The Dark Side of Arthritis and Chronic Illness: Combating Depression and Suicide – by Ashley Boynes-Shuck

Sure, I always strive to be happy and live well with illness. I push positivity, and, I’m not alone –  research has shown that a positive attitude and optimistic outlook is beneficial both to your mental AND physical health.

While we should at all times try to live our best lives despite our conditions, the fact remains that there is a “dark side” to chronic illness. My thoughts are that the more we educate people on this not-often-spoken-of part of these diseases, the more we can spread awareness and the more that outsiders can understand the devastation that these conditions have the potential to create.

Two things made me think about writing this blog. First off was the fact that this week is National Invisible Illness Week, and last week was Suicide Prevention Week. The second part of the equation was that an old article was passed along to me discussing a renowned astronaut who killed himself because of his rheumatoid arthritis.

A British study from August 2011, showed that AT LEAST 1-in-10 suicides were linked to chronic illness. However, statistics from the official Invisible Illness Awareness Week Ministry claim that “sadly, physical illness or uncontrollable physical pain are major factors in up to 70% of suicides.”  As for older arthritis patients, millions of seniors ages 65 and older suffer from light to severe depression, and some symptoms include loss of a sense of self worth and fixations on death or suicide.

According to Johns Hopkins, “of patients with chronic pain referred for evaluation to comprehensive pain programs, 8-50% have been reported to have current major depression (Smith 1992)” A severe and morbid potential consequence of major depression is, unfortunately, suicide. Sadly, a 2003 Oxford University Rheumatology study showed the following: “Females were significantly over-represented among RA patients who committed suicide (52.6% RA women vs 17.3% women with neither RA nor OA). Comorbid depressive disorders preceded suicides in 90% of the female RA patients. Before their suicide, 50% of the female RA patients (vs 11% of the male RA patients) had experienced at least one suicide attempt. The method of suicide was violent in 90% of the RA females. RA males were less often depressive, but committed suicide after experiencing shorter periods of RA and fewer admissions than females. Conclusion Attempted suicides and especially depression in female RA patients should be taken more seriously into account than previously in clinical work.”

It is even documented that the controversial “Dr. Death” a.k.a. Jack Kevorkian assisted in the suicides of both rheumatoid arthritis and fibromyalgia patients. Two examples: On March 5th of 1998, he assisted with the suicide (or, as he called it, “mercy killing”) of a 61-year-old RA patient. On the very same day, he dropped off a deceased 42-year-old man at a hospital who he had “assisted” and who had Fibromyalgia.

In 2006, American physicist and NASA astronaut Charles E. Brady, Jr. took his own life. Brady’s death was the result of suicide. As his death was announced to the public, many reports stated that he had died after a lengthy illness (severe pain and paralysis from his rheumatoid arthritis) and other sources speculated that Brady’s decision to take his own life might have been brought on by his chronic pain and diminished mobility, which is supported by NASA internal emails related to Brady that  have been released.

Both rheumatoid arthritis and fibromyalgia are painful, chronic conditions that can wreak havoc on one’s quality of life. It should not, however, be a reason to end one’s life!!!! You can still live a great, happy, FULL life even with chronic pain or a disability.

That being said, loved ones, caregivers, and doctors should be very aware that physical illness most definitely increases the risk of mental health problems and vice versa. Researchers say patients with chronic conditions “should be considered a high- risk group for suicide within national policy, and much greater attention should be given to providing better medical, practical and psychological support to these patients.”

Dr. Jo Ferns says, “People with chronic conditions might not be suicidal, but perhaps could be apathetic about living or dying. They are not saying they will kill themselves, but are making decisions that do increase the risks of dying. I think that’s what we have to watch for.”

Listen, rheum mates and spoonie friends: You may feel that you can’t go on another moment, another day. The pain may be unbearable. BUT….there’s always hope, there’s always light at the end of the tunnel, there are always ways that you can make your  life better, even when it seems that you cannot go on any longer. You have value in this world, people who love you – even if you don’t know it – and there are always resources for support if you want it. Reach out – talk to someone! Whether it is a counselor, friend, psychologist, psychiatrist, rheumatologist, sibling, spouse, parent, teacher, family member, minister, priest, suicide hotline, online support group, a Twitter pal, a Facebook friend, your journal, or whatever God you pray to – get those feelings out! There are many things in this world to be grateful for. If your pain is unbearable, talk with your doctor, and keep trying out new options until you find something that provides you with at least some relief! If the pain is deeper than just the physical side of it, there is no shame in talking to a professional about what you are going through. Sadly, you’re not alone. Many of us can relate to what you are going through when dealing with these illnesses. Together, we can cope, and we can stay optimistic, and push on through! “You are braver than you think, and stronger than you know!” Also, just remember, that no matter how bad your pain, there are people who would  love, or who would have, given the chance , loved to be in your shoes.

