Being a teen is tough, and it’s no secret that teens with juvenile arthritis tend to have higher incidences of anxiety, depression, and other mental health problems. Neither is it surprising — it takes a toll to live with chronic, invisible pain, especially at such a young age.
Overlapping symptoms
Something very frustrating is that many signs of depression are similar to typical symptoms of juvenile arthritis (JA), or can be side effects of treatments. It can be hard to pinpoint which symptom is caused by depression and which is caused by JA.
In many cases, it may be a mix of both since it’s not uncommon to feel a drop in mental well-being during a flare or particularly painful time. While these symptoms aren’t the only ones that overlap between JA and depression, they seem to be some of the most common:
1. Unexplained aches and pains
This one goes without saying. You can easily dismiss the aches of depression as the aches of JA and vice versa. The thing to note is that these can go hand in hand: A flare can feel extra painful because you’re depressed.
2. Difficulty concentrating
I’ve written about brain fog time and time again, but it never ceases to amaze me how much it can take over my life during a JA flare. Unfortunately, it can also surface in those experiencing depression. You may see this affect your child’s schoolwork, social life, and even their mannerisms.
3. Loss of interest in hobbies
It’s not uncommon for some hobbies to be put away after the onset of arthritis or during flares. You can’t blame your teen for being unwilling to do an activity that has become painful. Or just putting down an activity they don’t feel they have the energy or concentration for: I crochet like crazy, but the times I stop are when I’m going through a flare and can’t concentrate on counting stitches.
A helpful way to note whether your child dropped a hobby due to arthritis or depression is by trying to find patterns. Which activities get cut during a flare, and to what extent? Maybe she doesn’t go to choir practice when she’s hurting, but still practices at home. But during a depressive episode, she doesn’t practice at all.
4. Change in appetite
Medications and pain levels can play a significant role in your child’s appetite and eating habits. Kids taking prednisone may continuously feel hungry, but kids using certain disease-modifying anti-rheumatic drugs may feel nauseous.
Always keep your child’s treatments and any potential side effects in mind, especially if they just started a new medicine or a steroid burst.
5. Change in sleep habits
JA isn’t just joint pain — it can also cause malaise and fatigue. Unfortunately, depression can also cause these symptoms. As someone who has gone through this, I can attest that it can be difficult to tell whether your fatigue or need for more sleep is due to JA or mental changes. Sometimes, a flare drains you physically and mentally so it’s a bit of both.
It’s challenging to diagnose
It can be hard to pinpoint whether symptoms are JA- or depression-related since so many overlap. But trust your instincts: If you’re truly concerned for your child’s mental health, the best thing you can do is talk to them and get them to a mental health provider who can help. The provider might be able to get a better idea as to what’s going on.
Arthritis and depression can occur simultaneously
Parents, if you take anything away from this column, let it be this: Always acknowledge that your child is going through both physical and mental pain. It is critical not to imply that depression is the source of your child’s illness, or that their pain level would improve if they went to therapy. This can backfire horrifically because your teen will assume that what you are saying is, “You’re causing yourself pain, and it’s all in your head.”
Even if this isn’t how you mean it, there’s a good chance that is how they’ll take it. That’s certainly how it sounded to many of my friends with JA and me when we were teens! It just made the issue worse because we did our best to hide our symptoms. I’m still insecure about bringing up my mental health symptoms as an adult.
It’s OK to talk to your child about depression and how you’re concerned for them. In fact, a lot of teens wish their parents would bring it up! But please acknowledge that they are going through two painful experiences — depression and JA. Flares and bouts of depression go hand in hand.
***
Note: Juvenile Arthritis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Juvenile Arthritis News, or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to juvenile arthritis.