A patient with dark skin sitting on a medical examination table, having a conversation with a doctor with light skin. Un patient à la peau foncée, assis sur une table d’examen médical, en train de discuter avec un médecin à la peau claire.According to the Canadian Mental Health Association, in any given year, one in five people in Canada experience a mental health challenge or condition, and by the time Canadians reach 40 years of age, half experience or have experienced a mental health challenge or condition.

A diagnosis of a mental health condition like an anxiety disorder or major depression is based on a framework called the Diagnostic and Statistical Manual of Mental Disorders (DSM). This framework generally requires the symptoms to interfere with your daily functioning for a specific period of time, and there may be other criteria that need to be met in order for a diagnosis to be made. As can be the case with arthritis, getting diagnosed with a mental health condition can sometimes take a long time. Even if you don’t meet all the criteria, you may still experience symptoms of these conditions that interfere with your daily life to a degree that would benefit from support.

Anxiety disorders are related to feelings of anxiety, and symptoms may include uncontrollable worry, strong fears around everyday things or situations, unwanted thoughts, and the experience of panic attacks. There are many types of anxiety disorders, with panic disorder and generalized anxiety disorder being some of the most commonly experienced by people living with arthritis.

Panic disorder involves the repeated experience of panic attacks. A panic attack is a sudden feeling of intense fear that arises unexpectedly and usually lasts for a short period of time. It can cause physical feelings like a fast heartbeat, shortness of breath, and nausea. Panic attacks can be a normal reaction to a stressful situation and can also occur alongside other anxiety disorders. With panic disorder, people experience persistent worry about panic attacks and their consequences or alter their behaviour to prevent additional panic attacks (e.g., refraining from leaving the house).

Generalized anxiety disorder is extreme worry about everyday problems that is difficult to control and lasts for more than six months. Someone with this type of disorder might feel intense anxiety over a concern that someone without an anxiety disorder would consider to be a minor concern – but that doesn’t mean the anxiety isn’t real. Many people also have physical symptoms like muscle tension and sleep problems.

 

Major depressive disorder is a type of mood disorder sometimes simply referred to as depression. Signs of depression include feeling little interest in things you used to enjoy, feeling down or hopeless, excessive guilt, or recurrent thoughts of death. Other symptoms include a loss of energy, a lessened ability to focus and remember information, and difficulties eating or sleeping. With a major depressive disorder, these symptoms occur most of the time across more than half of the days during a 2-week period or longer.

The term suicidal ideation refers to having thoughts of ending one’s own life, and self-harm refers to causing harm or injury to oneself on purpose. These are not mental health conditions themselves, and not all people who harm themselves or die by suicide experience a mental health condition, but they both may be linked to a mental health condition. People who live with chronic pain are at an increased risk of suicidal ideation when they believe they have become a burden to others.

If you are having thoughts of suicide or hurting yourself, you deserve support. Anyone in Canada can call 9-8-8 for immediate assistance – a trained responder will listen without judgement, provide support and understanding, and can tell you about resources that will help. You can also call 9-8-8 for advice and support if you are concerned about a loved one who may be experiencing a mental health crisis. If your or your loved one’s immediate safety is at risk, you should call 9-1-1.

Contributors

This mental health resource was developed and last reviewed in March 2026 with expert advice from:
Dr. Joshua A. Rash, PhD, RPsych (NL), R.D.Psych. (SK)
Memorial University of Newfoundland; University of Saskatchewan
Marg Smit-Vandezande, MSW, RSW
Arthritis Rehabilitation and Education Program, Arthritis Society Canada
Nikolas Harris, MSW, RSW
Senior Manager, Mission, Arthritis Society Canada

