MS, Depression and Anti-Depressants

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MS, Depression and Anti-Depressants

Postby kareng7 » Sat Jun 11, 2005 11:59 am

Wondering how many folks out there are taking antidepressants, whether depression seemed to be the result of MS diagnosis or otherwise.

I have struggled with dysthemia, characterized as chronic mild depression, for years. Attempted to fight it without medication with mixed results. When I got optic neuritis last December and did steroid treatment, I went through a period of elation followed by crushing, debilitating depression. Could have been the steroids, but I don't think so. Finally decided that rather than fight without meds, I'd get a little help.

Been on Zoloft for about a month now. Doing well (but started doing better right before I started taking it anyway). Am a bit depressed again, due to the fact that I'm about to go meet an MS specialist and am scared to face talking about all this again, since I've had a few blissfully "ignorant" months.

In any event, I know from reading and talking to my neuro that they consider MS and depression to have "co-morbidity," meaning, to occur frequently together but not necessarily to have a proved, causal relationship.

What are your experiences?
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Postby bromley » Sun Jun 12, 2005 3:12 am

Kareng 7,

This is my opinion i.e. no medical training / qualification.

At my dx my unsympathetic neuro said 'you've got ms, there's no cure, it's a progressive disease in the long run, you've got it for life.... arrange another appointment if you want to ask any questions'.

A couple of week's research on the internet revealed that his disease was much more than pins and needles (my limited knowledge of the disease prior to dx). Given that your life has changed for ever and that most of the things you did before / dreamed of doing wil be affected some way or another - this is about as life-changing an event as one could get. We are now living in a world of the unknown - will I be walking / working next week / next year etc etc? This all sounds depressing, but the point I am trying to make is that it is - none of my friends or colleagues have to cope with this. This monster plays on my mind every second of every day (the numb hand being a constant reminder). I think it is completely natural to feel depressed particualrly in the period after dx. My GP told me that I should view the dx as the same as a bereavement - on reflection this was sensible advice. As time goes on things look slightly rosier but everytime you loose something more you're bound to feel depressed again. That's the beauty of MS!

Anti-depressants may provide relief, but the real anti-depressant (in my view) would be for a treatment that halts this disease in its tracks (and perhaps allows some lost functions to be regained). Once we can begin living our lives without fear of what the future holds, the depression will lift pretty quickly.

All the best

Bromley
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Re: MS, Depression and Anti-Depressants

Postby HarryZ » Sun Jun 12, 2005 8:02 am

Kareng,

About 5 years ago when my wife started to use Prokarin, the doctor who prescribed it ran a small clinic that that offered psychological and chiropratic services as well. The doc believed in treating the entire patient and not just the disease.

The psychologist told Marg that when you have a chronic disease such as MS, that condition by itself can create depression which in turn feeds the MS. You get into a cycle of the MS contributing to the depression and vice versa and unless you do something to break this cycle, you are headed for trouble.

Sometimes anti-depressants can help but they are usually short-term fixes for long term problems. It's a lousy situation to find oneself and it makes dealing with MS just that much harder.

Harry
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Anti-Depressants

Postby Brainteaser » Sun Jun 12, 2005 5:55 pm

Where is Odd-duck when you need her? Doesn't Odd-duck have a treatment working for her based on the use of anti-depressants?
Phil.
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my depression

Postby jaycee » Wed Jun 15, 2005 12:37 pm

Maybe I should post this in the "regimens" topic but this one on depression seems more suited. My "regimen" is to survive through each day as best I can, enjoying what turns out to be enjoyable. Mostly, I just exist. I am 56 and feel guilty for not being sicker. I feel guilty for feeling sorry for myself when I know there are people worse off than me. I am seeing a therapist, going for the fourth time next week. I can't tell yet if it has or will help but I do feel better when I so something instead of nothing. That's what made me think to post here, Kareng7 saying: "Been on Zoloft for about a month now. Doing well (but started doing better right before I started taking it anyway). " That happens to me. I get better just having a plan. I shy away from anti-depressants as I do all meds. Right now I'm taking a sulfa drug for a UTI and it is making me feel horrible. My urologist prescribed (in the past) taking one per day for 5 days. The GP I got the current prescription from said to take 2 per day for 10 days. (That makes me depressed-when 2 doctors say totally different things.) After taking the first one, I knew I couldn't take 2 per day. I have made it through 5 days of one and now I will stop. I already feel better...I have a plan. Sorry to ramble but each event seems to be such a struggle with this disease and the depression it causes. I was a psych major in college and remember learning that depression was sadness with no valid reason. Well, we certainly have a reason. Is it still depression?
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Re: my depression

Postby kareng7 » Mon Jun 27, 2005 4:32 pm

jaycee wrote:depression was sadness with no valid reason. Well, we certainly have a reason. Is it still depression?


