Sadness and Frustration With Arthritis Cross Over Into Depression

A Look at Depression Associated With Arthritis

Woman that is beyond sad.
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Sadness is a normal emotion that we all feel at times. It's not the same as depression. When does sadness and frustration, which may be expected to be associated with chronic arthritis, cross over into clinical depression? When are antidepressant medications indicated? When is professional counseling recommended? What can an arthritis patient do to help themselves or recognize that they need help for depression?


Depression is a common problem for people with arthritis and related conditions. The United States National Health and Nutrition study showed that 16% of people with chronic musculoskeletal pain had depression and other studies have shown an incidence of depression as high as:

Young patients with rheumatoid arthritis may be at an increased risk of depression due to an increase in pain and stress.

Sadness or Depression?

There are two questions that may help determine whether sadness and frustration experienced by people who have a chronic illness have crossed over into depression:

(1) During the past month, have you often been bothered by feeling down, depressed or hopeless?

(2) During the past month, have you often been bothered by having little interest or pleasure in doing things?

If the answer is no to both, it is unlikely major depression.

Warning Signs And Symptoms

Even if a patient does not have major depression, it is important to notify your doctor if you have any of the following signs and symptoms including:

  • depressed mood
  • lack of interest or pleasure in your usual activities
  • weight changes
  • sleep disturbances
  • lack of energy
  • excessive guilt
  • poor concentration
  • thoughts of death or suicide

Remember, if you experience any of these signs and symptoms, counseling (social worker, psychologist or psychiatrist) and medication may be needed to get back on track.

More Information

  • Treating Depression Relieves Arthritis Too
  • Conquering Depression
  • Beyond Sadness: Is It Clinical Depression or Sadness?
    Although depression is often thought of being in an extreme state of sadness, there is a vast difference between clinical depression and sadness. Sadness is a normal part of being human, a natural reaction to painful circumstances. All of us will experience sadness at some point in our lives. Depression, however, is a physical illness with many more signs and symptoms than an unhappy mood.
  • Sadness is Not the Same as Depression
    We all feel sad sometimes. Sadness is a normal emotion that can make life more interesting. Sadness almost always accompanies loss. Learn ways to experience normal sadness in a healthy way and to allow this emotion to enrich your life.

Answers provided by Scott J. Zashin, M.D., clinical assistant professor at University of Texas Southwestern Medical School, Division of Rheumatology, in Dallas, Texas. Dr. Zashin is also an attending physician at Presbyterian Hospitals of Dallas and Plano.


Hawley DJ, Wolfe F J Rheumatol 1993;20, NEJM Vol 343 Number 26