  1. Mental health. World Health Organization. https://www.who.int/health-topics/mental-health.
  2. Aaron RV, Ravyts SG, Carnahan ND, et al. Prevalence of Depression and Anxiety Among Adults With Chronic Pain: A Systematic Review and Meta-Analysis. JAMA Netw Open. 2025;8(3):e250268. Published 2025 Mar 3. doi:10.1001/jamanetworkopen.2025.0268. https://pubmed.ncbi.nlm.nih.gov/40053352/.
  3. The Difference Between Mental Health and Mental Illness. HelpStartsHere. February 18, 2026. https://helpstartshere.gov.bc.ca/blog/difference-between-mental-health-and-mental-illness.
  4. Positive Mental Health and Well-Being. Canadian Mental Health Association Ontario. https://ontario.cmha.ca/documents/positive-mental-health-and-well-being/.
  5. Keyes CL. The mental health continuum: from languishing to flourishing in life. J Health Soc Behav. 2002;43(2):207-222. https://pubmed.ncbi.nlm.nih.gov/12096700/.
  6. Stigma. HelpStartsHere. May 23, 2023. https://helpstartshere.gov.bc.ca/wellbeing/social/stigma.
  7. Thornicroft G, Sunkel C, Alikhon Aliev A, et al. The Lancet Commission on ending stigma and discrimination in mental health. Lancet. 2022;400(10361):1438-1480. doi:10.1016/S0140-6736(22)01470-2. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(22)01470-2/abstract.
  8. Addressing Mental Health Stigma in Diverse Cultural Communities. ConnexOntario. January 7, 2025. https://connexontario.ca/blog/mental-health-stigma-diverse-cultures/.
  9. Understanding Mental Health Care For People With Arthritis. Arthritis Research Canada. https://www.arthritisresearch.ca/mental-health-care-highlight/.
  10. Goel N, Wallace EB, Lindsay C. Hot Topics: Depression in Individuals With Psoriasis and Psoriatic Arthritis. J Rheumatol. 2024;51(Suppl 2):43-50. Published 2024 Oct 1. doi:10.3899/jrheum.2024-0362. https://pubmed.ncbi.nlm.nih.gov/39009389/.
  11. Wang ST, Ni GX. Depression in Osteoarthritis: Current Understanding. Neuropsychiatr Dis Treat. 2022;18:375-389. Published 2022 Feb 22. doi:10.2147/NDT.S346183. https://pmc.ncbi.nlm.nih.gov/articles/PMC8883119/.
  12. Stubbs B, Aluko Y, Myint PK, Smith TO. Prevalence of depressive symptoms and anxiety in osteoarthritis: a systematic review and meta-analysis. Age Ageing. 2016;45(2):228-235. doi:10.1093/ageing/afw001. https://pubmed.ncbi.nlm.nih.gov/26795974/.
  13. Sharma A, Kudesia P, Shi Q, Gandhi R. Anxiety and depression in patients with osteoarthritis: impact and management challenges. Open Access Rheumatol. 2016;8:103-113. Published 2016 Oct 31. doi:10.2147/OARRR.S93516. https://pmc.ncbi.nlm.nih.gov/articles/PMC5098683/.
  14. Murphy LB, Sacks JJ, Brady TJ, Hootman JM, Chapman DP. Anxiety and depression among US adults with arthritis: prevalence and correlates. Arthritis Care Res (Hoboken). 2012;64(7):968-976. doi:10.1002/acr.21685. https://pubmed.ncbi.nlm.nih.gov/22550055/.
  15. Staying Healthy with Arthritis: Body AND Mind. Johns Hopkins Arthritis Center. August 15, 2012. https://www.hopkinsarthritis.org/arthritis-news/staying-healthy-with-arthritis-body-and-mind/
  16. Arthritis & Mental Health: It’s Complicated. Arthritis Research Canada. https://www.arthritisresearch.ca/understanding-rheumatoid-arthritis-and-mental-health/.
  17. Howren A, Sayre EC, Avina-Zubieta JA, et al. Do individuals with inflammatory arthritis receive minimally adequate treatment for incident depression and anxiety: A population-based study. Arthritis Res Ther. 2025;27(1):13. Published 2025 Jan 21. doi:10.1186/s13075-024-03466-8. https://pubmed.ncbi.nlm.nih.gov/39838484/.