Jaycee, I'm sorry to hear that you're struggling so with guilt. I do, too. At least, I have in the past, a lot. For what it's worth, try to remember that your journey is your journey and no one else can take it for you, just like you can't take theirs. So feeling guilt about what you have or don't have only takes away what you do have and doesn't do those you feel guilty about any good either. (Remember, I'm saying this as much to myself as you.)

In any event, I had depression before the MS diagnosis, there's no doubt in my mind. I've been working on it for years. And no, MS doesn't help. Right now, it's mostly fear I'm struggling with. I've had a few symptoms, some most recently, and I fear what the future may hold, but I'm also trying to just enjoy right now, too.

Like you, I also didn't want to deal with any more meds than I have to, but I'm glad I'm on Zoloft finally. It was time to stop fighting it alone, MS or not.

BTW, for anyone who's interested, the way I've been ramping up on Zoloft may have helped alleviate side effects. We started with 12.5 mg, up to 25 mg, then 37.5 mg, then 50, now 75, all over a period of 5 weeks, increasing the dose gradually each week. I'm thinking when I start Avonex that I'd like to try this route, as I've heard others have done.
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Re: Anti-Depressants

Postby kareng7 » Mon Jun 27, 2005 4:40 pm

Brainteaser wrote:Where is Odd-duck when you need her? Doesn't Odd-duck have a treatment working for her based on the use of anti-depressants?
Phil.


Wow, Phil. That's fascinating. I tried searching on the user name "Odd-duck" but nothing came up, even after several different tries. If you know how I can get in touch with her, I'd love to, just out of curiosity.

My neuro said depression and MS have "co-morbidity," as I said earlier. She also said some people's first symptom is mood-oriented. I find that fascinating. There's no doubt in my mind that there's a relationship, which is why I'm fighting the depression.
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Postby Shayk » Mon Jun 27, 2005 7:52 pm

Hi

I think the medication that Odd Duck did lots of research on was desipramine. Here's a link to the article she wrote.

Sharon
Last edited by Shayk on Sat Aug 27, 2005 7:20 pm, edited 1 time in total.
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oddduck

Postby jaycee » Tue Jun 28, 2005 12:33 pm

Karen-thanks for your words. I appreciate it. The spelling of the person mentioned to look up is "Oddduck," no hyphen. There are tons of posts by her about an anti-depressant she uses, or used. I think she left the board when she decided she didn't have MS.
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hormones

Postby jaycee » Tue Jun 28, 2005 12:41 pm

Shayk-I'm so interested in your ideas about hormones. I know several women who were diagnosed right after giving birth, including me. I also know several whose symptoms went crazy right after beginning menopause, including me. I'm intrigued but don't know what to do about it.
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Postby Shayk » Tue Jun 28, 2005 7:13 pm

Hi Jaycee

You wrote about hormones:
I'm intrigued but don't know what to do about it.


I was intrigued too and still am. I didn't know what to do about it either. It's been quite the challenge and quite the education.

Briefly, I’m using 8 mg of estriol (based on the Phase I trial at UCLA) and trying to achieve “physiologically balanced hormone levels” of estradiol, estriol, progesterone, DHEA, testosterone and cortisol.

I used saliva rather than serum testing to assess my hormone levels. Based on these results, a health care practitioner provided recommendations about how to proceed on the road to “balanced hormone levels”. Specific prescriptions and/or possible steps to take are totally dependent on your individual test results.

Since only one of the hormones I had tested was within the normal range, I started reading about all of them. So far it seems like research exists to at least suggest that cortisol, DHEA, estradiol, estriol, melatonin, progesterone, testosterone, thyroid, and Vitamin D 3 (all hormones) could be factors in the MS disease process and/or treatment. Collectively they also seem to possess anti-inflammatory, immuno-modulatory, myelin maintenance and repair and/or neuroprotective properties.

Since research by necessity must focus on each of these separately rather than collectively, (and I sure don’t have time for that :lol: ) I decided “hormone balancing” might be a way to help manage my MS.

Besides the circumstance you mentioned, if 90% of people with RRMS eventually become SPMS, you have to ask yourself what drops with age besides hormones? They drop in women and men.

I hope this helps a little bit. Since we’ve strayed way off the topic of depression, I’ll pm you with more information.

