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This depression won't go away

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Posted 11/5/2013 3:28 PM (GMT 0)
What meds are you using for the Crohn's?

A few years ago, I had to go off all biologics (Remicade at the time) to get rid of a lingering and extremely awful respiratory infection that I couldn't shake while being immunosuppresed. I lasted for a year or so until I started a major flare. I was over the infection and in so much pain that I started Humira (shots at home are easier than making appts for Remicade infusions).

I injected the 4 shot loading dose and within days the black, dark depression I was in cleared up - it was just gone. This is something the medical community has just really started looking into the last few years. It seems like inflammatory cytokines and tnf-a can get into your brain as well, causing depression. My doctors didn't even know about this aspect of inflammation and tnf-a.

I don't know if biologics would work for everyone, but it "fixes" me everytime. Here are some links:

From inflammation to sickness and depression: when the immune system subjugates the brain
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2919277/pdf/nihms213147.pdf>


Cytokine Effects on the Basal Ganglia and Dopamine Function: the Subcortical Source of Inflammatory Malaise
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3484236/>


Depression: an inflammatory illness?
<http://jnnp.bmj.com/content/83/5/495.full.pdf>


The TNF-a System: Functional Aspects in Depression, Narcolepsy and
Psychopharmacology
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2687935/pdf/CN-6-193.pdf>


Inflammation and social experience: an inflammatory challenge induces feelings of social disconnection in addition to depressed mood.
<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2856755/pdf/nihms171761.pdf>


High prevalence of fatigue in inflammatory bowel disease: A case control study
<http://download.journals.elsevierhealth.com/pdfs/journals/1873-9946/PIIS1873994611000511.pdf>

I hope this helps.
Leslie
Posted 11/5/2013 9:55 PM (GMT 0)
No meds at the moment. Am in remission due to surgery. But I was on Remicade for a year and Humira for a few months before I had the surgery. I do remember feeling quite good after the very first Remicade infusion; I felt better, more positive. Sadly I was in hospital a month after that with the worst flare-up I had ever had. The only thing which got me out of that flare-up were iv steroids. Steroids were the only med which worked for me, but of course once I got off the Pred, I would just relapse again.

But you got me thinking. Although I probably have loads of old whinging posts dotted about which contradict what I'm about to say, I don't recollect feeling depressed very often from 2011 to the beginning of this year (when I had surgery). For that time I was on Remicade and then Humira.

But then again, my inflammatory markers (in particular, CRP) were so much higher than they are now. *brain gives up* Thanks for the links. I did have a look at them. I managed to read one, but I'm too tired for any more heavy reading.

Edit: Yeah, found a quite upbeat thread posted by me in September 2012. What happened to me? How could I feel better and more positive when I was so ill? (and had recently been in hospital) :/ *shakes head* Maybe it was the Pred and Remicade combo.

Post Edited (NiceCupOfTea) : 11/5/2013 3:02:39 PM (GMT-7)

Posted 11/5/2013 10:25 PM (GMT 0)
Hey NCOT this is just a thought,
When I go through long periods of feeling ill, my focus shrinks and I just try to manage getting through the day etc. Then when I feel better, I suddenly realize how over time I have become less social, and I feel more depressed, lonely and isolated. It's that feeling of now that I'm not sick, what will I do with my life? I don't think I really have clinical depression and I'm not at all trying to diminish how much worse you feel, but I do wonder if the illness served a purpose for you....it gave you a focus and now that you are better, you are struggling to find meaning or a point to your life. So that would lend itself to more depression.
Posted 11/5/2013 11:35 PM (GMT 0)
Hey, it's not a contest over who feels worse. Much... <_<.

No, seriously, everyone struggles in their own way. I wouldn't ever say I'm feeling so much worse than you, 'cos I don't really know the trials and tribulations you go through on a daily basis. I'm feeling very down, but I talk about it: somebody else might be feeling just as down, but never talk about it in their posts.

Anyway, what you say makes sense and I suspect it's true. I was going to the hospital a hell of a lot: Remicade infusions, tests, appointments (more frequent because I was flaring up a lot), hospital stays and so on. And yeah, in a way I quite liked all that - even the hospital stays provided a bit of a "holiday" in their warped way. Certainly the nurses at the infusion centre were absolutely lovely; couldn't have asked for nicer staff.

Also, just being ill in itself consumed a lot of energy. Energy which I couldn't give over to depressing, guilt-ridden thoughts. But of course I guess none of that ever really went away. I sometimes thought it had, but now it just seems like it was being suppressed instead of actually dealt with; Prednisolone is an almost painfully apt analogy. Suppressed symptoms brilliantly, didn't actually deal with the underlying disease at all.

And now I feel like every single chicken of mine has come home to roost. All at once.
Posted 11/6/2013 12:51 AM (GMT 0)
Hi NCOT, sorry you are still feeling down.  How did you feel immediately following surgery?  I was fairly depressed following my surgery (which is not normal for me), which prompted me to look up "depression after surgery", and it turns out some of the meds used during and after surgery (anesthesia, pain meds, etc.) can cause depression in some people.  I think I started feeling better about 3 weeks after my surgery and then I was in the dumps again when I finally came off my pain meds (but that only lasted about 3-4 days), but I read it can last a lot longer for some people who are especially sensitive to these meds.  Just a thought.

I am definitely a proponent for talk therapy with a qualified therapist who can help you work through this.  But meds have a place too.  I have heard from friends who take antidepressants that it often takes trial and error with varying meds before finding the right one that works for you, so don't give up.  I do understand that a lot of your depression stems from your stoma, but there are medical advancements every day and things look promising in the area of Crohn's as well, so don't give up hope!

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