HI, I haven't posted for a while, but I have been reading lots of posts. I did a search for this topic in the discussions, but didn't find much. I am currently quite depressed. Many of you will know the feeling of waking up in pain and wishing you never had to wake up again. I am considering going to a psychologist for cognitive behaviour therapy. It has worked for me in the past when dealing with a very bad relationship I was in.
I was wondering if any of you have tried it for your disease and your response to it.
I know today is just today, tomorrow is another day, you can't tell what is in the future. You could have a long period that is more happy just ahead.
I hope you go, certainly if you feel depressed . No one should suffer without help If you could get someone you had success with before, even nicer. Even if it's someone new you might find you like them better.
I was especially unhappy until I had a long time to process. Sometimes it comes back and I know what you mean.
Its a required part of many pain management programs. You bet its good....... Great topic, I have moved it to the main discussion area. Keep in mind that this disease causes depression because of tnf's gone wild. Good disease control improves depression symptoms as well.
Welcome back, Philly! CBT is a good idea, of course, but as tntlamb says, improved disease control is key for some people. The single most dramatic effect of biologic therapy for me was a lifting of my depression. TNFs gone wild can play havoc with some peoples’ brains.
What treatment regimen are you on these days, and do you feel your PsA is well-controlled?
Yep, CBT (even just the online courses, or a bit of guided meditation - which is kind of like CBT to us lay people), is very good.
For me though, its getting the inflammation under control that really does it - and I’m with Seenie in that for me a huge, happy consequence of the TNF blockers was a lifting of both the brain fog and depression that is so ubiquitous to this disease. So if you still have lots of pain and inflammation, maybe a review with yiur rheumy to see if there are any meds you should be changing?
Please start the CBT if you find a practitioner yiu are happy with, without waiting for that though!
I'm a repeat customer of CBT. REcently, though, I participated in some Acceptance and Commitment Therapy (ACT)--it's like CBT's new little sister. I found this practice VERY helpful in getting me over a "hump". I needed to participate in several weeks of ACT to finally and fully come to terms with my illness. I would STRONGLY recommend it. While CBT focuses on acting right to think right and stresses feeling positive, ACT is a little different. In ACT there is a strong recognition that human nature includes positive and negative traits and that the human condition is, in part, about suffering. Learning to accept and lessen that suffering is central to ACT. I preferred that approach.
Welcome back, Philly! CBT is a good idea, of course, but as tntlamb says, improved disease control is key for some people. The single most dramatic effect of biologic therapy for me was a lifting of my depression. TNFs gone wild can play havoc with some peoples' brains. What treatment regimen are you on these days, and do you feel your PsA is well-controlled?
Hi, thanks for your comments. I am currently taking methotrexate and Enbrel. I was taking Celebrex, but developed a stomach ulcer so I had to stop taking it a few weeks ago. I had trouble even walking before Enbrel, so am a lot better than I was before it, but I am still not great and I have really noticed the lack of celebrex. I have very sore tendons at elbows, shoulders, heels etc and that stops me from doing a lot of things and when I do something physical they get even worse. I also am very fatigued and can't be bothered socialising or doing anything much.
I should add I have also overdone things by moving house twice in the last few months. (I had to sell my house due to not being able to work.) That involved lots of heavy lifting. Oh, and I fell of a horse about 5 weeks ago and dislocated my right shoulder and bruised my right hip. In short, I am in a fair bit of pain and am not getting much relief. My doc says I have to stay on what I am on as my blood results are all OK. He said I can take some prednisone if I want to, but I hate the side effects. I get really moody and can't sleep. I was on that stuff for 9 years and it really is a medicine of last resort for me now.
So, my problems as I see them now are grieving for my past life, the inability to work and earn a reasonable income and the loss of hope that things will get better. So, I thing I need to learn how to cope better. I have an appointment with my GP next week who will give me a referral to a psychologist. Here in Australia we can have 10 visits to a psychologist after a GP's referral and we get government subsidy for it.
I'm a repeat customer of CBT. REcently, though, I participated in some Acceptance and Commitment Therapy (ACT)--it's like CBT's new little sister. I found this practice VERY helpful in getting me over a "hump". I needed to participate in several weeks of ACT to finally and fully come to terms with my illness. I would STRONGLY recommend it. While CBT focuses on acting right to think right and stresses feeling positive, ACT is a little different. In ACT there is a strong recognition that human nature includes positive and negative traits and that the human condition is, in part, about suffering. Learning to accept and lessen that suffering is central to ACT. I preferred that approach.
