Anxiety and Depression with Chronic Illness | Rheumatoid Arthritis Warrior

Anxiety and Depression with Chronic Illness

I’m excited about this guest post to introduce an important discussion. Various types of anxiety and depression are more common in those who live with chronic illness & chronic pain. I hope this post will help us to think about when symptoms are serious enough to need help.

Hello brave RA Warriors!  My name is Karaleigh. I am a mental health professional currently working on my dissertation to complete my Ph.D. in Clinical Psychology.  I also am a fellow warrior and have been diagnosed with Ankylosing Spondylitis for many years.

Chronic illness can lead to anxiety and depression

Anxiety and depression with chronic illness postDo you remember the first time you were told you have an immune illness? Was there…

  • relief you felt that you were not crazy and your symptoms were real?
  • fear of the unknown?
  • sadness that your life will be altered?

These feelings are very common. Time must be given to mourn the “old me” before this illness snuck into your life. Many of us had hopes, dreams and goals that were shattered when we were diagnosed. Our lives were completely altered, we can no longer play the sports we once did, sleep so few hours or work 60+ hour weeks. We fear that we may not be able to care for ourselves or family or provide for them. We may fear that nobody will love us, our friends and family will abandon us, or we will become overwhelmed and alone. These changes and fears can lead to anxiety or depression.


Let’s look at anxiety. Among the different types of anxiety are panic disorders (anxiety that causes panic attacks), phobias, and generalized anxiety.

Women are three times more likely to be diagnosed with panic disorder than men. It can be hard to distinguish between a panic attack, heart attack, sudden anxiety, asthma attack or other medical condition, so it is important to get treatment or seek medical help when concerned.

Did you know that it is common for people to experience a panic attack or anxiety attack at least once in their life?  It is diagnosed as a mental health condition if it is persistent and affects your daily life.  

Have you ever suffered from a panic attack?  People who have often describe it as if a person took a gun to their head and threatened to pull the trigger.  They suddenly fear that they are about to die. Generalized anxiety is a more common form of anxiety and is suggested to have a genetic component. Like other anxiety disorders, generalized anxiety is more common in women than men, but does happen in both males and females.

Social Phobia is very common in individuals with chronic health conditions.  Many explain that they feel embarrassed about their physical appearance, inability to dance, consume alcohol, or do other activities that are “normal” during social experiences.  They experience anxiety and fatigue and do not enjoy social situations as much.

Symptoms of panic attack:

  • palpitations (rapid heartbeat, racing heart or pounding heart)
  • sweating, trembling, or shaking
  • feeling that you are being smothered or cannot breathe or that you are choking
  • chest pain/discomfort
  • nausea, stomach pain or upset stomach
  • dizziness, lightheaded or feeling as if you may faint
  • feeling as if you are not in reality, you are in a dream or detached from your own body
  • fear of dying, losing control, losing your mind or going crazy
  • numbness and tingling
  • hot or cold flashes

Generalized anxiety symptoms:

  • excessive anxiety or worry or irritability
  • anxiety or worry that is difficult to control
  • restlessness or feeling on edge
  • being easily fatigued
  • difficulty concentrating
  • muscle tension
  • difficulty falling asleep, staying asleep or unsatisfying sleep
  • anxiety that is not specific to anything in particular

Social phobia symptoms:

  •  persistent fear of social or performance situations.
  • fear that you will do, say or act in a way that would be humiliating or embarrassing
  • exposure to social situations provokes anxiety
  • fear that is excessive or unreasonable
  • fear leads you to avoid social or performances or they are continued with intense anxiety or distress
  • fear leads to interference in your life, normal routine, relationships or functioning


Those with chronic health conditions also frequently suffer from depression.  Most common is major depressive disorder, either single episode or a recurrent type. Depression, also known as major depressive disorder, clinical depression or major depression is not something you can snap out of, or brush off.  Like anxiety, it affects your life significantly. Here are some things to watch for.

Symptoms of depression

  • feeling continually sad
  • irritability and/or frustration even over little things
  • loss of interest in activities that were once pleasurable or decreased sex drive
  • insomnia or excessive sleeping
  • change in appetite, increased eating/food cravings, decreased eating/food cravings, weight gain or weight loss.
  • agitations/restlessness, wringing your hands, pacing, knuckle cracking, cannot sit still
  • slowed speaking, thinking or body movements
  • indecisiveness
  • distractibility or decreased ability to concentrate
  • fatigue, decreased energy, tiredness
  • frequent thoughts of death, dying or suicide, worthlessness, or guilt
  • fixation on past failures or self blame when things go wrong
  • trouble concentrating, making decisions, or remembering things
  • crying spells for no apparent reason
  • unexplained physical problems

Important: As with all symptoms listed here, symptoms of depression or anxiety that are explained by a health condition may not indicate that you suffer from depression or anxiety.  For example if you have trouble concentrating or fatigue that is due to RA, then it is not necessarily a symptom of depression.  Additionally some medications may create symptoms that mimic depression or anxiety.  Check with your pharmacist for a list of side effects of the medications you take.  ALWAYS contact your doctor before starting or stopping any medications, vitamins or herbs to avoid potentially harmful interactions.

