When inflammatory arthritis first hit me, I had been going through a period of extreme stress. What stuck in my mind was that same feeling of inertia. I couldn’t even pick the dead leaves off the geraniums in the sunroom – and it wasn’t because of the pain in my joints.

It has been known for decades that patients with rheumatoid arthritis, or RA, have a two-fold higher incidence of depression than the general population. This was previously dismissed as being secondary to the pain of arthritis. New research is telling us that the excess immune molecules themselves, released by an over-active immune system, contribute to these feelings of depression. No matter the cause, what we already know helps depression – and arthritis, too – are exercise, a healthy diet, social interaction and positive thoughts. So I gradually started to exercise again – first walking a little every day, then, when I felt stronger, swimming for short periods. I surrounded myself with friends and family, and began to eat salads and light amounts of fish and vegetables with olive oil.

Instead of lying in the semi-dark watching television, I sat outside on my deck and listened to the birds, breathed in the scent from my little jasmine tree and gave myself time to contemplate. This mindfulness meditation, where one focuses on the breath or soothing sounds, downshifts the brain’s stress response and turns on the relaxation response. It took a bit of effort to get started, but once I began, I soon felt energized and ready to face the world again.

Esther M. Sternberg, MD, rheumatologist and researcher, is the author of Healing Spaces: The Science of Place and Well-being (Harvard University Press, 2009).