Don't Blame Yourself for Your Arthritis

By Michele Cohen Marill

Some days arthritis simply won’t let you keep up with house chores, or go to a friend’s party, or pretend that everything is fine when it really isn’t. If that makes you feel guilty, ask yourself why and quit blaming yourself. Take the word “should” out of your vocabulary and focus instead on what you have accomplished, says Nicole Schechter, a clinical psychologist at Johns Hopkins University School of Medicine in Baltimore, who specializes in treating people with chronic pain.

It's common for people with arthritis and chronic pain to struggle with feelings of guilt when they don’t meet someone’s expectations, or their own, or when they regularly rely on help from others. “Managing arthritis and mental health absolutely go hand-in-hand and is extremely important,” says Craig Thomas, PhD, director of the Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion at the  Centers for Disease Control and Prevention (CDC). About 1 in 5 adults with arthritis in the United States has symptoms of anxiety and almost 1 in 9 adults with arthritis in the U.S. has symptoms of depression, according to the CDC.

“The issue about feeling guilty about needing the care and support of others – be it caregivers or family members – is a totally normal feeling,” says Thomas. “It’s very common; however, it’s not useful. There are lots of tips for how you can handle that guilt.” For example, he says, “look for evidence that there’s actually a problem. Oftentimes, it’s all in our own heads, so ask your loved ones, ‘Am I a burden to you? Is this too much?’ At the same time, appreciate who you are and what you bring and give to them, as well, and ask yourself, ‘If the situation were reversed … would that be OK?’ That will help you reframe the issue that this is something that is completely expected for anyone we care about and love.”

Here are more ways to reframe your guilt in common scenarios.

You cancelled plans. You wanted to join the gang for drinks after work or meet a friend for dinner, but by the end of the day, you were just too tired and in too much pain. “It’s OK to feel sad about canceling plans,” says Schechter. Acknowledge your disappointment without blame. Set yourself up for future success by scheduling social engagements at a time of day when you typically have more energy or on days when you can rest and pace yourself.

You can’t do a chore. Maybe it’s too painful to prepare dinner or to bend and reach to unload the dishwasher. Think about what you can and can’t do and communicate that, Schechter advises. “Guilt arises because you think you’re impacting someone negatively,” she says. You can pull your weight in other ways; for example, you may be able to sit and chop vegetables.

You withdraw from activities. Sometimes avoidance seems like the easiest path, but social isolation adds to emotional stress, says Schechter. It’s OK to be private about your medical condition, but don’t be afraid to tell someone you have limitations because of pain. “Most people understand and appreciate being told what’s going on,” she says.

You splurged. You binged on the wrong foods, stayed up too late or overscheduled your day, and now you’re feeling the effects. That’s OK. Everyone slips up sometimes. Make sure your goals are reasonable, and just do your best to get back on track.

When all else fails, try turn-around talk. “The way we talk to ourselves is very, very powerful,” says Schechter “Shift your focus from the things you can’t control to the things you can.” Here’s how:

When you think: “I should have gone to that after-work event.” 

Tell yourself: “I wasn’t able to do that today, but in the future I will.”

When you think: “I wish I could do the yard work.”   

Tell yourself: “I can do the laundry instead.”

When you think: “I should have kept on my walking schedule.”  

Tell yourself: “I will set small goals, like walking for 15 minutes tomorrow morning, and gradually add more activity.”