Living with a long-term disease like axial spondyloarthritis (AxSpA) can be physically and mentally taxing. Those with long-term and painful medical conditions are more prone to mental turmoil that may lead to anxiety and depression.


Depression is common among patients with AxSpA, but reports of its prevalence are highly variable. Patients with advanced AxSpA often suffer from limited mobility, which can affect their mental health. Long-lasting pain can lead to anxiety and depression. Along with physical health, it is also necessary to look after mental health. Often, the patient or their caregiver do not inform their doctor about feelings of anxiety or depression and suffer in silence. It is important to know that there are several treatment options available for depression and anxiety, which can help patients feel better with time.

Symptoms of depression

Most of the time, patients are unaware or are in denial of suffering from depression. Symptoms of depression can include:

Loss of interest in previously rewarding or enjoyable activities

Weight fluctuations              

Hunger and/ or sleep disturbances

Feeling of agitation or irritability


Suicidal tendency

Symptoms of anxiety

It is normal to feel concerned about one’s health. But constant worry that interferes with day-to-day life suggests underlying mental health issues such as anxiety. Symptoms of generalized anxiety can include:

Feeling of agitation or irritability

Trouble staying focused

Trouble falling asleep

Muscle tightness


The K10 checklist is a simple measure of your psychological health. It uses a series of questions to rate certain aspects of your wellbeing, with results showing whether negative feelings, thoughts or emotions have affected your daily life.

This test should only take a few minutes to complete. It is important to be as truthful as you can. It is extremely common for anxiety and depression to co-exist with inflammatory disorders, but the good news is there are treatment and support options that can help.

In the past 4 weeks: None of
the time
A little of
the time
Some of
the time
Most of
the time
All of
the time
1. About how often did you feel tired out for no good reason?
2. About how often did you feel nervous?
3. About how often did you feel so nervous that nothing could calm you down?
4. About how often did you feel hopeless?
5. About how often did you feel restless or fidgety?
6. About how often did you feel so restless you could not sit still?
7. About how often did you feel depressed?
8. About how often did you feel that everything was an effort?
9. About how often did you feel so sad that nothing could cheer you up?
10. About how often did you feel worthless?

Acknowledgement: “Professor Ronald C Kessler of the Department of Health Care Policy, Harvard Medical School is thanked for the use of research on the K10 funded by US Public Health Service Grants RO1 MH46376, R01 MH52861, RO1 MH49098, and K05 MH00507 and by the John D and Catherine T MacArthur Foundation Network on Successful Midlife Development (Gilbert Brim, Director).”


Acceptance is the first step to coping with AxSpA. Additionally, the tips below may help a patient come to terms with the condition:

Seek medical advice:

If there are symptoms of anxiety or depression, seek medical help. A doctor will prescribe medicines or may recommend some lifestyle modifications.

Be active:

When faced with mental or emotional challenges, maintaining a consistent exercise routine or workout schedule can help. Be it morning walks, gym training, yoga or a spin class, any form of exercise can help ease the symptoms of anxiety and depression. Light exercises may also help lower fatigue and pain.

Maintain a healthy diet:

Excessive intake of junk food may trigger swelling and cause pain and stiffness. This may worsen the disease symptoms and could also lead to depression. Eating a healthy, balanced diet containing fresh vegetables, fruits, foods rich in omega-3 fats - like flaxseed, salmon, and walnuts, may help manage the condition and positively boost mental health.

Talk it out:

When in pain, it is important to have someone to turn to. Most times, a simple pep-talk, or having a listening ear or a shoulder to lean on, in times of stress, can be a good stress reliever.

Practise stress management techniques:

Techniques such as deep breathing, meditation, progressive muscle relaxation may help one relieve stress and cope with the disease in a better way.

Seek professional help:

Seek the help of professionals like counsellors and psychologists who can offer support and help to deal with pain and other stress-related symptoms.

Join support groups:

By joining a support group, be it in-person or online, one can find other people with the same problem, and listen to and empathise with each other’s concerns regarding the condition.