Depressed - is it PsA induced?

Hi,

I’ve been feeling very depressed for several weeks now. I’m not sure if it is life, PsA or both? I’m already taking meds for depression. I live alone and don’t have anyone to help me with daily tasks and keep the house up. I feel very lonely, especially because I’m rarely getting out the house. I’ve been teleworking.

I had a flare up (terrible fatigue) that latest over two weeks until I got a shot of cortisol from my rheumy. That got me up and moving, but the shot has worn off and I’m on 15 mg prednisone/day and I still don’t have the energy to get through the day. It feels like the fatigue will never end and I haven’t been able to do much socially for quite awhile.

I’m wondering if I need to switch biologics even though I’ve only been on Consentyx for about 7 months - it didn’t seem to help much from the start.

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To be quite honest with you, loneliness would make me depressed. I know that PsA is linked to depression but I tend to wonder if there’s also a feedback loop of some kind whereby depression that would have happened without PsA is worsened by it. That is my subjective feeling about fatigue too.

What can you do to tackle the isolation you’re going through? I admire you for ‘outing’ the lonesomeness rather than hiding it, there’s a loneliness epidemic, it’s not ‘you’, it’s society. That’s my take on things anyway.

Seriously, how can you tackle this … what have you tried so far? I bet you’ve tried a load of strategies. Me, I’d talk to anyone, I already do. Nobody’s safe lol. I talk to the dog if the owner isn’t chatty. Are there any opportunities for socialising in your area that you haven’t explored already?

Big hugs Frances.

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Everyone with any sort of chronic condition is subject to depression. So I would say you’re right, it’s life in general right now. I think we all go through periods of depression when dealing with chronic, unrelenting issues.

I wouldn’t focus on teleworking as playing a part in it, though. I work from home as well and working from home is basically what allows me to work fulltime with as much success as I’ve had. There’s definitely something to be said for the ability to go to work in your jammies and slippers! Keep focusing on working from home as a positive thing in your life is my advice.

Do you have any pets? I can’t reccommend them strongly enough. They give you a compelling reason to get up, they force you to focus on something outside yourself, and as Sybil mentioned, they give you someone to talk to!

I have parrots (which are way too much work, in general) and they make constant noise, are always moving around, are beautiful, and interact with me. But they also have the option of being completly contained in cages, lowering the amount of up keep to a point - you don’t have to walk them like dogs. Maybe a medium size cage with several colorful finches would brighten not only your day but your house? Finches don’t even need to come out of the cage, but they make all kinds of fun noises and chirps and interact with humans. I think noise and other living things around you when you live alone are important (I live alone as well).

I’m a big fan of cats, don’t have any because of my obsession with large parrtos, but they’re wonderful companions that are largely self-contained as well. Pets are also known to help with depression, lower blood pressure, and generally increase positive outlooks. And I know that when I don’t feel good my dog is a good “sick dog” and will lay in bed with me and bring me her favorite toys to help me feel better. There’s something to be said for that kind of interaction and emotional support.

And having a specific pet opens up the social element of clubs and groups who have the same pets. I know there’s a Finch Fanciers club in my area that meets once a month, that’s the sort of excellent, low-pressure socialization that could help you. What about a book club? Again, low pressure, low physical activity, but social.

As for Conestyx, it’s not known to cause depression or interact with depression meds, but if you feel like it’s not working… I would say speak to your pharm about how long it takes for full effect of the medication and then speak to your doctor about options. I believe it always helps one’s mood when one is proactive!

azurelle

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Thanks so much for the helpful response Sybil - you’ve given me a lot to think about. I’m going to work on meeting more friends. I did recently, a couple months ago, start a Knit and Crochet group. We meet twice a month at my house. We are also having a holiday party with gift exchange. Everyone is the group is wonderful and one invited me to meet her for lunch today. However, I still get very lonely especially when I have a flare and I’m stuck in bed with fatigue and flu-like symptoms. When this happens I get anxiety and depression.

Thanks for listening! (it helps a lot)

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Thanks for responding Azurelle! And I agree it does help my mood when I’m proactive. Love your suggestion about a pet. I do have an affection cat and he does help my mood and loneliness. Book club is a good idea also - adding it to the list of areas to explore. I’d love to have the energy again to regularly exercise and go to exercise classes. It just seems that every time I wanted to start exercising I would get a flare, then recovery period. So, I stopped trying to exercise. Bad idea. I’m going to start exercising this week! Just start walking in the neighborhood and then work up to going to the gym. That will get me out of the house and the exercising should help with the depression.

Thanks for listening Azurelle.

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Hey it’s looking like you’ve already got lots of ideas, to ease the loneliness. I think loneliness is a societal epidemic, we’re so attached to screens of any sort, we’ve forgotten the art of conversation and general just chit chat. And society needs more people like you to just say it as it is too,

Is there anywhere like a cafe or something that you could pop into most days for breakfast or lunch in your neighbourhood? Sometimes something like that helps too. And always exercise limits depression. I used to have two cats and then I got a puppy. Sadly both cats are gone now due to old age and the puppy is two and half years old. He’s brilliant for making me exercise when I don’t want to and he’s brilliant for ensuring people stop and talk too. He’s a total flirt and makes me laugh just about every day. I also work from home a huge amount too so all this helps.

