Its popped up in a few threads so lets hit it head on.........

This disease causes depression. if you don't like the term, thats fine, pick one you like. Say like "suppressed endorphin production due to excess TNF production."

Now I'm not talking about "situational depression" death in family, worry about your disease etc. Fact is we (the USA) are one of the few places in the world that treat that with drugs first (and they usually don't work) instead of counseling.

This is an actual physical condition that increases pain level's, lowers the effectiveness of medications, effects blood flow/pressure, interrupts sleep, and cause's fatigue. The next thing that happens of course, because you are sitting on your rear tired, felling pain, lacking ambition etc, you get the other kind of depression.

Because you are not moving everything else goes in the toilet and you PsA symptoms really go to town. So what do you do? you go to your doc whinning you hurt soooo much. Of course you have turned down antidepressant meds in the past so she you throws you out. then you try the ER or your PCP or really scrape the bottom and go to "pain management" Some how some way you find someone to give you MORE depressent medication but it also has another effect it produces those missing endorphins and you "feel" better (if you have normal endorphins to begin wiht, you feel real good or take to much to get that same effect)

So here the question while you will take narcotics with out question, why in the Sam Hill when someone even (a doctor) remotley suggests a tricyclic medication that restores natural endorphins folks get immediatly defensive and start looking elswhere for answers????

We use canes, handicapped parking permits, we board airplanes first, use the electric carts in Wal-mart and sometime feel a bit bad about it all because "we look normal" (to who? put a picture of yourself from high school on your mirror and stand there naked compare and then tell me how normal you look)

But the instant someone says depressed, we freak out and invent all kinds of stigma, false pride and excuses. Get over it. Its a a bad term for a serious problem. few responsible "pain mangers" will prescribe without you using appropriate medication, and those that do will have you sign enough paperwork that you think you are taking out a mortgage on the pee cup they hand you with their other hand. (actually the contract comes anyway but you may not need it if you get your pain mechanism in working order)


Oh yes, Lamb, absolutely. I’ve got it, and I’ve had it bad ever since … come to think of it, my depression got really bad at about the time I started to ache and feel tired. And then I got high blood pressure. That all started about twenty years ago. Now, I know what the problem is, it’s TNF from my PsA.

I threw my pride overboard years ago. I have depression, and without my anti-depressants, I’d probably be dead by now.

But tell me: I don’t get the reference to signing paperwork and contracts.

The paperwork and "contracts" is the US government solution to prescription drug abuse. You essentially agree to neither seek nor accept pain medication from any where eles. Be on time for every appointment, never miss an appointment, submit to random drug tests to prove you haven't done so etc etc. What most don't realize is that tou have also entered your name into a data base (soon to go national but now limited to the states) that should you show up at a pharmacy early you will get turned down (a bitch if you are taking a trip) or with a different script busted.

A perfect example was my daughters 75 year old MIL with terminal cancer who WAS going on a cruise with her (and my wife) this last Jan. her Doc was out of town, she knew she would need her script filled early so she could have the necessary meds on the trip. She ended up having to go to another doc who knew the case gave her the scripts. She went to get them filled and was told to come back at 4:00 which she did. She had my Grandaughter with her as my daughter was holding court out of town. To make a long story short there were two officers waiting for her who took her into custody my grandaughter was taken by CPS (fortunately the social worker was a neighbor) She spent the night in jail (no meds of course) because it was a federal charge and a bail hearing needed to be held. She missed the cruise and is now serving a 12 month probation (fortunatly its a diversion so the charges will go away) As a federal felon it took (literally) an act of congress to get her social security back not to mention how to get her "pain contract" restored.

Makes my arrest for buying up a supply of Nyquil when they were taking it off the market look like a walk in the park.......

AVOID those contracts. Docs can prescribe a "short term" course of pain meds without (the term isn't defined yet but 90 days has been suggested)


Oh my word! seriously! This is what happens in the States if you want to fill a prescription early?!! That's insane. Thank god for the NHS.

Its not just early (they simply would have not filled it) She got another prescription from another doctor giving her "technically" two concurrent narcotics prescriptions. In areas with universal health care, it likley would have never happened.

And exactly how does this make America safer?
That poor lady.