I have just read your blog post janeatiu and I found it very encouraging and uplifting. Some time ago I read a book called "The brain that changes itself" and once I realised that in many ways we are what we think, it was life changing. That was when I accept that CBT can work and with the help of a good psychologist I really did change the way I thought about many social and relationship situations and how I reacted to them. If I can get similar results in relation to dealing with this disease and how I react to it that would be great.
I feel bad for you, and all the things you said hit home. I think it's really hard for people without this type of disease to know what you are going through. I never thought I'd be a depressed person....had the greatest outlook on life even though I've had psoriasis since my 20s. The PsA diagnosis changed me so much. The ups and downs of pain are sometimes unbearable. I hope you are able to get help with the depression. It is hard to get up in the morning...it's hard to go to bed at night, too.... Some of the comments by others about TNFs and other abbreviations--I need to educate myself because I don't know too much about any of those things. All I know is I'm so scared of the biologics, my rheumatologist has not been able to convince me to take them. The past few days have been so bad that I feel like I have to begin something soon. Hang in there.....like someone messaged...there are better times ahead. It's not always this bad, even though the disease is always there. There are some good days, right?
Philly said:
Hi, thanks for your comments. I am currently taking methotrexate and Enbrel. I was taking Celebrex, but developed a stomach ulcer so I had to stop taking it a few weeks ago. I had trouble even walking before Enbrel, so am a lot better than I was before it, but I am still not great and I have really noticed the lack of celebrex. I have very sore tendons at elbows, shoulders, heels etc and that stops me from doing a lot of things and when I do something physical they get even worse. I also am very fatigued and can't be bothered socialising or doing anything much.
I should add I have also overdone things by moving house twice in the last few months. (I had to sell my house due to not being able to work.) That involved lots of heavy lifting. Oh, and I fell of a horse about 5 weeks ago and dislocated my right shoulder and bruised my right hip. In short, I am in a fair bit of pain and am not getting much relief. My doc says I have to stay on what I am on as my blood results are all OK. He said I can take some prednisone if I want to, but I hate the side effects. I get really moody and can't sleep. I was on that stuff for 9 years and it really is a medicine of last resort for me now.
So, my problems as I see them now are grieving for my past life, the inability to work and earn a reasonable income and the loss of hope that things will get better. So, I thing I need to learn how to cope better. I have an appointment with my GP next week who will give me a referral to a psychologist. Here in Australia we can have 10 visits to a psychologist after a GP's referral and we get government subsidy for it.
If you are that depressed,while totally understandable, you should see someone. Attitude is everything will any chronic illness. Sometimes we just need some help to find that better place
Hang in there and remember, there is still plenty of good
Hi Philly, just a quick note to mention that if you are in Aus, once on a “standard” biologic you can swap to others regardless of bloods (so my Rheumy told me and I did because of stomach issues). So you could just do a straight switch to Humira if the Enbrel is not working adequately, though obviously there’s no guarantee the Humira will either.
Hi Philly, just a quick note to mention that if you are in Aus, once on a "standard" biologic you can swap to others regardless of bloods (so my Rheumy told me and I did because of stomach issues). So you could just do a straight switch to Humira if the Enbrel is not working adequately, though obviously there's no guarantee the Humira will either.
Hi TNF is Tumor Necrosis Factor. That is what the biologics target to reduce inflammation.
Hi TNF is Tumor Necrosis Factor. That is what the biologics target to reduce inflammation.
Thanks for the info Jen. You are right. I switched from Humira to Enbrel, but I think the rules are that I can only try three of them. I was told it is too much of a risk to try the third unless my bloods are bad.
Hi Philly, I do remember that now - there are only 3 approved for PsA.
Despite fulfilling the CASPAR criteria for PsA diagnosis, my rheum decided to diagnose me with seronegative RA. Blessing in disguise, tuns out there are more PBS approved treatments for it. (His reasoning it couldn’t be PsA - you can’t have PsA unless you have massive, conspicuous dactylitis!)
CBT is a lot of work, but is very worth the effort. Dialectical Behavioral Therapy, a treatment originally developed for borderline personality disorder, focuses a great deal on mindfulness, radical acceptance and distress tolerance, all of which are incredibly helpful for pain and disease management. DBT is also very hard work, but the exercises are very helpful for people with chronic illness/pain.