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An AS Diagnosis Hurts Emotionally, Too

Doctors have long known that patients with chronic diseases often feel sad and unsupported. They are also aware that these symptoms can lead to depression, and sometimes, self-harm.1 While many clinicians know that these factors that can lead to mood changes, one group of Canadian doctors took the initiative to see if there were numbers to support their idea that patients with rheumatoid arthritis and ankylosing spondylitis are more likely to commit self-harm after their diagnosis compared to patients who are not diagnosed with a chronic illness.1

A sad reality

Researchers found that patients with AS were twice as likely to harm themselves after their diagnosis than a patient who didn’t have a diagnosis of AS. Initially, the data showed that RA patients were also more likely to harm themselves as well, but this data was found to be inaccurate after adjusting for other variables.2

But why?

Patients who have a diagnosis of AS have a 59% increase in incidences of deliberate self-harm, but why? There does appear to be some evidence that patients who have AS are at a greater risk for developing a major depressive disorder.1 This may be in part due to the symptoms of pain and limited sleep that can be brought on by AS.

It may also be due, in part, because of lack of social support. Researchers also believe that patients with AS have access to multiple medications, which may explain why poisoning is the most common form of self-harm in these patients.1 Researchers also believe chronic inflammation may play a part in the role of patient self-harm but are still studying this theory.4

Mental health checks are important

This study highlights the ongoing need for behavioral health checks in patients with long-term chronic pain conditions.1 It also highlights the need for better social and behavioral support for these same patients, as well as many other patients with chronic illnesses. Patients should be monitored for early intervention in depressive episodes and both rheumatologists and primary care physicians should play a part in this monitoring and intervention.4

If you or someone you love seems to be in danger from self-harm, there are immediate resources for you. The National Suicide Prevention Lifeline is available 24 hours a day, 7 days a week, and is not just for those contemplating suicide. They provide resources for patients, caregivers, friends, and family of those who may be suicidal, and will talk to those in distress or in crisis immediately.

You can reach the National Suicide Prevention Lifeline at:

  • 1-800-273-8255 (TALK)

For those who are deaf or hard of hearing you can call:

  • 1-800-799-4889

En Español:

  • 1-888-628-9454

You can also visit the website at https://suicidepreventionlifeline.org for many other resources.

Many people are not comfortable talking on the phone but may prefer to contact help through text or chat.
For text:

  • Text HOME to 741741 for the Crisis Text Line

For chat:

  • www.imalive.org for a 24/7 anonymous chat line

Talk to someone

If you are feeling down, feel like you have the blues, feel unsupported, or even just need to talk to someone, use these lines. You should also have a conversation with your health care team. It is important to let them know how you feel, so they can look at all factors of your illness and find the best way to help you, whether it be a medication change, finding the right person to talk to, or a referral to a social worker who can help you to find resources you need. Don’t hesitate to ask for help. Your behavioral health is as important as your physical health. If you have a friend or family member you can talk to, ask them to join you at your appointments to help you be honest with your caregiver. It sometimes helps to have accountability.

If you are in immediate danger of harming yourself, call 911, or go to the emergency room before you do so. It’s better to get help before you harm yourself than after!

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The AnkylosingSpondylitis.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Freeman S. Ankylosing spondylitis diagnosis linked to self-harm attempts. Mdedge.com. https://www.mdedge.com/psychiatry/article/168286/ankylosing-spondylitis/ankylosing-spondylitis-diagnosis-linked-self-harm. Published 2019. Accessed September 05, 2019.
  2. Kuriya B, Widdifield J, Luo J, Vigod S, Haroon N. OP0296 The risk of deliberate self-harm in rheumatoid arthritis and ankylosing spondylitis: a population-based cohort study. FRIDAY, 15 JUNE 2018. 2018. doi:10.1136/annrheumdis-2018-eular.3004
  3. Risk of Self-Harm Elevated in Patients With Ankylosing Spondylitis. Rheumatology Network. https://www.rheumatologynetwork.com/ankylosing-spondylitis/risk-self-harm-elevated-patients-ankylosing-spondylitis. Published 2019. Accessed September 05, 2019.
  4. Laday J. Patients with AS have 59% increased risk for deliberate self-harm. Healio.com. https://www.healio.com/rheumatology/spondyloarthropathies/news/online/%7Bd69204a7-8adf-4e63-b38e-556e95768d54%7D/patients-with-as-have-59-increased-risk-for-deliberate-self-harm. Published 2019. Accessed September 5, 2019.

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