Coping with Fear and Anxiety in Arthritis
by Dr. Gulabani
Although arthritis is primarily a disease of joints, its effects are not just physical. Persons with arthritis suffer from anxiety, depression, hopelessness and helplessness. Arthritis affects almost all areas of person's life. Persons with arthritis tend to suffer from high levels of stress in life. Therefore they must learn effective ways of coping with the disease and its consequences.
Initial reaction of a person with newly diagnosed arthritis is often sadness and disbelief. One feels anxious and is unsure of his future. Pain is the constant companion. Person with pain responds to fear and anxiety. Fear is experienced in human beings in the face of external threat or perceived danger. Common fears in arthritis are, whether pain will worsen in the future or whether joint injury will cause limitations in work. Anxiety is experienced as a general sense of restlessness and unease. One feels that the worst possible will happen to him. This type of thinking worsens the pain further and it can lead to further anxiety and depression.
Some amount of anxiety is essential as it motivates one to know more about the problem. This also motivates one to learn effective coping skills.
To deal with the stress of ongoing disease in person's life one needs coping skills. These coping strategies are dictated by person's underlying personality. Some individuals seek more information about the problem, while others develop new skills to deal with the problem. Sometimes realistic change in one's goal is also required.
Remedial measures to deal with fear and anxiety.
RELAXATION
Relaxation helps in managing the pain of arthritis. It also helps in effectively managing anger, depression arising as a consequence of living with arthritis.Deep breathing, progressive muscular relaxation and visualization techniques are important elements in this.
Deep breathing is marked by expansion of abdomen rather than the chest while breathing. This is one of the best ways to lower stress in the body. When you breathe deeply, it sends a message to your brain to calm down. The brain then sends this message to your body. When you are tense, your heart rate increases, breathing becomes fast, but when you breathe deeply and relax, the heart rate decreases and breathing becomes slow.
In progressive muscular relaxation person learns to relax his body from toes to head. In first step, you learn how to tense different muscles groups of body. In second step, you directly relax the larger groups of muscles at will.
In final step, you reach a state when your body whole body is related and at the same time you are visualising a relaxing scene e.g. sunset on the beach, here you involve all senses, sound, smell etc. While doing this, continue abdominal breathing.
The principal in this is, the tension cannot reside in a relaxed body .So, if you learn to relax your body, you learn to remain tensionless and calm.
EXERCISE
Pain in arthritis limits physical activity. Hence less active persons develop weight gain, joint pains, diabetes etc. This leads to increase in pain. Hence to avoid this, regular physical activity is essential.
One needs to consult one's physician about the exercise to be started. Start low and go slow should be policy.
YOGA AND MEDITATION
Yoga under expert guidance helps in reducing pain, improving functional ability, reducing pain medication. Feeling of optimism and well being are experienced by doing yoga, Yoga laps body's natural healing ability. Various eastern meditation techniques help people cope with arthritis effectively.
COGNITIVE THERAPY
Our thinking influences our feelings and behaviour. If we replace our faulty thoughts with rational thoughts our feeling state and behaviour changes.
Consider an example: A student with arthritis gets up in the morning with swelling, pain and immobility .He is struck with a thought that he won't be able to attend his college, his angry professor will not allow him to appear for the exam and subsequently he will be considered a failure by others .This causes depression, alternatively, another boy with the same problem will say to himself that I often get better by medication and exercise. I will become mobile enough to attend college, though late my professor will be kind enough to allow me complete my studies & I will be able to clear my exam this brings out happy mood.
GOAL CHANGE. RECREATIONAL ACTIVITIES
Person with arthritis must find out what is important to him. Whether spending time and energy for full time job is important or he will be more satisfied by caring for children by devoting more time and energy towards it.
Physical limitations make it difficult for him to enjoy activities like running, hiking, playing cricket. He can develop alternative hobbies like photography, music. He can get satisfaction by doing voluntary community work.
By virtue of arthritis person leads to avoid activities, shun contact with people .This leads to feeling lonely and missing pleasure. In effect he feels depressed. So one must add some fun to life. This will improve mood, relationship and energy.
SUPPORT GROUPS
Self help groups are a great help in dealing with stress of arthritis and its consequences.
Here one shares experiences with others. Self help groups provide mutual help and encouragement.
Professor Alex Zauntra has aptly said "Arthritis is a mind-body problem. What happens in the body affects the mind, but the mind affects how much energy people have to be resilient in the face of pain."