Check out part 2 of this series on anxiety and depression with chronic illness, where Karaleigh discusses seeking help.

Recommended reading:

Kelly O'Neill

Kelly O'Neill (formerly Kelly Young) has worked about 12 years as an advocate helping patients to be better informed and have a greater voice in their healthcare. She is the author of the best-selling book Rheumatoid Arthritis Unmasked: 10 Dangers of Rheumatoid Disease. Kelly received national acknowledgement with the 2011 WebMD Health Hero award. She is the president of the Rheumatoid Patient Foundation. Through her writing and speaking, she builds a more accurate awareness of rheumatoid disease (RD) aka rheumatoid arthritis (RA) geared toward the public and medical community; creates ways to empower patients to advocate for improved diagnosis and treatment; and brings recognition and visibility to the RA patient journey. In addition to RA Warrior, she writes periodically for newsletters, magazines, and websites. There are over 60,000 connections of her highly interactive Facebook page. You can also connect with Kelly on Twitter or YouTube, or LinkedIn. She created the hashtag: #rheum. Kelly is a mother of five, longtime home-schooler, NASA enthusiast, and NFL fan. She has lived over fourteen years with unrelenting RD. See also https:/

Leave a Reply

Your email address will not be published.

20 thoughts on “Anxiety and Depression with Chronic Illness

  • August 16, 2010 at 2:46 pm

    Very interesting article. I am seeing a clinical phycologist myself after being refered by my GP.I am finding it very beneficial.

    • August 16, 2010 at 6:59 pm

      I’m glad it’s helping. I saw a counselor for the first two years after diagnosis. I always say I wish she had understood more about RA, but it still helped to deal with the grief & shock of sudden disabilty and prognosis. It’s a very big adjustment from active take-charge life to needing so much help.

  • August 16, 2010 at 5:54 pm

    I for one have indeed had a panic attack. I lost several people in my family in a span of 1 year and we believe it just threw my state into overtime. It took about years worth of xanax, bio feedback training and implementaion & talk therapy to get through it all. Only to find out I am suffering from PTSD brought on by violence in my family when I was 8 years young. I no longer have panic attacks or anxiety but have been dealing with the effects of PTSD. THat coupled with two Auto-Immune Disorders and a host of other issues, it can be tricky staying on the right side of depression. I’ve never dealt with it yet but I have watched others suffer with it. It gives me a helpless feeling for them. I just want to make them feel safe and secure again. I know that sometimes, just listening is all they need. More attention needs to be brought to the depression/anxiety phenom with chronic illnesses. I think the stigma in society far outweighs the actualities of the two issues. People can be very cruel and say horrible things to others and they go unchecked. It doesn’t help those who suffer with it.

    • August 16, 2010 at 7:02 pm

      Tazzy, Thank you for sharing. I’m glad you found a way to work through it. Yes, we need greater awareness – I agree there is too much cruelty & too little understanding.

      • July 29, 2011 at 10:12 am

        Kelly ive been so depressed lately i cant tell you how much. I know i suffer from PTSD but cant do anything about it. I told my rheumy about it and she said Find a Psych. Ive seen them before and they dont help. I have what i call a heart attack at least once a week. It feels like a heart attack! Always starts in my throat and then goes to my chest,back arm etc..the longest one was 20 minutes. It hurts so badley..Ive had 2 heart decaterters tests and its not my heart. Im so worn out with all of this. Ive tried to stay away from your site trying to kid myself that im ok..Doesnt work. Ive had a hard life and this is not fair. But nobody told me life would be fair. Thought after all this time i had found the right medicines to help this but i guess not. Dont have anything positive to say today so thats that. Still so appreciate all that you do. Just having a hard time lately…thanks Kelly

        • July 29, 2011 at 10:54 am

          I’m SO sorry Judi. That sounds so hard. Do they think it is an anxiety attack? Did they give you any medication for that? It is important to rule out heart issues too with RA. The hard part is that the psych doc AND the cardio doc have to know about RA and how it’s affecting you to consider all options & hopefully communicate with your rheum doc too. I’m so sorry you have had so much hardship – if you can find a good counselor who knows what’s going on with your health, it could help you – even if someone you saw before did not help. They are all different, just like patients – they are just people.

