Resource Depression and rheumatoid arthritis Depression is more common in people with RA than in the general public. People sometimes say they feel depressed when they really mean they feel a bit low. There is a difference, so how do you know if this may be depression? Print At a glance Everyone experiences periods of low mood. When this feeling occurs regularly, for a long period of time, this could be depression. Signs of depression A change in appetite or change in weight Sleeping too much or not sleeping enough, especially if you wake early Restlessness or feeling slowed down Fatigue or loss of energy Feeling guilty or feeling worthless Being unable to concentrate or being unable to make a decision Thinking about suicide. People with depression often experience: Negative thoughts about themselves and the future Self-criticism, low self-esteem and low self-confidence Seeing other people as critical or mean Focusing too much on negative thoughts and events A lack of willingness to try things that might help Thinking about suicide as a possible way out (in worse cases) If you recognise these symptoms in yourself, consider speaking to your GP. You can also contact The Samaritans (available 24 hours per day) for emotional support. A GP may refer you to a psychologist or counsellor. You can contact these services yourself through private healthcare. Treatment Psychological treatments such as CBT and counselling tend to be the first line of treatment for mild depression. If these are not effective enough alone, your doctor may suggest a course of anti-depressants. Often, changing your behaviour is one of the first steps to improving your mood. The important things to remember are that depression is treatable, and that you can get help. The first steps you need to take are to recognise the symptoms and to find someone to talk to. Did you find this article helpful? Total likes: 0 If you feel low in mood, hopeless and have lost interest in activities you used to enjoy, this may be depression. Think about how long you have felt this way and how often the feeling lasts. Does it last most of the day? Every day? For at least two weeks in the past month? If so, you may be suffering from depression. The important signs to look out for are: A change in appetite or change in weight Sleeping too much or not sleeping enough, especially if you wake early Restlessness or feeling slowed down Fatigue or loss of energy Feeling guilty or feeling worthless Being unable to concentrate or being unable to make a decision Thinking about suicide. Some of these symptoms, such as fatigue, changes to weight, appetite and sleep may be down to your RA. They may feel worse now, or harder to cope with, so it is important to talk this through with your GP or rheumatology team. People with depression often experience: Negative thoughts about themselves and the future Self-criticism, low self-esteem and low self-confidence Seeing other people as critical or mean Focusing too much on negative thoughts and events A lack of willingness to try things that might help Thinking about suicide as a possible way out (in worse cases) For me, depression goes with fatigue. When I feel it coming on I try to give myself an easier time and plan some positive things like lunch with friends or a trip to the theatre. If you recognise these symptoms in yourself, consider speaking to your GP. It could be that friends and family notice changes in your behaviour before you do. You do not have to face this alone. You can also contact your rheumatology helpline if you have one. The NRAS Helpline cannot provide counselling but can offer information and support. You can also contact The Samaritans, available 24 hours a day. If you would prefer to speak to someone that you know, reach out to someone you trust. Anti-depressants would not usually be the first treatment for mild depression. NICE guidelines (see NICE guideline CG91) recommend trying other options first in most cases. Psychological treatments such as problem-solving therapy and counselling can be very effective. If these measures work well for you, you may not need to take anti-depressants. If your doctor does recommend medication for your depression, they will discuss this with you. Talk to them about why they think it will help, how long you will be taking them for and what to expect. Anti-depressants can be a very useful part of therapy. Think of your depression as a brick wall in front of you. Medication is like a box to stand on. It will not take the wall down but it will help you to see over it. If your GP recommends counselling, they can refer you to a local service. Counselling varies depending on your needs. You can usually expect to see the psychologist for a few weeks for about an hour each time. You’ll spend some time getting to know the person you are seeing and agreeing what you will work on. Some forms of counselling, such as cognitive behavioural therapy (CBT), focus on links between thoughts, behaviour, emotions and physical symptoms. It can teach you how to break unhelpful cycles. Your GP might also refer you to a local service that offers group-based therapy. This may include doing gentle movement or a computer-based CBT programme. You can also contact a counsellor or psychologist yourself. Some work privately, although some take referrals from GPs and health insurance companies. You can find a qualified therapist through the following websites: British Psychological Society website www.bps.org.uk British Association for Counselling and Psychotherapy www.bacp.co.uk Psychology Today www.psychologytoday.com It is worth asking how much services are likely to cost. Some counsellors and therapists negotiate fees depending on income. A counsellor will also work with you on learning how to make positive plans and set goals. If you are experiencing anxiety, they may want to help you manage this first, as this can reduce feelings of depression. Often, changing your behaviour is one of the first steps to improving your mood. They can also help you with talking to your family, helping to make sure you have emotional support. The important things to remember are that depression is treatable, and that you can get help. The first steps you need to take are to recognise the symptoms and to find someone to talk to. Updated: 03/09/2025 Next review: 03/06/2028
At a glance Everyone experiences periods of low mood. When this feeling occurs regularly, for a long period of time, this could be depression. Signs of depression A change in appetite or change in weight Sleeping too much or not sleeping enough, especially if you wake early Restlessness or feeling slowed down Fatigue or loss of energy Feeling guilty or feeling worthless Being unable to concentrate or being unable to make a decision Thinking about suicide. People with depression often experience: Negative thoughts about themselves and the future Self-criticism, low self-esteem and low self-confidence Seeing other people as critical or mean Focusing too much on negative thoughts and events A lack of willingness to try things that might help Thinking about suicide as a possible way out (in worse cases) If you recognise these symptoms in yourself, consider speaking to your GP. You can also contact The Samaritans (available 24 hours per day) for emotional support. A GP may refer you to a psychologist or counsellor. You can contact these services yourself through private healthcare. Treatment Psychological treatments such as CBT and counselling tend to be the first line of treatment for mild depression. If these are not effective enough alone, your doctor may suggest a course of anti-depressants. Often, changing your behaviour is one of the first steps to improving your mood. The important things to remember are that depression is treatable, and that you can get help. The first steps you need to take are to recognise the symptoms and to find someone to talk to.