Ankylosing Spondylitis and Taking Care of Mental Health

Learn why this type of inflammatory arthritis can impact mental and emotional wellbeing—and what you can do about it.

Female therapist holds notebook and chats with male patient in an office.

Ankylosing spondylitis (AS) is a type of arthritis that causes inflammation of the joints of the spinal column. In severe cases, AS can cause the bones in the spine to fuse together, causing the spine to become stiff and less flexible. And while the spine is the primary site of inflammation when a person has AS, the disease can also cause pain and symptoms in other areas of the body.

There is no cure for AS, but there are treatments that can help ease symptoms, control inflammation, and avoid complications. In addition to managing the physical symptoms, mental and emotional health should be an important focus of treatment.

AS and mental health

The impact AS can have on a person’s mental health can be attributed to a number of different factors:

  • Pain, loss of mobility, fatigue, brain fog, and the assortment of other symptoms that may accompany AS can make it difficult to enjoy normal activities like going to work or socializing.
  • Pain at night is a common symptom of inflammatory pain. This can make it difficult to get a good night’s sleep for people who are living with AS—and a lack of sleep can be harmful to your mental health.
  • Finding yourself unable to perform everyday tasks due to a loss of mobility can be embarrassing and lead to feelings of shame, low self-worth, and social withdrawal.

Research has shown that anxiety and depression are more common among people with ankylosing spondylitis (as well as other forms of inflammatory arthritis). There is also evidence that the relationship between AS and mental health disorders can be cyclical—having AS can make it more likely for a person to develop a mental health disorder, and having a mental health disorder can make it more difficult to effectively manage AS. This further stresses the idea that mental health is an important component of treatment for AS.

Being proactive about mental health

It’s important to remember that conditions like AS impact everyone a little differently. This is true of the physical symptoms, as well as mental health, emotional health, and quality of life. If you’re living with AS, it’s important to spend some time thinking about the impact the condition is having on your life and talk to your healthcare provider about what you need from treatment.

In addition to working with a healthcare provider, there are other steps you can take to be proactive about managing the impact of AS:

  • Patient education. Learn everything you can about your diagnosis by reading patient information guides and asking questions.
  • Keep a journal. Keeping a record of your day-to-day symptoms and experiences can provide useful information for you and your healthcare provider.
  • Be honest with your healthcare provider. Mental health checkups should be a part of your appointments. While it may not feel easy or comfortable to talk about your emotions and how you are feeling, these are important topics to discuss with your healthcare provider.
  • Focus on your physical health. Exercise regularly, eat healthy, get enough sleep, and avoid drinking alcohol. If you smoke, quit (and avoid secondhand smoke).
  • Make time for yourself. Take time to do things you enjoy, such as making time for a hobby, relaxing with a book, or practicing meditation.
  • Spend time with loved ones. Staying connected with friends and family is another important aspect of mental and physical wellbeing. If you are feeling lonely, isolated, or having trouble connecting with others, tell your healthcare provider.
  • Consider joining a support group. It may be helpful to connect with others who understand the struggles and frustrations that come with your diagnosis.
  • Work with a mental health professional. A counselor, therapist, or healthcare social worker can help you find healthy ways to cope with your diagnosis.
Article sources open article sources

Spondylitis Association of America. "Overview of Ankylosing Spondylitis."
Stewart G. Eidelson and Kristen Sturt. "Ankylosing Spondylitis Center.
Arthritis Foundation. "Axial Spondyloarthritis."
Cleveland Clinic. "Ankylosing Spondylitis (AS)."
Global Healthy Living Foundation. "Raising the Voice of Patients: A Patient's Guide to Living with Ankylosing Spondylitis." First Edition, 2017.
S. Mechiel Korte and Rainer H Straub. "Fatigue in inflammatory rheumatic disorders: pathophysiological mechanisms." Rheumatology (Oxford, England), 2019. Vol. 58, Suppl. 5.
UpToDate. "Patient education: Axial spondyloarthritis, including ankylosing spondylitis (Beyond the Basics)."
Laurie Gelman. "Back Pain at Night: When It’s a Sign of Ankylosing Spondylitis." March 25, 2019.
Cheng-Che Shen, Li-Yu Hu, et al. "Risk of Psychiatric Disorders following Ankylosing Spondylitis: A Nationwide Population-based Retrospective Cohort Study." The Journal of Rheumatology, 2016. Vol. 43, No. 3.
Dibs Baer. "Here Are the Embarrassing Moments of Arthritis No One Wants to Talk About." September, 11, 2019.
Casper Webers, Laura Vanhoof, et al. "Depression in ankylosing spondylitis and the role of disease-related and contextual factors: a cross-sectional study." Arthritis Research & Therapy, 2019. Vol. 21.
Joel T. Parkinson, Eimear M. Foley, Deepak R. Jadon, and Golam M. Khandaker. "Depression in patients with spondyloarthritis: prevalence, incidence, risk factors, mechanisms and management." Therapeutic Advances in Musculoskeletal Disease, 2020. Vo. 12.
Arthritis Society. "The Link Between Emotions and Arthritis Pain."
Emma Haglund, Ann Bremander, Stefan Bergman, and Ingrid Larsson. "Educational needs in patients with spondyloarthritis in Sweden – a mixed-methods study." BMC Musculoskeletal Disorders, 2018. Vol. 18.
Laurie Berger. "When Your Doctor Won’t Listen: Tips for Women With Spondyloarthritis." MySpondylitisTeam. April 06, 2021.
Charlotte Hilton Andersen. "20 Things Arthritis Patients Wish Rheumatologists Knew." January 23, 2019.
National Axial Spondyloarthritis Society. "7 reasons why you shouldn’t smoke with axial SpA (AS)." "Stress Management."
Marianne B. Kool and Rinie Geenen. "Loneliness in patients with rheumatic diseases: the significance of invalidation and lack of social support." The Journal of Psychology, 2012. Vol. 146.

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