Sharon
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Postby kareng7 » Sat Jul 02, 2005 5:08 pm

Shayk wrote:Briefly, I’m using 8 mg of estriol (based on the Phase I trial at UCLA) and trying to achieve “physiologically balanced hormone levels” of estradiol, estriol, progesterone, DHEA, testosterone and cortisol. Sharon


Hi Sharon,

I'd say hormones and depression are still on topic. And I'm also wondering, how is your hormone balancing regimen working out for you? And how long have you been doing it?
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Hormone Balancing

Postby Shayk » Tue Jul 05, 2005 7:25 pm

Hi kareng

You’re right about hormones and depression. So far I’ve not had to use any anti-depressants but if I did I'd think I'd initially go with DHEA. My DHEA levels were low but the progesterone I'm on may correct that to some extent (or so they say).

You asked:
how is your hormone balancing regimen working out for you? And how long have you been doing it?

I’ve been on 8 mg of estriol and 300 mg of progesterone for about a year. Testing subsequent to my initial prescription indicated my progesterone level was still low and a prescription of 100mg/g progesterone cream was added about 6 months ago.

I think the hormone balancing is working out pretty well.

MS Symptoms: My primary MS symptom was difficulty walking. My walking/gait has improved significantly since I started the progesterone cream. I jokingly told them last week at the fitness center that they’d better look out because I’d be doing marathons in no time. :lol:

Relapses: I’ve only had one (2/04) since being diagnosed (10/03) and none since using the estriol and progesterone.

Change in Lesion Load: Unknown. My neuro only does MRIs if needed for treatment decisions and so far none have been warranted. At diagnosis I had more than 9 greater than 2 cm.

Progression: Even though my primary MS symptom is much improved I still have this nagging feeling that the disease is progressing. I periodically experience a “new to me” MS symptom. For example, I’ve had 2-4 “ice-pick” headaches that last about 10 seconds. I’ve noticed the outside edge of my little fingers “tingle” several times. I tire more quickly. I am still working full time, managing a house and yard and having fun though. :D

Other: I also exercise 3-5 times a week, try to eat a diet low in saturated fats and sugar, take some supplements and am on Avonex.

What's been really hard with the hormone balancing is finding health care practitioners who are familiar with saliva testing and bioidentical hormones. So far I'd say it's really worth it though. I definitely recommend giving it serious consideration.

I hope you get the depression under control. Take care and good luck if you try hormone balancing. If you do try it be sure to let us know how it goes. This MS is some adventure. :roll:

Sharon
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depression

Postby ramairdad » Wed Jul 06, 2005 11:36 am

I really have had some bouts with depression (brought on by having to live with MS). I have been on Prozac and Fluoxetine. Both seamed to do the job. I'm currently not taking either one and my mood seams to be allright. I've finally came to the realization that I'm dealing with a harsh case of MS and feel there is some hope in the future. ( I've had MS for over 17 years, and as far as symptoms go, you name them I've had them!) The hardest to me is not being able to accomplish the physical things I want to do. But I've learned that my goals are still accomplishable, just at a slower pace or adjusting the way of doing them to meet my physical ability. And being able to do something I'm not used to, ASK FOR HELP! You wouldn't believe the number of people out there who will give you a helping hand when you need it! I guess that's what brought on a lot of my depression, having to depend on others so much, and losing my independance! I'm currently trying LDN and hope it will get me by untill something else comes along. ( I'm also taking beta seron injections ever other day, which I hate). I feel the injections have slowed my progression, the LDN has helped in small ways.(every little "bit" helps). The main thing I can say is HANG IN THERE! HELP IS COMMING!I believe I will walk again, someday, and there will be a cure or at least a way to reverse symptoms soon. That's all for now, I'll let everyone know if there is improvement at 5mg LDN over 2.5mg. Thanks, ram air dad
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Depression comes for many reasons

Postby art » Wed Jul 06, 2005 12:10 pm

When talking about depression and MS, it's good to understand all the different ways it can come about:

1. It can be caused by the course of the disease itself. That is, the damage to the brain might be what brings the depression on.

2. It can be caused indirectly due to other symptoms of MS. E.g. if you aren't sleeping well due to spasticity or bladder problems then the lack of sleep might bring on depression.

3. It can be a side-effect of many medications. If your family is prone to depression, then interferons are known to increase the chance of depression for you. Other medications can also have side-effects that can result in depression.

4. Having a chronic disease can suck enough to cause depression via psychological mechanisms.

5. It's entirely possible to get depression *and* MS - it might be completely separate.

So keep in mind it is important to consider what meds you are on, whether you are getting enough sleep, etc. before trying anti-depressants. If you go that route, keep in mind the effectiveness of anti-depressants varies tremendously from person to person. Effectiveness tends to run in families, so if you have a relative who has benefited from one drug, but not another, it might help to start with what worked for the relative.

It's also difficult to notice your own depression. Be open to the input of those around you to let you know when you are sinking - especially live-in family members. It's not normal to think that thw world is a sucky place every single day. Talk to someone about it if you feel that way.
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