Mental Health is just as important as physical health. Addressing anxiety and depression in people with arthritis


“I remember it was in 2015, a year before I was diagnosed. I was complaining to myself a lot about my back. But always shrugged it off,” Chris Pudlak tells us. The following year, Chris received a diagnosis of ankylosing spondylitis (AS).

The father of three who had always been active was taken by surprise when told that his back problems would never go away. His rheumatologist explained that ankylosing spondylitis is not something you die from, but is something you die with. “Upon hearing that, I broke down and cried.” Chris shares.

Ankylosing spondylitis is a type of inflammatory arthritis that affects the spine and the sacroiliac joints that attach the pelvis to the base of the spine. ‘Ankylosing’ means fusing and ‘spondylitis’ means inflammation of the spine. The inflammation caused by AS contributes to severe chronic pain and discomfort. Ankylosing spondylitis is also an autoimmune disease, causing the body’s own immune system to attack healthy tissue.

AS can also make you sensitive to light and increases fatigue. What’s more, in some severe cases ankylosing spondylitis attacks your spine in a way that the bone erodes, causing the body to try and repair the area itself by fusing the spine, thus leaving the back stiff and inflexible. It is estimated that 300,000 Canadians live with AS and while it affects both men and women, the occurrence rate is higher in men and that spinal changes and inflammation also happen faster in men.

Learning to live with his disease has not been without its challenges and there have been days that Chris needed to be focused on his wellbeing. “I remember saying to myself, ‘9 times I fall down, and 9 times I must get back up again. It was a lot about my mental attitude and more than just seeing myself get better, I had to create that image in my mind and turn it into my reality.” Chris says.

According to Dr. Mary De Vera, research scientist at Arthritis Research Canada, there has been an increase of depression and anxiety in people with ankylosing spondylitis. Dr. De Vera’s study to learn more about this issue is actually the first part of a larger study addressing mental health in arthritis, called MATTERS.

Due to the pain and disability associated with arthritis, research has historically focused on the physical aspects of the disease. “There is evidence that shows a connection with depression and mental health because of the inflammation caused by arthritis,” De Vera said. “We know now that by the time people are diagnosed with arthritis, there is already a high percentage struggling with depression, and those who don’t have depression, are at a much higher risk of developing it.”

As noted above, AS occurs most often in men and that generally men are less likely to talk about their mental health makes this area of study all the more crucial.

“It is just as important to pay attention to one’s mental health symptoms as it is the physical symptoms,” De Vera added. “Patients need to monitor all symptoms to allow for early intervention and proper care.”

For Chris, it took months before he started noticing any changes. He journaled his experiences, alongside his medications, taking notes of the diets he tried, what foods worked and which ones didn’t, and the different kinds of exercise plans he tried. Now, Chris helps to keep his mental health in check by cycling to work, swimming four times a week, and generally staying physically active. He also has a great support system and knows that they will always be there when he needs them.

Like many members of the Arthritis Research Canada – Arthritis Patient Advisory Board (APAB), Chris joined because he wanted to help others by sharing what he has learned. “It’s been a good experience. Everyone is always very friendly and has a fairly high level of knowledge about their form of arthritis,” Chris says. “It’s not a support group, but it’s very supportive to hear how others are facing the same or similar problems and how they are coping.”

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