Suicide Rates Are Rising in Those with Rheumatoid Arthritis

While suicide is universally viewed as a massive problem that needs to be prevented, many don't realize that it is not only mental illnesses that can trigger this type of action. For those dealing with rheumatoid arthritis, suicide attempts are now at a higher rate than ever seen previously.

Too much to bear

It’s common to hear someone say "this pain is killing me." Perhaps they were talking about a slight pain and utilizing hyperbole, but if they have rheumatoid arthritis, they might’ve been serious.

For those who have rheumatoid arthritis, their risk for suicidal thoughts or tendencies are significantly higher than that of the general population, according to researchers looking into the subject.

At the University of Toronto, a study was published in Rheumatology International that looked into how often people with rheumatoid arthritis attempt suicide. A total of 21,744 Canadians were involved in the study, with 4,885 of them having arthritis.

They found that 1 in 26 men with any type of arthritis has already had at least one suicide attempt. They compared this to 50 men who were completely free of arthritis and found the rate was much lower.

Then, the researchers looked into women with arthritis. They found that the rate was even more elevated.

Approximately 5.3 percent of women who have some form of arthritis have attempted suicide, while a lower 3.2 percent of women without any such condition have. Of course, any of these numbers are too high, as no one should be driven to take their own life, but it remains that those with arthritis are at a significantly higher risk.

Results

These results offered evidence of arthritis's capability to push many to suicide. The results were adjusted to account for mental health, age, socioeconomic status, and chronic pain. Even so, the risk was approximately 46 percent higher in those with arthritis than those without.

Those with arthritis who also suffered from traumatic childhood, substance abuse, or anxiety disorders were at an even further elevated risk of attempting suicide.

Those who had lower incomes and arthritis were also at an even higher risk, along with those who were younger or less educated.

However, in all events studied, escaping arthritis was the leading motive behind the suicide attempts. A direct link can not be definitively proven, but the researchers are confident that this is the case.

Co-author of the study and doctoral student Stephanie Baird stated "due to the cross-sectional nature of this survey we cannot establish causality. We do not know when the arthritis began nor when the suicide attempts occurred. It is possible that other factors that were not available in the survey may confound the relationship. For example, childhood poverty has been strongly linked to both the development of arthritis and suicide risk ... Younger adults with arthritis were more likely to report having attempted suicide. Future prospective research is needed to uncover plausible mechanisms through which arthritis and suicide attempts are linked."

How is physical pain linked to emotional pain?

Those who have rheumatoid arthritis are more likely to have depression, serotonin deficiencies, and other forms of mental illness. For those who have depression, it becomes extremely difficult to endure the physical pain of their daily lives. As such, it is not altogether surprising that suicide attempts are higher among those with rheumatoid arthritis.

In 2002, the journal Rheumatology published a study that explained how people in the rheumatoid arthritis community should be on the lookout constantly for suicidal thoughts and tendencies in those around them. It is important to take these warnings seriously, especially among women as the rate is higher.

In the study, researchers noted "attempted suicides and especially depression in female RA patients should be taken more seriously into account than previously seen in clinical work so that the most appropriate psychiatric treatment can be provided for such patients."

While this publication did make progress, there is still significantly more to be made. Unfortunately, the discussion of depression or suicide attempts carries a bit of a taboo or stigma, meaning that it is not always accepted in casual conversation. However, it is important to break those boundaries and inform the ones you love, as it could save someone's life. Not only does the proliferation of the stigma around suicide prevent meaningful discussions, but there are also not enough tests that have looked into the matter. If suicide is studied further, novel ways of prevention may arise. It's important for suicide not only to be linked to mental hardship, while that is often the case, but also to physical pain or illnesses that become simply unbearable for those who suffer from them.
There have been some reports that even state that chronic sickness or pain can contribute to up to 70 percent of attempted or successful suicides. A study that was conducted in Great Britain in 2011 showed that around 10 percent of suicides were prompted by a terminal or chronic illness. Yet, despite this data, the conversation still only circles around mental illnesses such as depression. While this is massively important and should not be decreased in any way, it is crucial to expand the conversation to those who are in physical pain that makes them feel as if life is no longer worth living, because they constitute a very sizable portion of those who attempt to take their own lives.

Maria Marino is a member of numerous "online communities" for those who suffer from either rheumatoid arthritis or chronic pain. She says "we have had three people commit suicide, one person attempt suicide while hurting themselves [in] the process, just in the past 7 years alone in some of the RA Facebook groups I've been on. This is an epidemic in our country."

Sadly, what Maria has experienced fits in with the little information available about those with rheumatoid arthritis or other forms of chronic pain. With such a high percentage of those trying to take their own lives, it is not unlikely that if someone has a few friends within that community, they might try to take their own lives.

So, what can be done? If you know people with rheumatoid arthritis, make sure that they are constantly aware that you are there for them for whatever they need. If you stop hearing from them for a bit, go and check on them - it will definitely be worth it. Encourage them to talk with experts about the overlap of the physical and emotional pain that they are going through, as sometimes medication treating the depression aspect of it can help.

Various doctors joined together to write a letter that was published in the British Medical Journal on the subject. It stated "rheumatoid arthritis, the most prevalent chronic inflammatory musculoskeletal disease, has been associated with several negative psychological outcomes, including depression. Our ongoing studies indicate that almost 11 percent of hospital outpatients with rheumatoid arthritis experience suicidal ideation."

Final thoughts

If you have friends, loved ones, or even mild acquaintances in the rheumatoid arthritis community, make sure that you are checking in on them to make sure they're alright. If you have rheumatoid arthritis, ensure that you're taking care of yourself and never be afraid to speak with a professional.

Reference

https://www.healthline.com/health-news/suicide-attempts-high-among-arthritis-patients#4