If you are contemplating suicide PLEASE talk to someone before it is too late. Arthritis and chronic illness do not have to ruin your life!

Some resources:

The National Suicide Prevention Hotline: 1.800.273.8255 – suicidehotlines.com

To Write Love on Her Arms – http://www.twloha.com, or @TWLOHA on Twitter.

Also – in 2009, the Arthritis Foundation & Arthritis Today Magazine released a list of 3 Fibromyalgia drugs and a stunning 20 other medications that lead to increased suicide risk. Read the article by clicking here.

It can get overwhelming and frustrating to know that you may live with these conditions for the rest of your life, but you are NOT alone. Remember that bravery is a great weapon against arthritis.

Stay well,

Ashley Boynes-Shuck

What’s YOUR weapon against arthritis?

Follow us on Twitter @MidAtlanticAF!

“Like” us on Facebook here!

23 thoughts on “The Dark Side of Arthritis and Chronic Illness: Combating Depression and Suicide – by Ashley Boynes-Shuck

  1. Wow, who ever wrote this has never really experienced true chronic pain. I have a condition that studies have shown pain can be at the level of late stage cancer pain. I’ve met two other women with my disorder who can are cancer survivors, both described the cancer ordeal far less painful then then the disorder we share. So to trivializing chronic (severe) pain…You can “have a great, happy, FULL life”…. Is pretty offensive and depressing. This isn’t a site I would recommend for anyone with sever chronic pain.

    • Dear Val, First, I apologize for the way you feel. But, actually, the person who wrote this has suffered with severe chronic pain since the age of 10 (polyarticular rheumatoid arthritis), and has since developed osteoarthritis, drug-induced lupus, and palindromic rheumatism, and at one point suffered disabling systemic migraines. She also lives with gastrointestinal problems AND has undergone brain surgery, and was hospitalized twice last month. So, I’d say she knows a thing or two about chronic pain & illness, and how debilitating both can be. I know this because I am her. I make a CHOICE to live a HAPPY FULL LIFE. Does that mean I am pain-free? No. Does it mean I am healthy? No. It’s all about perspective, though. It just means that I’ve learned to live and thrive despite being chronically ill. I choose to live well with illness. It took me years to get to that point — I used to get pretty down about my health situation — but I decided to focus on things I’m grateful for, and the good things that I do have in my life (of which there are many) instead of focusing on the pain and sickness. I know people, too, with cancer and with rheumatic diseases and with other chronic pain conditions — some choose to have a negative outlook and some choose to have a positive outlook — just as healthy people do. I’m sorry you disagree with the site but thousands of others have applauded my attitude, and have agreed with what I have written. I have devoted my adult life to advocating for rheumatic diseases, autoimmune conditions, and other chronic illnesses and pain disorders, so please don’t tell me I’m trivializing life with pain. I don’t remember a life before pain and yet I choose to LIVE ON in spite of it instead of dwelling in it. Your comment was very presumptuous and hurtful. Remember you should never judge someone until you’ve walked in their shoes. And since I live by that rule, I won’t judge you for you had know way of knowing all I’ve gone through. I hope that, even if you cannot find relief from pain, that you find happiness within yourself, and if you are suffering depression or suicidal thoughts, that you please talk to someone and seek help. I respect your opinion, though, and I do thank you for reading. None of my posts are ever meant to offend, but your comment also offended me. – Ashley Boynes-Shuck a.k.a “Arthritis Ashley”

      PS

      Also please know that I noted how serious of a topic this blog post was, and I thought that I handled it with delicacy, respect, and sensitivity, but from an optimistic standpoint. How that is offensive — when it has been scientifically and medically proven that a positive mindset can help physical symptoms – is lost on me. I am sorry that you feel that way. Please note, too, that my personal views on this topic are not necessarily that of the Arthritis Foundation. I wish you the best. – Ashley

    • I don’t think Ashley was trivializing anything – she’s just trying to get the point across that being happy and being pain-free are not the same thing.

      You sound very angry & upset – there are resources out there for you, where you can turn to for support. Everyone has bad times where everything seems like it’s just not worth it, but to be like all the time is bad for your health – emotionally & physically. I hope you can find it in you to feel better mentally Val. Good luck.

