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Feelings and emotions

Being in pain and having a chronic health condition like arthritis can sometimes lead to low mood and frustration. These feelings are natural, common and understandable.

You may feel isolated and feel like you struggle to keep up with your friends or your work when you’re feeling unwell, in pain or have hospital appointments.

Sometimes friends and teachers might not understand any difficulties you experience because symptoms like pain can be ‘hidden’.

You may feel guilty that you need to rely on other people for help and support from time to time.

It's important to remember there are lots of other young people with arthritis – it’s estimated there are about 16,000 young people in the UK with JIA.

Many people who had arthritis when they were young have had successful and happy lives. They've started families and done well in their careers.

Everyone relies on friends an family for support when growing up.

While arthritis has lots of challenges, it’s nothing to be ashamed of. There are positive steps you can take to help yourself feel better.

Staying healthy

Exercise is very important for your overall health and well-being, and can also help you to manage your condition. When you exercise it releases hormones called endorphins in your body, which can help you feel physically and emotionally better.

Exercise can also improve your self-esteem. Exercising with friends, or meeting new friends through exercise, can also help your self-esteem and your mood. If your arthritis is active, swimming may be good as it doesn't put strain on your joints.

If you haven’t already, talk to your healthcare team about setting up a specific exercise programme of things you enjoy.

Having a balanced, varied and nutritional diet, which is low in fat and has a healthy mixture of the main food groups, is good for your overall health and well-being. Getting five portions of fruit and vegetables a day is important.

An unhealthy diet, with a high intake of saturated fat, refined carbohydrates and processed food, has been consistently linked with poor mental health.

Exercising and having a healthy diet might not immediately take away the pain, frustration or sadness you might be feeling, but they can improve your health and sense of well-being. This in turn can help you sleep better and help you feel more able to cope with challenges and life in general.

Do something you enjoy

It can help if, each day, you manage at least one activity to give you a sense of enjoyment and at least one activity to give you a sense of achievement. These activities don't have to be big or time-consuming.

Talk about it

It’s important you talk to someone you can trust if you’re feeling worried. This can help you make sense of how you’re feeling and often leads to finding solutions or ways forward. Keeping your concerns to yourself may lead you to feel overwhelmed.

If you, or your family, are concerned about your mood being low, it’s important to get help as soon as you can, by visiting your GP or speaking to your healthcare team.

Try to remember you’re not alone, and there are plenty of people who want to help you.

Psychological services

Some paediatric and adolescent rheumatology departments have a psychological service. Some of the issues these services help young people with include:

  • coping with difficulties around procedures like blood tests, injections and scans
  • adjusting to a new diagnosis or treatment
  • coping with symptoms which interfere with life, such as reduced mobility and pain
  • finding ways to deal with the questions/reactions of others
  • helping others to understand your condition and its impact
  • dealing with worries of any kind, but commonly worries about keeping up with your peers, concerns about the future and fears about not making the most of life.

Four of the main therapies often used by psychologists are:

  • cognitive behavioural therapy (CBT)
  • mindfulness-based stress reduction (MBSR)
  • acceptance and commitment therapy (ACT)
  • psychodynamic therapy.

Some therapy sessions can involve the whole family or family members, so you and your family can have some time to talk about what’s going on. These are all called talking therapies.

If you’re interested in any of these theories and therapies, ask your rheumatology nurse or consultant if it’s possible to be referred to a psychologist.

Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) is a combination of talking about difficulties and finding different ways to think about them.

One of the aims is to reach an understanding of how you can become affected by vicious circles of interconnected thoughts, feelings, physical sensations and actions about a particular difficulty.

Mindfulness-based stress reduction

Mindfulness-based stress reduction (MBSR) uses meditation-type exercises, sometimes yoga and various mind-body exercises, to help cope with worries and tension. It’s often used as help for pain.

Mindfulness teaches you to pay attention and focus on the present moment.

Acceptance and commitment therapy

Acceptance and commitment therapy, or ACT, is about finding ways to accept things that feel out of your control. At the same time it helps you to make choices and take actions to improve your quality of life, based on what’s most important to you.

Psychodynamic therapy

With this therapy, you're encouraged to talk freely to the therapist – often simply the first things that come to mind, rather than attempting to shape ideas before they’re said.

There's no need for your thoughts and feelings to be shared in a chronological or linear way, but more in a spontaneous manner without any worry about whether what you're saying is painful, illogical or sounds silly.

If you’re interested in any of these theories and therapies, ask your rheumatology nurse or consultant if it’s possible to be referred to a psychologist.


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