Managing your mental

Managing your mental wellbeing

Professor Kathryn Nicholson Perry, Psychologist

When living with ankylosing spondylitis, it’s understandable to focus just on symptoms like pain. But emotional wellbeing is just as important as physical health. Some people living with AS may struggle with feelings of depression and anxiety. While there’s no one-size-fits-all approach to supporting good mental health, there are a few simple steps which may help you feel back in control.

Build a team around you

Support networks can play a valuable role in supporting and managing mental wellbeing, and that team can sometimes be bigger than you think. Involving a team of healthcare professionals including your specialist, GP, rheumatologist, psychologist and/or counsellors can be helpful. On top of this, family, friends, neighbours – even your employer – can all play an important role in supporting your mental wellbeing. The key is to surround yourself with people you can trust to offer non-judgmental support.

Focus on what’s important to you

If you only have a certain number of ‘cups of energy’, spend them on the things that matter. For people with AS, that could mean focusing on the people and activities that ‘fill your cup’ with energy (rather than drain it altogether). Find ways to build more of these ‘cup-fillers’ into your life, and be honest about your limits, too. If the idea of that big weekend event has you running on empty, your cup might be better filled with a quiet night in.

Set smaller goals

It’s okay to start small!. If you’re feeling overwhelmed by a goal, try breaking it down into small, achievable milestones. And if you don’t achieve something the first time around, that’s ok, too. Instead of beating yourself up over a perceived failure, try to reflect on what you have achieved, and use what you’ve learned to move onwards and upwards.

Be kind to yourself

Your thoughts can affect the way you feel mentally and physically. Negative thoughts can worsen pain and fatigue and negatively affect the immune system. On the other hand, positive thoughts may help to boost mood and relieve stress and pain. And a little self-compassion can go a long way. If you find yourself thinking ‘I should be able to’ or, ‘I really ought to’ on a regular basis, it might be time to give yourself a break.


Learning about chronic pain and skills for managing these symptoms and your emotional wellbeing may be helpful. These skills may help reduce the impact pain has on your life, regardless of the cause or severity of the pain. MindSpot has an effective pain management course – it’s free and can be accessed online.

Some people find it helpful to hear what strategies others are using to manage their condition so you might want to check out the Me First, My Condition Second podcast series to hear from others living with an autoimmune condition.

Share your flare-up plan

It can be hard to think clearly in the middle of a flare-up. That’s where your flare-up plan comes in. Designed in partnership with your rheumatologist and healthcare team, your flare-up plan can act as a handy go-to when your symptoms get too much. Your flare-up plan doesn’t have to be complicated – it just needs to work for you.

Two things you might include in your plan are:

  1. Exercises may be good for your body and mind. Check out these exercises in consultation with your health care team. They may help you manage your AS.
  2. Meditation and relaxation techniques may help you to regain focus and control.

As you try out different ways to manage your flare-ups, note what’s worked well, and share this information with your team. In addition, all of the strategies outlined above can be helpful to manage mental wellbeing during a flare-up.

This information is general information for people with AS and may not suit all individuals. It does not take your own circumstances into consideration. Your team of healthcare professionals are the best people to advise you on what is suitable for you depending on the severity of your condition and your management plan.

Managing your mental wellbeing

Ready to take control of AS?

Your rheumatologist and healthcare team are your best allies in taking control of AS. It doesn’t matter whether it’s been one or many years since your diagnosis with AS, it’s never too late.

If you think AS is holding you back or impacting your life, it’s time to talk to your rheumatologist about your goals and how you’re managing. Don’t let AS hold you back, take control.

Download the guide to help you make the most out of your conversations with your doctors.

Download the Conversation GuideDownload the Conversation Guide