    • I have to agree with you, Val.. I’m reading this article now because I have RA and am at a point of pain I never thought could exist. All this rosy bright talk about it’s not that bad – batter days to come. BS.

      • Sorry you feel that way. I certainly did not say “it’s not that bad.” I used to think like you, though, and I wasn’t on a path to healing until I changed that mindset. And before you decide to make an ignorant remark about my condition, let me share with you that I’ve lived with autoimmune arthritis (RA) since age 10, also have osteoarthritis, Lupus (SLE), Sjogren’s Syndrome, Mixed Connective Tissue Disease, refractory celiac disease, fibromyalgia, chronic migraine, and Chiari malformation for which I had brain surgery. So, I know a thing or two about pain — and I stand by my remarks that a positive attitude is half the battle. It may not “cure” you but it DEFINITELY can’t hurt and is healthier than constantly looking at everything in a negative light. Good luck and I truly wish you the best. What’s BS is insulting people whom you know nothing about. It’s one thing to disagree; and another to be nasty about it. A quote I read recently is just because you are sick doesn’t give you the right to be mean. So true. – Ashley

  2. Ashley would never trivialize chronic pain. I have followed her for several years now and she is an amazing young lady advocating for all of us. She is one of us, She has lived in pain and thru many health issues. Her positive outlook is inspirational and I thank her for sharing her stories.

  3. Val,

    I have to agree with all of the other responses but especially with Melissa above me when she said this;

    “You sound very angry & upset – there are resources out there for you, where you can turn to for support. Everyone has bad times where everything seems like it’s just not worth it, but to be like all the time is bad for your health – emotionally & physically. I hope you can find it in you to feel better mentally Val. Good luck.”

    I am a firm believer that how you approach your illness, how you approach your life, has tremendous effects on your illness. I have lived with RA and Fibromyalgia for over 5 years now and have proven over and over in my own life that the more stress I am under, the more quickly a flare will come on. I have also seen that the more I allow anger or the “why me?” or the more I wallow in my pain, the more it consumes my whole life. The more negativity I allow in my life, the “worse” my pain and limitations seem.

    Ashley is 100% correct. The opposite of negativity can make a huge difference. Positivity, gratitude, and making the decision to live your very best life can work wonders. Plainly speaking, when you are concentrating on all that you are blessed with in your life, you just don’t have time to wallow in your misery.

    You can choose to be miserable if you want, that’s your right. You can choose to allow your illness to consume you. You can “suffer from” and make everyone else in your life suffer right along with you. Negativity feeds on itself and pretty soon it can have and effect on every aspect of your life.

    As for me? I chose to “live with” my illnesses not “suffer from” them. I choose to make it just a part of my life, not be who I am. I choose to take back the power and not let the illnesses control my every thought and action. I choose to concentrate on all that is terrific in my life, all I have been blessed with, not how poorly I feel today or what I cannot do any longer. We only get one chance at this life; I choose to live it and make it the very best life it can be. One way to do that is to choose to surround myself with other people, like Ashley, who are also living from a positive place because just like negativity, positive thoughts and actions feed upon themselves. It’s the old law of Karma- you get out of life what you put into it.

    • Thankyou Jules for your words that I really needed to hear. The pain is particularly bad today as we go in to winter and it has been really difficult. The burning in my hands knees, elbows and feet kept me awake for most of the night and even today I was not able to sleep.
      Since reading your words I realize I really am very lucky to have a wonderful husband, child and family and friends. Tomorrow will be another day and hopefully with a a bit more sleep, everything will look better in the morning.
      One thing I do know is that distraction is my best weapon against this war. Whether it’s seeing a movie, going for a walk with my dogs or having a coffee with friends. To forget, even for half an hour does help.
      Hang in there Val, I hear you and wish you well

  4. Great article, but I have been living w/ a chronic illness since I was a child and am now over 40 and I must add that there are other stressors in addition to chronic pain associated w/ a life long illness that can lead to depression and suicide…….(e.g. loss of work; financial insecurity due to loss of work, medical bills/expenses; inablility to build a nest egg; isolation, hopelessness). Not knowing when the next major episode with the condition will occur can lead to inability to effectively plan your life which in turn can lead to less hope/confidence in the future. In addition, isolation or loneliness b/c of the disability. Lets face it, we live in a country that is obsessed w/ physical appearance…studies reveal physical appearance affects how we are evaluated by others. Many people don’t want to date a person w/ a disability(I’ve had guys not want to date me b/c of my condition).
    , so this can also lead to feelings of loneliness and lack of self worth, feelings of being unloveable , which can also lead to depressive symptoms.There are also other factors than just the pain to deal with that can lead to depression and suicidal thinking…these are just a few.

