Recently diagnosed with PsA and Depression

General
1

Hey guys, this topic doesn't seem to have had too much activity recently so maybe this will kick start it...

My name is Mark, 31 years old and I am an English guy living in Brazil. My pain started around 2 years ago and after numerous trips to doctors, 3 MRI scans, countless x-rays and lots of different medication tried, I was diagnosed with PsA in February. While I was very happy to finally be able to start the correct treatment, all of the uncertainty, mental and physical pain and stress that this has put on myself and my marriage to my wonderful Brazilian wife has left me with not only depression but another serious problem.

Over the last 6 months or so, I have been using food as a way to try and make myself feel better and less sad. My biggest vice in life has always been food. Not drink, drugs, gambling or anything else, food has always been my escape. So when PsA came along and affected my life so profoundly, I didn't know how to deal with it. So, I ate.... a lot! Somehow I managed to keep it a secret from my wife but the more I continued, the more in denial about it I got. I not only ate but I also spent. I used money from my savings, money that was supposed to pay for a trip to England in September.

It all came out around 3 weeks ago. I couldn't live with the burden and shame any more and I told her everything. The response was mixed. She was understandably upset and disappointed that I had lied to her and spent all that money over the months (I had spent around 3000 Brazilian Reals at that point), but she didn't kick me out, she didn't demand a divorce and she didn't refuse to help. Quite the opposite actually. She told me that I needed help and that she would do all she could to get that help. Not just for me but for us and our lives together. Things have been tense and there have been good and bad days but progress is being made.

Having said that, it is still hard. This experience has forced me to admit something that I never thought I would say...I am depressed. Maybe its the PsA, maybe it's moving to a new country or missing my family or adjusting to a new culture or maybe it's a bit of everything. Regardless of the cause, I know now that I am not well and I need help.

That brings me on to the reason for this post. I am getting help here. I am seeing a psychologist once a week and I will be starting new PsA treatment soon. However, the impulse to self medicate using food still remains and the thoughts of depression have not gone away. So I am just asking if anyone has any good advice or suggestions. I am getting help here but a new and different perspective would be useful. Here's hoping.

Mark

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So sorry you are going thru this as many of us have. I too have depression in addition to the PsA. The depression makes the PsA worse, and the PsA makes depression worse. Ugh! What a cycle. I hit the bottle to deal with pain and emotional pain. 13 months ago I joined AA and the program has given me tools I never had. It is my belief that a 12 step program of some sort can help everyone on this earth find health and happiness.

Overeaters Anonymous is a registered 12 step program and can be found all over the world. I have attended some meetings for my bulimia then anorexia. My main issue is alcohol though.

I am under the treatment of a rheumatologist and take prednisone, methotrexate, Cimzia (biologic), Mobic (anti-inflammatory), topical magnesium chloride for pain and other pain meds. I take Zoloft for depression and Seroquel for insomnia. Sleep is a big treatment for us as lack of makes pain so much worse.

I hope you find the help you need. I just began private therapy with a pain counselor. I believe she will provide priceless assistance to my thoughts, ideas and feelings surrounding my pain, stiffness and disability. -michelle

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Mark - the condition absolutely can and does cause depression and so also the various other things you are dealing with: new country, new relationship/hurt relationship, disappointment with self, etc.

The condition not only affects functional limitations and chronic pain but the depression is also biologically generated just like it is for Diabetes. Of course we can be depressed due to limitations, diet restrictions, etc. but the condition itself generates depression.

It is good that you are seeing a psychologist. You will eventually find life and functionality improve and then you must find how to be kind to yourself and nurture self. We have all been where you are now and I can tell you that things will eventually improve but you have to eventually be more active in the positive choices and decisions/actions for yourself. You are not alone.,

another Marc

4

Hi, Kingbear

I'm so sorry that you are suffering this, and I know I'm not the only one here who has struggled with similar issues. I think there are probably a number of factors at play for you, as Marc mentions. New life, many adjustments, disappointments, missing what was, all of those things will affect your mood. Then add pain and physical restrictions into the mix, and as Michelle says, what a cycle.