Now I'm exposing myself for the liberal a PART of me is. Danged if i know Seenie. There is a reason we have the worlds largest prison population (per capita) I blame Joe Kennedy who supported prohibition while all along negotiating exclusive distribution rights for scotch whiskey when it would end. As with all things in life (and politics) there is money at the end of the trail

But getting back to the subject of this thread DEPRESSION and doing everything one can to IMPROVE their situation including other means of pain control. To surrender even a small part of control over you pain/life because you are afraid of a stigma of being depressed is just plain stupid......

Yes, Lamb. I agree with all of the above! Accepting a diagnosis of depression, and being committed to doing something about it, is a key step to getting better on all fronts.

And I’m sorry I exposed you, or rather part of you. Not really. No, I’m not sorry. :wink:

Wow!!! Its a crazy world!

There's no shame to having mental health problems............I've had my fair share.

I am a strong, independent woman, mother, nurse, partner, friend......most people I know would, and have, described me as level headed and sensible person.

but I've had a breakdown

I've had depression

I fight the demons and come out on top BUT..........I wouldn't be winning if I didn't rely on professional help with my mental state if I need it, both medicinal and counselling, whatever the reasons for the need.

So, good on you Lamb for raising this issue

Lamb and Seenie, I too have depression and have been treated for it since 1998. Was diagnosed with Fibromyalgia in 2002 and PsA in 2006. I proudly say that I take meds for my depression and like you Seenie probably wouldn't be alive today without it.

Yes Lamb, there are ppl who will take anything else and be treated for anything else but when it comes to depression there is such a stigma attached that it makes it hard to admit you have it. My mom is one who just doesn't understand how you can be a Christian (which I am) and "be" depressed. She is 88 so I stopped trying to explain. oh well...

Thank you for exposing yourself and for you posts. I learn so much here.

Well said Louise!!

I agree Lamb ! Depression itself can be very painful.

I have to admit, that there are some people that I would hide it from if I, or my kids, needed to take antidepressants. I would hide it from my sister and my mother-in-law.

My sister, because she is mentally ill, and is always looking for mental illness in others. I would never hear the end of it. And my mother-in-law, because she is always looking for weakness in others so that she can be more of a martyr. Yet then she tells me that the meds that I'm on are dangerous. Not real helpful.

Other wise, I agree completely, there is no shame. I would be keeping it a secret from the people who would be guaranteed to manipulate the situation.

So, does this depression have physical symptoms? I have been telling my doc for years I think I am depressed. Almost 16 yrs ago I remember having post partum depression,fatigue, crying,blurry vision,listless…and I also remember the day the “cloud” lifted almost 2 years later. I didn’t take meds.
The doc is telling me I have fibro with my PsA now…and that Is why I’m so achy and tired. I am sad most of the time…but I hide it well with family. They are still trying to accept that there may actually be something physically wrong with me lol. I have had 3 different rheumys with 3 different plans to treat me. Maybe I am not depressed, maybe I’m just feeling lost. Sometimes I think I would like to try anti-depressants just to see if they help me…

Yes, actually physical conditions cause the depression (chicken and egg) Many Rheumys ROUTINELY prescribe tricyclics (amitriptyline) as they help with symptoms, sleep, [pain AND depression. They are an older class antidepressant, but for most PsA patients are very helpful.

Is Cymbalta in this group of anti-depressives?

tntlamb said:

Yes, actually physical conditions cause the depression (chicken and egg) Many Rheumys ROUTINELY prescribe tricyclics (amitriptyline) as they help with symptoms, sleep, [pain AND depression. They are an older class antidepressant, but for most PsA patients are very helpful.

There have been great advances in anti-depressant meds over the last twenty years or so. Amitryptilene (or however you spell it) is a fairly old one. Cymbalta is a relatively recent addition to the arsenal. Cymbalta is interesting in that, besides its anti-depressant action, it also helps with chronic pain from conditions such as arthritis.
Coach, there’s no huge risk to trying an anti-depressant. If it doesn’t do you good, you go off it. Certainly worth asking your GP about! Life is hard enough, especially for those of us with PsA. We don’t need an extra burden making it hard for us to cope with what we are already dealing with.

I am on an anti depression med I am not afraid to say so. I am so glad I finally have a doctor who would listen to me. My family is so much happier with me now. I would say do not be afraid to ask for help.

Thanks Seenie. I will try doc one more time…hope he doesn’t say "no " again.

Tntlamb …so my PsA symptoms are exaggerated by physical depression? And perhaps I could function better physically if I took anti depressants aside from PsA meds? What if I actually don’t have this physical depression…would the med still help PsA symptoms? What would anti depressants do to me if I wasn’t depressed?