As depression and anxiety often accompanies PSA and other chronic diseases lets share some ideas for getting through it and maybe enjoying life while treating it.
I have been treated for anxiety and depression for the last 20 years with an SSRI. Similar to the drugs for PSA the SSRI work best long term. I have little to no symptoms now but I do remember well how frightening, embarrassing and painful it was. I also have recieved good psych care for 5 years at a time periodically. Like finding a Rheumy I had a couple of lousy Psych before I found some good ones. It has made such a huge difference for me. What has worked for you?
I found that dealing with underlying issues that I'd put off helped, significantly. I needed to do some trauma work (a combination of psychotherapy, mindfulness practice and lifestyle changes) and learning how to deal with trauma and the depression related to that helped me deal with the pain from PsA and the hopelessness/helplessness associated with the awful Gap period. Now that I'm feeling better, I'm making better use of my time and dealing better with daily stressors, as well as large ones.
I worry a lot. Probably a million times a couple of our daughters have told me I need anxiety meds... But I never really felt it was bad enough for meds-and god forbid I'd ever admit to being depressed! And, I don't think I've ever really been depressed-at least not enough in my mind to think I needed drugs. However, in recent months (before finding you guys and Enbrel) I did go as far as saying that if I ever DID get depressed I would take antidepressants and get therapy.
This all stems, I think, from having really strong parents--my dad especially. He was the strongest person I ever knew, both physically and emotionally. Very easy-going and good natured. And, he never complained--not even on his deathbed!
Asking him for strength is sometimes helpful when I'm feeling weak and defeated!
I do take meds for both depression and anxiety, however the best remedy to get me through those times when either or both rear their ugly heads more than the usual is prayer. Lots of prayer. My strength comes from my relationship with my Lord Jesus Christ.
One of the biggest steps for me was learning not to beat myself up on days where I'm too tired to do anything. I've used the techniques taught to me by a counsellor I had quite a few years ago to help me see the positive stuff about myself rather than focus on the negative. I do something every day that is just for me, that brings me joy.
When things have gotten really bad I've engaged a therapist to help me. The most useful strategies I learned from acceptance and commitment therapy were: a) to diminish the power words have over our lives (words like "arthritis" and "chronic illness") and b) to stop engaging in a battle with the things that trouble me and, instead, accept their existence as a reality and make space for them in my life. I am sure this sounds hokey to some of you, but these two small steps were incredibly meaningful to me in being able to move from grieving about being ill to living my life with both integrity and a chronic illness. I have also taken a mindfulness based stress reduction workshop series and picked up some very useful tips and habits about slowing down and even meditating. Again, it isn't for everyone, but it has worked really well for me.
That is great advice, jane. It is really hard not to let those words cloud all your thoughts! I often have to tell myself to cheer up–things could be way worse! I am really good at covering up my sad feelings so my coworkers and extended family don’t have to see me as a whiner or wanting sympathy…It has been very helpful for me to get on here and vent or join discussions and try to help others.
Jane I can relate to what you are saying. I have been doing something similar. I find I have to stop putting on a brave face. That doesn't mean I go around whining but I stop my pretending. It is helping the people around me to know more clearly where I am at and has made my relationships more genuine and closer. I think I was afraid I would drive people away if I acknowledged what is going on with me on certain days. Put that has not proven to be true. I also have found myself thinking about the difference between pain and suffering. I have pain every day but suffering is a choice. Even on my worst days I can find something to do that brings me joy even if it is simply watching netflix and waiting for my husband to make dinner! Of course I am very lucky to no longer work and I have a husband who "gets it" and does not blame me. I have done a lot of work on letting go of chores, hiring help and being happy in a dirty home! I have raised beds on the patio I can still garden in (Thank you Jim!) and a new recliner for bad days (thanks to my skill at saving money all my working life!). I am very lucky but I do believe the saying, "Bloom where you are planted".