  5. You state the following: ” Both rheumatoid arthritis and fibromyalgia are painful, chronic conditions that can wreak havoc on one’s quality of life. It should not, however, be a reason to end one’s life!!!! You can still live a great, happy, FULL life even with chronic pain or a disability…”

    How could you have a happy “full” life while you are sleeping awaking and breathing pain? How could you have a “happy & full life” if the quality of life has been severely subverted by the slowly bur progressive immobility… I am -basically my soul .. awareness and consciousness is- trapped in this burning hot and restrictive fleshy case that my body has become?!

    I just want to escape this torment chamber, but I know it simply means death..

    Thankfully I am faithful and come from a faith that particularly frowns at suicide and promises an eternal unabated torment form which there is no escape, there is no death in it nor can one live with!… Having had a first hand glimpse of this imagery, no thanks to my chronic ailment… I can pretty much relate to the concept..

    So I bide my time till my time comes… Can’t help but wishing I had never been born..

    • Please see the comment threads below.

      I’m sorry that you’re so bad off.

      Have you tried counseling? It sounds as though you should reach out to someone.

      Thanks for reading.

      Ashley

  6. I agree that chronic pain with comorbid depression can and should be treated, but to claim someone is mentally unstable because they choose suicide is a logical fallacy. If someone has lived with severe, chronic, unrelenting pain long enough to have exhausted all treatment options, then it’s their right to be able to make the choice to end it on their own terms. I think that unless you experience this too versus the typical chronic pain that waxes and wanes, you should respect the decisions of the people who do know this life. To not do so is self-righteous and judgemental, not positive and uplifting (not that I think ill of your motives). And even if you can relate because you experience this too, it’s still a logical fallacy as I mentioned earlier. You’re assuming that this is a black and white, right or wrong situation when it’s really not. For you, being positive and making the best of the life you have may be right, but for someone else, it may not be the right choice. It all depends on ones values and preferences as not everyone shares the same ones.

    • I respect your opinion, there is a such thing as medical suicide and medically assisted euthanasia but it is far off from being a common practice in the United States and is more than scrutinized as part of a moral and ethical debate. “Mercy killing” certainly isn’t mainstream, or encouraged!

      I take offense to you claiming that anything I said was a logical fallacy. I do my research, and, I am not a dumb person. Studies have shown that over 90% of people who die from suicide have one or more psychiatric disorders at the time of their death….so how is what I wrote illogical in any way?

      I’d also like to share this with you:

      “Tragically, suicide is a fatal response to a treatable illness, usually depression.” ~ Douglas Jacobs, MD, President & CEO, Screening for Mental Health and Associate Clinical Professor of Psychiatry, Harvard Medical School.

      I didn’t say to feel frustrated and depressed from being in pain or sick was a “wrong” response. I never claimed that it was a black & white issue, either. Please do not put words in my mouth.

      Of course it’s a person’s right to choose to end their life (well, if they aren’t religious; many religions believe otherwise, but that is neither here nor there..)….but just because they have that right, it doesn’t MAKE it “right.”

      Most doctors would disagree with you that my point of view is a “logical fallacy.” Suicide is almost always associated with mental illness or emotional instability. I do not write solely based on my opinion. That would be irresponsible. I could cite a plethora of reputable articles that would agree with the idea that suicide is usually the response to mental duress, or emotional/mental problems. The quote above — from a pretty reliable source, I’d say — is just one of many.

      Let’s agree to disagree on this one — but remember that I never once in this article or in the comments followed it said that anyone’s perspective or personal feeling is “wrong.” Everyone is entitled to their feelings!

      That being said, I do, however, believe that it would be wrong to condone suicide. I don’t think that there is any “logical fallacy” there. (In fact, quite the opposite.) Sorry if you don’t agree with me; there is always the choice to not follow the blog if it is offensive to you or anyone else.

      I do my best to encourage people to live their lives to their fullest and thrive in spite of illness.

      I know sickness and pain myself, but I know, too, that the severity of everyone’s illness and the response to that illness differs. Even the same condition in the same person can wax and wane throughout the course of their own lives.

      But, if you follow my blog posts, and follow me on social media outlets, you know that all I want is the best for everyone and to encourage people!! … (I just don’t think that “suicide” falls into that category…)

      Thanks nonetheless for reading and participating.

      – Ashley

  7. “You can still live a great, happy, FULL life even with chronic pain”

    A great many people in fact cannot. You do not get used to chronic pain and it can completely remove any desire to continue, just as constant nausea would. Suicide is a completely rational choice under these circumstances.