As if that weren't enough already, there's the whole biological thing to factor in. This article may put a slightly different spin on your situation:

https://www.psoriasis.org/advance/prone-to-depression-your-immune-s...

What it says to me is that aggressive treatment for your disease may make a big difference to your depressive moods. This certainly was so for me: going on biologics made a big difference in my depression long before I noticed improvement in my pain levels. (And conversely, when Biologic #1 stopped working, my depression returned.) I saw a psychiatrist, and he suggested a different anti-depressant which worked wonders for me: suddenly I found myself with a manageable appetite, after years of struggling to control my food intake.

Good that you are seeing a psychologist. You have a great deal on your plate. But I think you also need to see someone who can address your depression as part of your disease, and who may consider treating it as a biochemical imbalance, which it is. That would be your rheumatologist and probably a psychiatrist as well.

All the best with this, Mark. Not only are you not alone, as Marc says, but you are also in good company.

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Hi Mark. Your post really spoke to me. I've been there, and in many ways am still there. Depression is, in and of itself, a terribly painful process. Add in the physical symptoms of PsA, and you have a recipe for disaster.

I recently had to undergo a psychological assessment for my disability application, and it was truly difficult to read the report that the psychologist submitted. In his educated opinion, I am one emergency or chaotic event away from suicide. I'm not sure I agree with that assessment, but I also don't disagree. How's that for being indecisive? I am taking medication for depression as well as for an anxiety disorder, and most days it controls the self-destructive tendencies for me. But then again, every Saturday I have to take a high dose of Prednisone in addition to a high dose of Methotrexate. The end result is that every Saturday I feel like I'm going to puke all day while craving sugar in any form - preferably pastries and donuts. In fact, most Saturdays the only thing I can make myself eat is something sweet and (if one is lying around) an Ensure. And then I don't sleep for 48 hours. The SSA doctor that I also had to see is convinced that I am perfectly fine except for side of effects of medications he isn't convinced I need. What a whack job.

My point here (and I know it was a long, rambling road to get here) is that we truly understand what you are going through and where you are right now. We all have ways that we've learned to cope, and we can give you some suggestions, but the reality is YOU are going to have to figure out what works for YOU. Like medications to treat our disease...everyone responds differently. My husband uses sketching and painting as a mechanism to cope with having to live with someone with a chronic disease (actually, several chronic diseases as I also have diabetes, high blood pressure, Crohn's disease, PsA, hideously bad psoriasis, and 4 herniated lumbar discs). I use my tablet to cope - this is how I post here, I watch Youtube videos, I play various games, and I read. A LOT. Considering my previous very active lifestyle, the sedentary nature of my issues causes a lot of stress for me. I can no longer be the CEO that worked 120 hours a week, went to grad school, and raised 2 medically challenged kids on my own. I can't go camping, and garden, and dance, and do all the things that used to bring me joy. I can't even play the piano or cello anymore because the joints in my hands are so inflamed that moving them hurts like the dickens. I used to type 90 words a minute. Now its more like 4.

But I realized quite a while ago that lingering on all the things I can't do anymore is not only unproductive, its also very destructive. Switching your perspective isn't easy, but it can be done. Now I concentrate my waning energies on those things that I CAN still do and can still do with some modifications. I used to love to go to state parks and go camping for a weekend. Now I go to parks for a few hours - sit in my car on really bad days, or have my son push me in a wheelchair along the paths that are handicap friendly. I enjoyed camping because I loved to be surrounded by nature. Made me feel small in the overall scheme of things. Helped with my perspective. I can still do that! Once I broke down the camping thing into what it really did for me/meant to me, I figured out ways that I can still be fed by that without the added stress of trying to sleep on the ground in a tent (so not going to happen - I can't get back up!) So again....(lol) my point here is that if you can figure out what food and spending money does for you on a psychological level, you can figure out a way to indulge in activities that do the same things for you (again on a psychological level) without the self-destruction. I'm not saying its easy - its actually pretty hard work - but it is worth it. Add me as a friend. We can talk through things via messages. I can talk you down when things get really bad. You can talk me down when things get really bad. Its a win/win. :)