Doctors have long observed the link between pain and emotions. “90% of
patients with painful arthritis and rheumatic diseases experience depression,”
says Joel Rutstein, MD, an arthritis specialist and founder of www.ArthritisCentral.com.

“The chronic pain that inhibits the mobility of an arthritis patient, coupled
with not being able to do the activities they once derived pleasure in doing,
puts patients at high risk for depression,” says Dr. Rutstein. “Many patients
feel that others can’t possibly understand what they are going through. It can
put a real strain on personal relationships and affect work performance.”

Dr. Rutstein and colleague, Dr. Nancy Logan, a psychologist, identify 9
symptoms to watch for that may signal a person is clinically depressed. If 5 out
of the 9 symptoms are present, lasting over 2 weeks, the experts suggest you
talk with your doctor.

• Prolonged sadness or irritability that lasts more than 2 weeks
• An increase or decrease in appetite
• Lack of enjoyment of things you used to enjoy, and lack of interest in your
  favorite activities
• Extreme lethargy or the opposite—fidgeting, can’t sit still
• Sleep disorders, either sleeping too much or too little
• Feelings of worthlessness and decreased self-esteem
• Difficulty concentrating and forgetfulness
• Chronic fatigue or decreased energy
• Thoughts of death or suicide

“For patients in chronic pain, their doctors need to treat both the pain and
the emotional changes that occur in order to help the patient to get well.
Otherwise, the circle simply magnifies as the pain reduces a person’s level of
activity, it fuels emotions that let anxiety and depression creep in,” says Dr.
Logan. “It becomes a vicious cycle.”