Rheumatoid Arthritis: Psychological Implications For The Occupational Therapist Part 1

A person newly diagnosed with rheumatoid arthritis (or any medical conditions for that matter) usually gets shocked, before becoming anxious then settling into a saddened and depressed mood. There is a grief cycle that he or she will go through, as grief for losing a part of themselves, their health and fitness. By the time the person suffering from the disease's progression to reach a stage where operation is required, they would have gotten over the initial shock, but will still be vulnerable to bouts of moodiness, depression and helplessness.

These are common and usual response of people towards having to live with pain and deforming disease. Sometimes, antidepressants are required to manage sleep, loss of weight etc.

The person with the rheumatoid arthritis disease may feel overwhelmed with the disease, but may internalise it and keep it inside themselves. These people need to be encouraged to express their feels, fears, hopes, in order to accurately help them define and manage their fears, regardless if they were perceived or real. An example is if a person feels that they have lost the ability to handle or the physical ability to maintain the joints integrity, they might feel frustrated over the apparent loss of control, but they perceive that they aren't supposed or allowed to be angry as the people around them are already doing their best to make him or her as comfortable as they can.

They may develop body image disorders, or have body image issues as they would have to perceive or wait in fear "when or in case" their joints change in shape, functionally or esthetically. What will couple this is if pain comes into the picture, of if they are placed on steroids, which often cause fluid retention and the effect of weight gain and puffy faces.

The occupational therapist may then create a "safe room" or where the patient with rheumatoid arthritis will be allowed to express their feelings through verbal or written forms of communication, directed or undirected by the trained occupational therapist. They need to be assured and re-assured that the feelings that they have are normal, a part of the the grieving and loss process.

Patients needs to understand that, and to be respected and given the space, chance and ability to grieve over his or her loss (real or perceived) of function, mobility and independence. By this, we can help them to overcome their mobility and functional problems.