  • August 19, 2010 at 11:31 pm

    I am so thankful to have such a caring rheumatologist. I was able to talk to her about some feelings I was experiencing and she recommended I see a counselor immediately. I didn’t realize how deep a pit I had dug myself into until I began sessions. The great thing is that my counselor has given me “coping skills” to help with my daily life and situations and my life is so much better. Don’t ever be embarrassed or afraid to go and talk to someone. I found it much easier to express my fears, etc to someone who wouldn’t “judge” me.

    • August 19, 2010 at 11:46 pm

      Great comments Teresa. Thanks. I’m so glad you took that step. 😀

  • December 1, 2010 at 8:42 am

    Many of us with RA fight depression as a result of chronic pain. I have a mood disorder and I take an antiseizure medication called Lamictal. I have tried to take Enbrel for RA and it interfered with the Lamictal – central nervous system clash of the titans of some sort.

    Has anyone on the website discussed the challenge of how RA meds upset the balance of depression meds that affect the control the nervous system for mood stabilization?

    Mrs. Ramos

  • January 5, 2011 at 11:41 am

    I found myself needing the help of a counselor in the first years of my diagnosis(AS) too. It took me a long time to go through the stages of loss because that is what happens to us. Now that I’ve lived with Ankylosing Spondylitis for many years I’ve accepted it is part of who I am – as much as that is really possible 🙂 I would encourage newly diagnosed people to look for a support group in your local town. The SAA and the Arthritis Foundation offer many groups – and then there is the online support like RA Warrior and others that are invaluable. It will get easier to deal with… Jenna

    • January 5, 2011 at 12:11 pm

      Thanks Jenna. We do have a local support page here and on Facebook that has helped lots of patients to link up.

  • February 25, 2011 at 9:32 am

    I am both a Rheumatoid Arthritis warrior and a Bipolar Disorder type II warrior. I currently blog weekly for BP Hope magazine (Bipolar disorder I & II) plan to cover the topic of how one chronic illness incites the other to create a hamsters wheel of emotional chaos. I face it every single day…Feel free to check it out. I want to use any platform I can to share our struggle. I’m sure many of my RA warriors here are championing both and I send you warm cyber hugs.

  • July 29, 2011 at 6:57 am

    My friend has been suffering from a chronic degenerative autoimmune disorder with no established treatment protocol for the past 8 years. She has severe pain and fatigue caused by peripheral neuropathy. She spent the last year providing hospice care to her mother who recently passed away. She is now deeply depressed and despairing. She is struggling to make it through each day. I live far from her. What can I do? What can she do?

  • September 17, 2012 at 10:37 am

    Hi Kelly its been awhile.. i just found my post from over a year ago talking about my depression and anxiety. Well i still havent done anything about it. The “heart attacks”come more now and hurt worse. I dont know why i wont see someone but i just havnet done it. i think really the pain is from a condition i read about where the muscle tears from the chest bone? I dont know. My husband says,Judi you’ve been doing this for 10 Years! Yeah i know.Still cant make myself do anything about it. oh well..I know im not alone. At the same time i am…

  • April 22, 2013 at 10:17 pm

    I too am so anxious about dying from RA. I read that with or without treatment we die 20 years earlier than average. So nearly every night I go to bed wondering if I will die tonight; I am 61 so am at the 20 year mark for early death. It is so frustrating because no one else seems to understand that sore joints don’t kill us; heart disease does.


  • December 3, 2015 at 6:10 pm

    After 11 years, I think I mostly get frustrated. Took 10 years to accept the fact that I have RD, I guess because I am seronegative. For instance, today I wanted to clean house. I worked until my back, shoulder, and hands were in spasms. Now I will pay and pay dearly. Yes, frustrated is my word of the day. My mind says yes and body says NO! Again, thank you for this site. I pray for you warriors every day. ❤ You make me feel less crazy☺

  • December 9, 2015 at 9:40 pm

    I too have been diagnosed with RA I’ve tried two different times to take the methotrexate injections I am going to go to the pills next week I have had a lot of side effects and I’ve been treated for depression for a long while. I could swear that I’m going through menopause again because now I feel panicky for heat flashes and so many mixed emotions. I do not like the person I have become but some days are better I am relieved that I am not alone in this. My doctor doesn’t take me seriously about needing relief from this my present anti depression medicine is not working

  • March 8, 2017 at 10:59 am

    Very succinct.

  • March 8, 2017 at 7:30 pm

    I loved this article . I have been dx with RA, PsA, probable Lupus and I had a pleural effusion and constant chest pain and chronic shortness of breath. I also have Reaynauds disease . Another dx of fishnet like rash on both legs. On methotrxate and remicade .


Would You Like Free Email Updates?

Stay in touch with RA Warrior.

We respect your privacy. Your email address will never be shared.