  18. Patten SB, Williams JVA, Lavorato DH, et al. Patterns of association of chronic medical conditions and major depression. Epidemiol Psychiatr Sci. 2018;27(1):42-50. doi:10.1017/S204579601600072X. https://pubmed.ncbi.nlm.nih.gov/27784343/
  19. Berk M, Köhler-Forsberg O, Turner M, et al. Comorbidity between major depressive disorder and physical diseases: a comprehensive review of epidemiology, mechanisms and management. World Psychiatry. 2023;22(3):366-387. doi:10.1002/wps.21110. https://pubmed.ncbi.nlm.nih.gov/37713568/.
  20. Manning-Bennett AT, Hopkins AM, Sorich MJ, et al. The association of depression and anxiety with treatment outcomes in patients with rheumatoid arthritis – a pooled analysis of five randomised controlled trials. Ther Adv Musculoskelet Dis. 2022;14:1759720X221111613. Published 2022 Jul 22. doi:10.1177/1759720X221111613. https://pmc.ncbi.nlm.nih.gov/articles/PMC9310212/
  21. Snoeck Henkemans SVJ, Vis M, Koc GH, et al. Association between depression and anxiety and inability to achieve remission in rheumatoid arthritis and psoriatic arthritis. Rheumatology (Oxford). 2025;64(5):2411-2421. doi:10.1093/rheumatology/keae621. https://pmc.ncbi.nlm.nih.gov/articles/PMC12048054/.
  22. Salas-González J, Heredia-Rizo AM, Fricke-Comellas H, Chimenti RL, Casuso-Holgado MJ. Patterns of pain perception in individuals with anxiety or depressive disorders: A systematic review and meta-analysis of experimental pain research. J Pain. 2025;35:105530. doi:10.1016/j.jpain.2025.105530. https://www.jpain.org/article/S1526-5900(25)00757-6/fulltext.
  23. “Psychology Works” Fact Sheet: Arthritis. Canadian Psychological Association. July 25, 2019. https://cpa.ca/psychology-works-fact-sheet-arthritis/.
  24. Mental Illness and Addiction: Facts and Statistics. Canadian Mental Health Association. https://www.camh.ca/en/driving-change/the-crisis-is-real/mental-health-statistics.
  25. Li L, Merchant M, Gordon S, et al. High Rates of Symptoms of Major Depressive Disorder and Panic Disorder in a Canadian Sample of Adolescents With Juvenile Idiopathic Arthritis. J Rheumatol. 2023;50(6):804-808. doi:10.3899/jrheum.220067. https://pubmed.ncbi.nlm.nih.gov/36521911/.
  26. Chen C, Bailey C, Baikie G, Dalziel K, Hua X. Parents of children with disability: Mental health outcomes and utilization of mental health services. Disabil Health J. 2023;16(4):101506. doi:10.1016/j.dhjo.2023.101506. https://www.sciencedirect.com/science/article/pii/S193665742300078X.
  27. Caring in Canada: Survey insights from caregivers and care providers across Canada. Canadian Centre for Caregiving Excellence. https://canadiancaregiving.org/caring-in-canada/.
  28. Social Isolation and Loneliness – Older Adults and Care Partners. Canadian Coalition for Seniors’ Mental Health. https://ccsmh.ca/areas-of-focus/social-isolation-and-loneliness/older-adults-and-care-partners/.
  29. Sherman DW, Alfano AR, Alfonso F, et al. A Systematic Review of the Relationship between Social Isolation and Physical Health in Adults. Healthcare (Basel). 2024;12(11):1135. Published 2024 Jun 1. doi:10.3390/healthcare12111135. https://pmc.ncbi.nlm.nih.gov/articles/PMC11171827/.
  30. Morina N, Kip A, Hoppen TH, Priebe S, Meyer T. Potential impact of physical distancing on physical and mental health: a rapid narrative umbrella review of meta-analyses on the link between social connection and health. BMJ Open. 2021;11(3):e042335. Published 2021 Mar 18. doi:10.1136/bmjopen-2020-042335. https://pmc.ncbi.nlm.nih.gov/articles/PMC7978290/.
