Axial Spondyloarthritis and Mental Health: Understanding the Mental Toll and How to Cope

Disclaimer: You should always consult your healthcare professional before making any changes to your exercise regime, diet or healthcare.

Axial spondyloarthritis (axial SpA) is a type of inflammatory arthritis that affects the spine and sacroiliac joints, often leading to chronic pain and stiffness. However, the emotional and psychological impact of living with axial SpA is often overlooked. Anxiety, depression, and social isolation are common among those living with chronic pain, creating a complex mental health burden that is closely linked to the physical symptoms of axial SpA.

The Link Between Chronic Pain and Mental Health

Research shows a strong connection between chronic pain and mental health conditions like anxiety and depression. According to the NHS, people with long-term health conditions, including axial SpA, are more likely to experience mental health issues due to the constant challenges of managing their illness. A study published in Rheumatology International reports significantly higher rates of depression and anxiety in axial SpA patients compared to the general population.

Living with daily pain, managing fatigue, and dealing with the unpredictability of flare-ups can increase stress levels, leading to a decline in mental well-being. This connection is reinforced by poor sleep, limited mobility, and reduced participation in social or physical activities—all of which can amplify feelings of isolation and hopelessness.

Anxiety and Depression in axial SpA Patients

Studies indicate that 30-50% of patients with axial SpA experience symptoms of depression and anxiety. Chronic pain often fuels anxiety over the future and unpredictability of flare-ups, leading to avoidance of social or physical activities. This reinforces feelings of isolation and exacerbates mental health issues.

Depression is equally prevalent. The frustration and limitations imposed by axial SpA, particularly in younger patients, can diminish self-esteem and create feelings of despair. The inability to engage fully in professional or social life due to fatigue or pain contributes to a decline in mental health, making it critical to address both emotional and physical symptoms simultaneously.

Managing Mental Health in axial SpA: Strategies to Cope

While axial SpA presents significant challenges, there are ways to manage the emotional toll effectively. By adopting proactive strategies, individuals with axial SpA can significantly improve their mental well-being.

1. Seek Professional Help

Cognitive-behavioral therapy (CBT) is a well-established treatment for managing anxiety and depression, particularly in individuals with chronic pain. According to the NHS, CBT can help people adjust negative thought patterns, thus improving their ability to cope with both physical pain and emotional stress.

2. Stay Active

Regular physical activity is essential for managing axial SpA symptoms, and it can also improve mental health. Exercise releases endorphins, which are known to boost mood. Low-impact exercises such as walking, swimming, or yoga can help reduce stiffness and alleviate symptoms of anxiety and depression. Consult your healthcare provider to develop a personalized exercise plan.

3. Practice Mindfulness and Relaxation Techniques

Mindfulness and relaxation techniques have proven effective in reducing stress and improving mental well-being in those with chronic conditions. Mindfulness-based stress reduction (MBSR) programs, in particular, have shown benefits for those with chronic inflammatory diseases, as published in The Journal of Rheumatology.

4. Build a Strong Support Network

A strong support system is crucial for coping with the emotional challenges of living with axial SpA. Family, friends, and support groups can provide encouragement, share experiences, and reduce feelings of isolation. The NHS also recommends seeking out local or online support groups for people living with chronic conditions.

5. Make Healthy Lifestyle Choices

Adopting a healthy lifestyle can significantly improve both physical and mental well-being. A balanced diet, regular sleep, and avoiding harmful habits such as smoking or excessive alcohol consumption can reduce inflammation and improve mood. Research in Arthritis Care & Research has shown that people with inflammatory conditions who make healthy lifestyle choices report lower levels of depression and fatigue.

Conclusion

Axial spondyloarthritis is not only a physical condition but also a mental and emotional challenge. Recognizing and addressing the psychological impact of axial SpA is essential for overall well-being. By employing strategies such as seeking professional help, staying active, practicing mindfulness, building a support network, and making healthy lifestyle choices, individuals with axial SpA can better manage the mental health challenges that accompany this condition.

Taking steps to care for your mental health is just as important as managing the physical symptoms of axial SpA, and with the right tools, you can live a fulfilling life despite the challenges posed by this chronic condition.