I have been suffering from both depression and issues sleeping. I started taking one medication for both this past winter. They seem to help. I really don't think I would have gotten this far without them. I know I could use someone to talk to about other underlying issues but am already finding myself tired of doctor appointments.
It is an uphill battle, Dini, and hopefully the medication you are taking will continue to relieve you of the depression.
Some of us do have underlying issues that it's hard to bring up here or to family or friends. It's always nice to have someone to go to who you can trust to be open with.
I can't talk about my ailments with my husband--he is in his own self pity. If there's one thing I can't stand it's a person who complains that we have a hell on earth. It's hard to be in everyday life with a person like that, but luckily the rest of the people close to me are generally happy and fun to be around.
We're here for such a short time and we don't know what's to come. If we can take pleasure in the simplest of things, life is wonderful. I hope you can find happiness and someone who understands you.
Dini said:
I have been suffering from both depression and issues sleeping. I started taking one medication for both this past winter. They seem to help. I really don't think I would have gotten this far without them. I know I could use someone to talk to about other underlying issues but am already finding myself tired of doctor appointments.
When I was first diagnosed, I wanted to scream at the world. It took me time to realize how unhappy I was, but when I did, I went to therapy for a few months. It helped tremendously.
I don’t really know, and I’m pretty sure that’s a bad thing.
I had a panic attack - what I thought was “out of the blue” a short while ago.
On reflection, I realised I’d been ramping up specific relaxation techniques for months - starting with yoga and moving on to guided meditation apps.
I’d also had a lot of experiences in the last few months forcing to make myself decisions - really struggling to be decisive.
It seems I’ve probably been self-managing anxiety for months, and not even realizing it. Now I see it as just something I need to learn more about and get better at. All advice welcome!
I’ve been thinking about this discussion for the last week or so, because I’ve been plagued with attacks of panic and anxiety lately. Janeatiu said some interesting things about therapy, but what really caught my eye was her mention of meditation. A while back, I read a book called “How to be Sick”, which is written from a Buddhist perspective. I was surprised that I liked it, and I did find it helpful. I was intrigued by what a central role meditation played in the author’s handling of her condition.
Anyway, I wondered about how one learns to meditiate. And then, I had a flash when I realized that there must be an app for that! LOL Sure enough, the App Store has loads of guided meditation apps. Which to choose? Well, I went googling and came up with this article:
The reviews were really positive, and it is produced by a non-profit foundation.
I got the free “Stop, Breathe & Think” app, and bought a couple of the add ons (less than $5 in all, and the app works fine without the add ons) and for the last few days, I’ve been trying it out. I’m surprised at how much I’m enjoying the guided meditation. I do it for only ten minutes or so at a go, but I’m surprised at how relaxing and refreshing it is.
I’ll carry on with this and see where it takes me.
I like what you say here about pretending, Michael. I need some help with that. I put on a brave face and don't complain much, but sometimes I think it makes me feel very alone and isolated, emotionally. I need to find a healthy way to express myself and connect with others in an honest, but positive, way. I think sometimes people expect too much of me because I pretend I am feeling OK.
michael in vermont said:
Jane I can relate to what you are saying. I have been doing something similar. I find I have to stop putting on a brave face. That doesn't mean I go around whining but I stop my pretending. It is helping the people around me to know more clearly where I am at and has made my relationships more genuine and closer. I think I was afraid I would drive people away if I acknowledged what is going on with me on certain days. Put that has not proven to be true. I also have found myself thinking about the difference between pain and suffering. I have pain every day but suffering is a choice. Even on my worst days I can find something to do that brings me joy even if it is simply watching netflix and waiting for my husband to make dinner! Of course I am very lucky to no longer work and I have a husband who "gets it" and does not blame me. I have done a lot of work on letting go of chores, hiring help and being happy in a dirty home! I have raised beds on the patio I can still garden in (Thank you Jim!) and a new recliner for bad days (thanks to my skill at saving money all my working life!). I am very lucky but I do believe the saying, "Bloom where you are planted".