Another thing I did was join a local community choir as first singing (even badly) raises your moood and it’s by definition sociable. If there’s one near you, I couldn’t recommend it more.

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Thanks for all your ideas. I’m going to look for a local cafe/restaurant to frequent. I crochet and can bring it along with me while I drink a cup of coffee.

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I agree with what others have put and have enjoyed reading around this topic, thanks for posting Frances. It is a societal problem but that’s not to say PsA hasn’t played it’s part for me at least. I’m definitely lower in mood when I’m flaring but would also identify myself as lonely even when my symptoms are more dormant.
After 6 months on a waiting list, I attended a course for anxiety and depression and found it very generalistic, not really suited to what I need. This made me reflect more on why I am low and personally feel that PsA informs my mood and makes me feel my limitations (I’ve never liked being told what to do!) and that can make me grumpy and frustrated as well as depressed.

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Thanks for responding MommaBear. I’m sorry you feel lonely at times also. Depression and anxiety are as bad as any disease - it can be crippling, at least for me at times.

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Hi Frances. Do you take any meds that can have a SE of depression? I s’pose the Cosentyz could. I got depression from taking a statin (Crestor) for high cholesterol. It was real, and horrible. My doctor realized right away the statin was the culprit! I wasn’t off it long and the depression went away.
Could luck—I know the loneliness from living alone is probably the worst thing… but maybe an adjustment of meds could help, or a new anti-depressant.

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Thanks Grandma J. I really do think the depression is situational and I do take meds for depression. I made need an adjustment of that med to get me through this bout of depression.

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Hello, thank you for sharing. Depression has been an issue and reading comments on its relation to psa is certainly intriguing. Have about one month ago eliminated sugar,gluten and starch from my diet, and started short feeding time intervals, once a day or not eating for one or two days, and my mood changed consistently. Apparently fasting causes elation. I started this way of eating trying to improve symptoms and decrease inflammation for my various autoimmune conditions, and the strong mood improvement was a side effect had not intentionally looked for. The inflammatory symptoms also have diminished dramatically. I love the idea of parakeets and or a puppy, and will try and get one too. Please write as much as you can to give updates on your situation and to tell us how you get on, have a nice day,

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Letizia, thanks for responding. I am feeling less depressed but I would say I have a low-grade depression. It’s much worse at night when I’m not distracted and I’m alone. And it gets much worse when I have a flare up because I feel out of control.

My sister has Lupus and when she eliminated sugar and other things (?) from her diet she felt much better. She’s in remission now, although she doesn’t contribute it to the diet change - I don’t think she stuck with the diet.

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I too live alone and loneliness can really hit hard sometimes. Especially when you are in pain. Being part of a community really helps me. I have joined our local historical society and volunteer there. I also get out to the local cafe and now have met many regulars there. Hang in there.

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Thanks for the helpful reply @Aldb!

Depression indeed is a result of PsA. There is a long complicated physiological/biochemical explanation. In addition it’s all related to causing pain.

But here’s the thing. IT DOESN’T MATTER. It sucks. Now some folk get better when their treatment program gets their PsA under control some don’t. What does matter is getting treatment for depression. That gets it better and helps with pain. FWIW I’m sort of a purist when it comes to meds. I started a tricyclics antidepressant at the urging of my Rheumatologist primarily for pain management. Turned out I wasn’t nearly the grumpy cynical, introverted old fart I had become. Even if PsA isn’t the physiological cause of your depression, just having a degenerative painful disease that most folks don’t know anything about would make Mary Poppins depressed.

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Hehehehe Yes, even Mary Poppins would be depressed!

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Still looking for a good counselor to help me cope with this disease. So far, 2 have struck out - they were lousy.

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I’ve not had a great year. However … of late I’ve had just a few surprising days, VERY surprising. For example, I found myself cleaning the house and enjoying it. Another time, I did a whole load of admin tasks … and felt satisfied with my day despite the inherent boringness. How could this happen to a slob like me? The only answer I could come up with was that, for the first time in ages & ages, neither bending / scrubbing / hoovering nor sitting over my computer all day hurt at all.

What has been happening is that daily life has become very nearly unbearable, despite my rather positive ‘global score’ at rheumy visits. Pain makes everything a downer. Relief from pain + absence of fatigue makes an otherwise naturally happy person ecstatic, even while wielding a duster.

The ‘global score’ thing bugs me. Don’t know if this applies everywhere, but I’m asked to score myself from 1 - 10. 10 being the worst state I can imagine, 1 being the best. Having a vivid imagination, I think of 10 as literal torture and give myself a 2. So does my rheumy. Therefore I’m doing pretty well. Well no, that has not really been the case. Pain has ground me down. I’d rather have intense localised pain which invokes strong emotion than the overall ache and weariness that has become so commonplace and subtly undermines me to the extent that I’ve started thinking that feeling p*ssed off is part of my personality.

Just had another really good day. It is like being a whole new human being. I might get angry or irritated etc. while feeling so much more alive but depression seems less likely.

I make it sound as if I’m having massive mood swings. But that’s not how it is. I’ve learned to enjoy feeling better rather calmly. And the same goes for the down times … best kept to myself on the whole, though not totally denied.

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:slight_smile: the new Mary Poppins or the old?

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