Is stress a common challenge in your daily life? You’re not alone. According to a recent nationwide poll, eight in 10 American adults say that they grapple with stress either frequently or sometimes. Only a lucky 4% of Americans say they never have stress.
Anything can be stressful. You may feel stress due to problems or challenges in any aspect of your life: your job, finances, family conflicts, even your refrigerator breaking down. Right now, there are other, less personal but powerful stressors: politics, the pandemic’s disruption to our daily lives, the holidays, the turbulent economy.
Rheumatoid arthritis (RA) can be a major source of your stress too. You may be trying to manage your medications and keep up with bills. You deal with pain, morning stiffness and other symptoms. If you take immunosuppressants like most people with RA, you’re on high alert about contracting COVID-19. You may be worried, fearful and simply stressed to the max.
Stress actually sets off inflammation as part of your body’s immune response, also known as the “fight or flight response” and can trigger an RA flare-up. In RA, inflammation may be chronic and cause damage to joints and tissues. Many people with RA say that stress is one of the top triggers of flares, or spikes in disease activity.
Stress affects your immune system and overall mental health. Stress can trigger the release of natural killer cells (NKCs) and other inflammatory agents. People with RA also have high rates of depression and anxiety. RA joint pain and stiffness can put limits on your physical function, so it’s harder to accomplish simple daily tasks like buttoning your shirt, grasping your car’s steering wheel or making a pot of coffee.
Here’s the really important question: What can you do to tame your stress? There are a number of things you can do to manage your stress with RA and improve your quality of life. Find the technique that works for you and fits into your lifestyle.
Visualization and guided imagery. Use the power of your own imagination to control your stress. Visualization exercises, or guided imagery, have been shown to reduce anxiety, and they’re also free or low cost. Anyone can do them. Some experts believe visualization exercises can also lower blood pressure and heart rates, and even ease physical pain.
How to do it: All you have to do is find a quiet time and place, close your eyes, and visualize a calming setting and experience. Pick a mental image that you find soothing: sitting on a beautiful beach, strolling through a path in a leafy forest, lying in a grass field beneath a starry sky. Make time in your schedule for regular visualization exercises—mark this time as “busy” on your calendar so no one disturbs you. If you need help to do these visualization exercises, check out apps, online videos, or books that guide you through the process step by step.
Meditation and relaxation. Meditating is another mental and physical exercise that helps you practice mindfulness, or better awareness of your body and mind. Meditation and relaxation exercises can help you lower stress and learn to cope with RA’s effect on your daily life.
How to do it: You can take a meditation class or work with a therapist to help you develop a mindfulness meditation routine. But here are a few general tips. Find a quiet, comfortable place where you can be alone and undisturbed. Focus on your breathing: just at a normal pace of inhaling and exhaling, not deep or quick breaths. Think about how breath moves through your body and how you feel. Just learning to breathe calmly can help you harness and soothe stress. These steps will help you improve your mindfulness.
Exercise. Physical activities like walking, biking, swimming, golf, gardening and dancing also lower daily stress. Regular aerobic exercise, or any activities that rev up your heartbeat a little bit and make you sweat, not only ease tension, anxiety and stress, but also release endorphins—natural body chemicals that reduce pain and improve your mood.
How to do it: First, speak with your rheumatologist or primary care provider to make sure that any new exercise or fitness activity is safe for your body. Since you have RA, you want to stick to joint-friendly exercises that won’t make your pain worse or risk injury to damaged joints.
Second, make a plan. If you want to do something as simple as walking more often, set specific goals for when you’ll walk, how far and how often.
Third, get started! Try to stick to your exercise plan so you meet your physical activity goals. Find a walking or workout buddy, like a friend, neighbor or family member, to keep you company and stay motivated. It’s easy to skip your exercise if there’s no one to keep you accountable.
Seek support from a mental health professional if you need it. If you feel overwhelmed by your RA or chronic stress, seek help to control it. Let your doctor or nurses know that you are struggling to manage your stress or anxiety. They can refer you to a mental health professional or services in your community. Some therapists and psychologists offer telemedicine services, or remote sessions via private video links due to COVID, so you can get support while socially distancing.
More on your score: Using Vectra® to track your RA disease activity and levels of inflammation can help you and your doctor keep your RA under control. Use the myVectra patient portal to track your daily symptoms and pain so you can have a better conversation with your doctor at your next appointment.
Gallup Poll Social Series: “Eight in 10 Americans Afflicted by Stress.” December 2017.
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Nguyen J and Brymer E. “Nature-Based Guided Imagery as an Intervention for State Anxiety.” Front Psychol. 2018;9:1858.
Khoury B, Lecomte T, Fortin G, et al. “Mindfulness-Based Therapy: A Comprehensive Meta-Analysis.” Clin Psychol Rev. 2013 Aug;33(6):763-771.