I have the same problem mimiB. People expect too much as I am pretending I am fine. I am learning ways to express my struggles in a positive way as I will avoid expressing myself if it is in the least negative nor would I ever whine! I hate whiners! What seems to work for me is to turn it into humor; "well I was doing really well until my left hand turned into a hook suddenly. Maybe I'll put it to good use hooking rugs!" That kind of thing allows me to express frustrations in a way I find acceptable. My husband and son are good at reading me and allow me to struggle until it gets to be too much for me. But the rest of the world is not so finely tuned. Now I just have to get up my nerve to ask for my food cut up in restaurants. Ah another battle for another day!
Michael, I make my menu choices in restaurants based on how my hands are any particular day…maybe that’s masking the " I’m struggling" but for me its so I can enjoy the meal without having to make my hands worse, or feel like everyone is watching me lol …saying that, I still often “throw” food off my plate
So I'm kind of lucky that I dealt with a lot of depression, anxiety and PTSD (which made everything 2394872 times worse) before my arthritis was bad enough that I had to deal with it.
I'm on Cipralex (I think Lexapro in the states?) and have been for 3 plus years now. Before that I was on Zoloft and Paxil, Remeron, Um.... what else.... Ativan, Clonazapam.... I'm sure I'm forgetting some.
I've been in therapy on and off since my early 20s, one on one and group. I found group to be SOOOO BENEFICIAL. It was for my PTSD. We didn't talk about our trauma, but discussed how it changes our brains, and what we can do to change it back, or at least deal. It was so proactive, it really changed my life. I can cope with stuff now.
We often believe that we can deal with depression and anxiety on our own, and some of us can manage. I am not one of those people. Mental health is just as important as physical health and the two are so interlinked! We wouldn't expect someone to manage their physical health without the aid and guidance of health professionals, so why do we do it when it comes to our mental health?
In hindsight I'm really glad that I dealt with all that crap before I got as sick as I am now! Yes times are not always easy, but it really taught me to never ever suffer in silence!
West coast Meg what you say is so insightful. We do not expect ourselves to manage PsA without health care but we seem to think we should be able to handle emotional issues without assistance. Very true. I am not sure we ever really able to manage it but do successfully avoid it for a time! I am interested in what you said about PTSD changing the brain. That is new to me. Could you explain it a little more? I find this very interesting.
I can better relate to what you guys are saying in this thread since the "ordeal" I just went through.
It forces you to do some deep thinking about how you would handle being wheelchair bound. I thought how quickly life could change for the worse because of a health problem. I had weird, troubling thoughts of losing control. I'm a doer-people tell me our adult kids depend on me too much. But, that's what I enjoy! And nobody expects me to do anything-it makes me feel useful. They were here to help me when I needed them, too. I did a lot of contemplating about how I would ever deal with "not feeling useful" during the few days I was incapacitated. It's awful! How do you deal mentally with slowing down in your golden years?
Seenie, thanks for the link. Meditation sounds like a great idea. Years ago, my younger sister learned transcendental meditation and it worked well for her (it was against our Catholic faith, but she had severe juvenile diabetes, so my mom approved it). I've thought about trying TM.
1. Look in the mirror every morning and say " It's OK to admit that I feel sick/ tired/ sick of feeling sick & tired"
2. Smack any person that tells you that you need to "Just get over it" "Think positively" "Swallow goat tail juice"( or any other bizarre cure)
3. Keep a journal of both your feelings AND your symptoms- it's both good therapy and it's useful for monitoring your symptoms as well!
4. Reward yourself- you ARE being brave, and achieving your goals is worthy of celebration- even if it's only getting your clothes on by yourself!
5. Keep in contact with your friends... even if they don't really understand, they are still a big part of your support system
6. If all else fails, get a dog... preferably a small, non- shedding one... even if you feel like nobody in the universe is taking any notice of you, your dog will always think you are the most important person in the world! (And they make good hot water bottles when your hands are cold and achy!!)