    • While some people think they cannot, they can. It just isn’t easy. That’s for sure! And we all have dark days. BUT – making the most of one’s life despite circumstances IS a choice and all in how you view it. A “full life” means different things to different people. I, and many others, have gotten used to chronic pain and illness, and live a very full, happy life despite it. I made the choice to do so. It isn’t a choice everyone wants to make. However – suicide is not an option that is encouraged and should never be promoted as “rational.” If you or someone you know is battling suicidal thoughts, *PLEASE* call the Suicide Prevention Hotline at 1-800-273-8255! It sounds as though you could use someone to talk to. Please do.

      • “While some people think they cannot, they can”. This is special pleading and in fact wishful thinking. In fact, many cannot and it is not always a matter of choice. A life can be destroyed before it is over. You cannot speak for anyone else except yourself.

        You say suicide”should never be promoted as rational”. Why not if that’s the truth? Again, special pleading. There are many circumstances were it is the only rational option, unlike the leading of any kind of “full” life, which , in those same circumstances, would simply not be possible let alone a choice. A civilisation respects property rights in one’s own body, including the right to destroy it. This right exists whether it is respected or not.

      • You’re entitled to your opinion; I’m entitled to mine. Thanks for sharing your thoughts; we will agree to respectfully disagree. I can speak for a lot of people as I communicate with arthritis patients and others with chronic illness daily. But you are correct – I can’t speak for everyone and clearly some folks have vastly different mindsets. To each their own :) My way of thinking has fared me better than any other – I hope yours does the same for you. Be well.

  8. What if your pain is so severe that u cannot sleep, are allergic to opiates AND medical marijuana, burnt a hole in ur stomach with NSAIDS, lost ur appetite, are kept awake every night with severe pain and hot/cold flashes, when u can sleep it’s only for an hour or so in one position on ur back because turning on either side or ur stomach creates more pain, must try to sleep on a hard surface only because you discovered years ago that any mattress further throws out ur back. If u are consistently sleep deprived in pain, is this not a slow torturous death in and of itself due to the sheer gradual onset of secondary physiological problems (ie irregular heartbeat) that will ultimately kill you anyway? Please tell how one can live a full life under these circumstances.

  9. Dear Jonathan, I’m truly so sorry to hear that you are dealing with all of that. That’s sure a lot for anyone to handle. Unfortunately sometimes our symptoms & side effects are not our choice, and the lives we lead may be difficult. However, our attitude IS always our choice. Only we control that. I personally know people who live or have lived with ALS, cancer, etc. who have the most beautiful outlooks on life, whereas I know people with much lesser diseases who are much worse off because they get in their own way. You and everyone are entitled to feel however you feel about your health and your life, physically and mentally, healthy or not. All I’m saying is that it isn’t always black and white. Sick or disabled doesn’t have to automatically equal a crappy life. On the flip side, healthy doesn’t always equal a happy life. And terms like “full,” “thriving,” “happy,” “healthy,” etc. are all relative and open to interpretation. My definition may be different than yours and vice versa. I just want to let people know that, until a condition comes with a death sentence, it isn’t one, and even if it does become terminal, one can choose to make the best of the life they have, if they want to. Physical pain and mental agony don’t have to be mutually exclusive, and that’s just my opinion. Thank you for sharing yours, and I will pray for your healing and comfort. Take care of yourself as best you can, and thank you for sharing your story.

  10. Ashley,
    I have been following you for a few years. I appreciate this blog as I have been at the bottom. I have RA, I am married with 2 kids, had a very promising career and had the worst flair of my life. I haven’t worked for 4 years now because of the RA. I have tried every pill, injectable, infusion, which some came with severe side effects , including my lungs closing, and I had to be on oxygen for a few months. I’ve had double knee replacement, now have terrible back pain. I have taken NSAIDS like Jonathon, until my stomach couldn’t handle anymore. I don’t sleep without taking clonazepam. I have had periods of depression, anxiety, and felt worthless. The only thing I have control of is my attitude. I choose to wake up and be happy, I choose to do whatever I can to make myself better. I choose to try to keep my body moving, which includes swimming. I have surrounded myself with positive people, and every time I feel sorry for myself I think of so many who have it worse than I do. I am active in my community, and currently am helping Gold Star Parents who have lost a son or daughter in the military. You are an inspiration to so many ! Keep the faith and keep fighting, your words encourage more then you know :)

  11. Hello all. There are plenty of powerful words being spoken on here and I REALLY needed to hear it. I have quickly progressing RA and am really struggling with constant pain.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s