  31. Office of the Surgeon General (OSG). Our Epidemic of Loneliness and Isolation: The U.S. Surgeon General’s Advisory on the Healing Effects of Social Connection and Community. Washington (DC): US Department of Health and Human Services; 2023. https://www.ncbi.nlm.nih.gov/books/NBK595227/pdf/Bookshelf_NBK595227.pdf.
  32. Raufi S, Refol J, Frost A, Card K. How can we promote disability inclusion? Social Connections Guideline Evidence Brief. Published 2024 Feb 27. https://www.socialconnectionguidelines.org/en/evidence-briefs/how-can-we-promote-disability-inclusion.
  33. Social Connection Guidelines. https://www.socialconnectionguidelines.org/en.
  34. Coping with a diagnosis of chronic illness. American Psychological Association. August 1, 2013. https://www.apa.org/topics/chronic-illness/coping-diagnosis.
  35. Stress. Canadian Mental Health Association. February 28, 2016. https://cmha.ca/brochure/stress/.
  36. Stress. Mental Health Foundation. https://www.mentalhealth.org.uk/explore-mental-health/a-z-topics/stress.
  37. Mental Illnesses. Canadian Mental Health Association. February 28, 2016. https://cmha.ca/brochure/mental-illnesses/.
  38. Anxiety Disorders. Canadian Mental Health Association. February 28, 2016. https://cmha.ca/brochure/anxiety-disorders/
  39. Depression and Bipolar Disorder. Canadian Mental Health Association. December 18, 2015. https://cmha.ca/brochure/depression-and-bipolar-disorder/.
  40. Wilson KG, Heenan A, Kowal J, Henderson PR, McWilliams LA, Castillo D. Testing the Interpersonal Theory of Suicide in Chronic Pain. Clin J Pain. 2017;33(8):699-706. doi:10.1097/AJP.0000000000000451. https://pubmed.ncbi.nlm.nih.gov/27768608/.
  41. Marques A, Santos E, Nikiphorou E, Bosworth A, Carmona L. Effectiveness of self-management interventions in inflammatory arthritis: a systematic review informing the 2021 EULAR recommendations for the implementation of self-management strategies in patients with inflammatory arthritis. RMD Open. 2021;7(2):e001647. doi:10.1136/rmdopen-2021-001647. https://pmc.ncbi.nlm.nih.gov/articles/PMC8166594/.
  42. Exercising to relax. Harvard Health Publishing. July 7, 2020. https://www.health.harvard.edu/healthy-aging-and-longevity/exercising-to-relax.
  43. Pluess M, Conrad A, Wilhelm FH. Muscle tension in generalized anxiety disorder: a critical review of the literature. J Anxiety Disord. 2009;23(1):1-11. doi:10.1016/j.janxdis.2008.03.016. https://pubmed.ncbi.nlm.nih.gov/18472245/.
  44. Positive Self-Talk. ConnexOntario. April 4, 2022. https://connexontario.ca/blog/positive-self-talk/.
  45. Self-Talk & the Impact it has on our Lives. Trauma Research UK. https://traumaresearchuk.org/self-talk-and-the-impact-it-has-on-our-life/.
  46. Zautra AJ, Johnson LM, Davis MC. Positive affect as a source of resilience for women in chronic pain. J Consult Clin Psychol. 2005;73(2):212-220. doi:10.1037/0022-006X.73.2.212. https://pmc.ncbi.nlm.nih.gov/articles/PMC2593933/.
  47. Strand EB, Zautra AJ, Thoresen M, Ødegård S, Uhlig T, Finset A. Positive affect as a factor of resilience in the pain-negative affect relationship in patients with rheumatoid arthritis. J Psychosom Res. 2006;60(5):477-484. doi:10.1016/j.jpsychores.2005.08.010. https://pubmed.ncbi.nlm.nih.gov/16650588/.
