional that works for you. With the right treatment and support, anxiety and depression can be overcome.

See your GP. Make a long appointment with your doctor. Be honest about how you feel. Discuss treatment options with your doctor and agree on one that’s suitable for you. Different types of depression require different treatments. Mild depression can usually be managed through lifestyle changes. For more severe cases your doctor may refer you to a psychologist or psychiatrist who may prescribe medication as well as lifestyle changes.

Psychological treatments. This form of therapy not only aids recovery, but builds your coping skills. It also reduces the risk of anxiety and depression returning. It includes the following:

Cognitive behavior therapy (CBT) – this treatment helps you become aware of your patterns of thinking and the beliefs you hold that may be triggering anxiety. The aim is to make you think about, assess and change your thought patterns and how you react to different circumstances.
Interpersonal therapy (IPT) – this treatment focuses on you and your relationships with other people to help improve your relationships, increase social support and resolve symptoms.

Take care of yourself physically by keeping as active as possible. Regular exercise has been proven to reduce stress, anxiety and feelings of depression, boost self-esteem and improve sleep. Consider joining an exercise class or exercising with a friend. You’ll get the benefits of exercise as well as the added social benefit of being with others.

Learn about anxiety and depression and the way your body and mind work. This will help you understand what you’re experiencing and why. It will also help you take control over what’s happening to you.

Talk to trusted family and friends about what you’re going through. This may help alleviate your depression. If there’s no one you feel you can trust and comfortably confide in, consider speaking with a counsellor or a psychologist.

Set yourself goals. Setting goals is an important step in managing anxiety and/or depression. It’s a great, practical way to increase your motivation to achieve something.

Goals need to be SMART: Specific, Measurable, Achievable, Realistic and have a Timeframe.

An example goal: For the next 2 weeks I’m going to walk 20 minutes a day, 3 times a week. After 2 weeks I’ll see how I’ve done and either continue at this pace or increase my walking.

This is a SMART goal because it’s specific—it tells you what you need to do, for how long and how often. It’s measurable—you know how often and for how long you need to walk. If you’re otherwise healthy and well this should be achievable and realistic. And it has a time frame—2 weeks.

Goals can be short-term or long-term. Sometimes it’s useful to break down large or long-term goals into smaller steps or goals that can be achieved more quickly.

These ‘small wins’ give you a sense of achievement and help you maintain focus.

Join a support group. Meeting with people who know what you’re going through and who have similar conditions and experiences, can be extremely beneficial. Musculoskeletal Australia has a network of support groups. Most of these groups meet face-to-face, but there are several that you can access via websites or social media.

Write down, or track, your pain levels, sleep quality and mood. This can help you recognise patterns and identify your triggers for depression or anxiety.

Eat well. A healthy, well-balanced diet is vital for good health and energy. Not only does it help you maintain a healthy weight and reduce the load on your joints, it can also help protect you against other health conditions such as diabetes and heart disease. We also feel much better in ourselves when we eat a nutritious, delicious meal. Talk with your doctor or dietitian for more information and advice.

Sleep well. If you’re not sleeping well and your sleeping patterns are all over the place, try to get up around the same time each morning, and go to bed at about the same time each night. If you find yourself lying awake at night thinking about your worries, write them down to think about the following day – this will ease your mind and help you avoid overthinking.

Avoid caffeine and alcohol for several hours before going to bed. Give yourself time to unwind before going to bed by doing something relaxing like taking a bath, going for a walk or reading a book. Avoid television and mobile devices.

If pain is keeping you awake consider altering the timing of pain relief medication, using a heat pack on sore joints, or doing some meditation or visualisation exercises. If pain continues to keep you awake at night, talk with your doctor.

Learn how to breathe properly from your diaphragm and not your chest. When you’re feeling anxious, you may begin to breath too quickly (hyperventilate). This can lead to lightheadedness and tingling fingers, which can increase your anxiety. Focus on your breathing and try to slow it down.

Learn a variety of relaxation techniques to find the ones that work for you. Options include progressive muscle relaxation, meditation and breathing exercises, but you can do anything that puts your mind at ease such as tai chi, colouring in, listening to music, reading a book, going for a walk.

Medication. Anti-depressant medication can be helpful in easing the symptoms of depression when used along with psychological treatments. It’s important to fully understand what medication you’re taking and why. This means finding the right doctor or psychologist you can have an open and honest discussion with about your options.

Where to get help

Your doctor
Psychologist or psychiatrist
Mental health nurses
Counsellor
Dietitian
Exercise physiologist
Physiotherapist
Musculoskeletal Australia
National Arthritis and Back Pain+ Help Line: 1800 263 265