  48. Müller R, Terrill AL, Jensen MP, Molton IR, Ravesloot C, Ipsen C. Happiness, Pain Intensity, Pain Interference, and Distress in Individuals with Physical Disabilities. Am J Phys Med Rehabil. 2015;94(12):1041-1051. doi:10.1097/PHM.0000000000000294. https://pubmed.ncbi.nlm.nih.gov/25802959/.
  49. Zautra A, Smith B, Affleck G, Tennen H. Examinations of chronic pain and affect relationships: applications of a dynamic model of affect. J Consult Clin Psychol. 2001;69(5):786-795. doi:10.1037//0022-006x.69.5.786. https://pubmed.ncbi.nlm.nih.gov/11680555/.
  50. How can you find joy (or at least peace) during difficult times? Harvard Health Publishing. October 17, 2022. https://www.health.harvard.edu/blog/how-can-you-find-joy-or-at-least-peace-during-difficult-times-202210062826.
  51. Building your medicine bundle: Understanding your mental health journey. Indspire and the Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health at the Centre for Addictions and Mental Health. 2021. https://indspire.ca/wp-content/uploads/2021/02/Indspire_CAMH_TipSheet-1.pdf.
  52. Journeying along the river: Reaching out for support. Indspire and the Margaret and Wallace McCain Centre for Child, Youth & Family Mental Health at the Centre for Addictions and Mental Health. 2021. https://indspire.ca/wp-content/uploads/2021/02/Indspire_CAMH_TipSheet-2-8.5-x20-Online-Version.pdf
  53. Traditional Methods of Healing. Teladoc Health Canada, Inc. https://library.teladochealth.ca/hc/en-ca/articles/38530701758995-Traditional-Methods-of-Healing.
  54. Land-Based Teachings: Indigenous Approaches to Healing. British Columbia Ministry of Health. https://www2.gov.bc.ca/assets/gov/health/accessing-health-care/assisted-living-registry/land_based_teachings_and_indigenous_approaches_to_healing.pdf.
  55. Culturally-Based Practices. Mental Health America. https://mhanational.org/resources/culturally-based-practices/
  56. Sleep and Mental Health – What’s the Connection? Mental Health Commission of Canada. 2025. https://mentalhealthcommission.ca/resource/sleep-and-mental-health-whats-the-connection/.
  57. Faber SC, Osman M, Williams MT. Access to mental health care in Canada. International Journal of Mental Health. 2023;52(3):312-334. doi:10.1080/00207411.2023.2218586. https://www.tandfonline.com/doi/full/10.1080/00207411.2023.2218586.
  58. Arthritis and Mental Health. JointHealth™ Education. https://education.jointhealth.org/jointhealth-education/course-6-mental-health/.
  59. Antidepressant Medications. Centre for Addiction and Mental Health. https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/antidepressant-medications.
  60. Anti-anxiety Medications (Benzodiazepines). Centre for Addiction and Mental Health. https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/anti-anxiety-medications-benzodiazepines.
  61. Everything You Need to Know About Psychotherapy. College of Registered Psychotherapists of Ontario. https://crpo.ca/resources/what-to-know-about-psychotherapy/.
  62. Cognitive Behavioural Therapy. Centre for Addiction and Mental Health. https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/cognitive-behavioural-therapy.
  63. Cognitive Behavioural Therapy for Pain Management. HealthLinkBC. October 20, 2022. https://www.healthlinkbc.ca/healthwise/cognitive-behavioral-therapy-pain-management.
  64. Psychotherapy. Canadian Mental Health Association. December 5, 2018. https://cmha.ca/brochure/psychotherapy/.