Depressed since starting blood pressure med

[NeverAgain127]

I'm female, 53, very healthy.  

Unfortunately, I have a troublesome family history.  Both of my parents have hypertension, and all four grandparents did as well.    

My mother has always been a very healthy person, an avid exerciser, who eat right.  She still developed high blood pressure in her 40's and has had it for over 30 years.

I developed pre-eclampsia AND diabetes when I was pregnant, despite only gaining 24 pounds and eating very healthy.   (This was 27 years ago.)

Fast forward to 2015.   I exercised 3-4 times a week; hard cardio on an elliptical/arker (its' like a combo stair-stepper).    A month ago I felt weird; very dizzy and my heart was beating too hard (my usual resting pulse is 60.)

I took my BP and it was 165/105, and stayed there or higher for the next 2 days.  My doctor put me on a low dose beta blocker; Metoprolol (the generic version of Toprol) 25 mgs, XR (extended release.)

That was a month ago, and I HATE the way I feel.

At first, I had awful tummy upset (I took the pill in the morning, with food, as directed).  So I started taking it at night, with dinner.  

I feel incredibly sad and depressed all the time.  I've doubled down on my exercise routine, working out 30-45 minutes every single day (7 days a week).   My heart rate and recovery time are excellent, and I feel okay for about an hour AFTER the workout, but the depression is back again.

I'm NOT a "crying" type person (although I was when I was a lot younger.)   My job is in sales; I own my own business, and have to cold call all day, every day.   The result is I've built up a very thick skin and can handle rejection pretty well.  

That being said, since starting this BP med, I'm crying over tv commericals and re-runs of Law & Order.  WTF?

What KILLS me is that when I ask my doctor about it, the answer I get is "You're symptoms are not typical for the dose you're on."   Same answer from my local pharmacist.  

Sigh.  I hate, hate, hate that I have hypertension.  It makes me feel like a failure at maintaining good health.    But I'm not usually a depressed person; in fact, quite the opposite.  I'm usually happy, motivated, very determined.

I have some medical conditions: hypothyroidism for which I take meds, GERD (also take meds) and I go through periods of time when I have panic attacks.

Sorry to be so long winded.  Has anyone else EVER gotten depression from their blood pressure medication?

Thanks!~

[Paxiled]

You know, if this was just for a couple of days and never before, who says you need BP medication at all?  All drugs have side effects, and they can be pretty nutty.  Doctors pooh pooh this because, first, they don't want to alarm you, but mostly they really don't know a lot about medication -- nobody does other than the pharmaceutical companies, and they only tell the doctor and you what they want you to know until forced to do otherwise.  So trust your instincts.  But again, if this only happened the once, dietary and lifestyle changes seem a better reaction than a rush to any kind of medication.  There may be a lot more to the story, but there are natural remedies such as hawthorn based formulas that often work very well, and meditation and relaxation exercises can help.  But don't overexercise -- you don't want to get injured and not be able to exercise, which is where I got myself to.  Good luck.

[LeapYearGUY]

Hi! Just a quick response to say I was put on a similar beta blocker two years ago and I have had the same response—very depressed, sleepy all the time, no energy, etc. the doctors response was always the same: those aren't side effects friom the medication. ..well, according to the manufacturer, they are "common" and "very common."
Bottom line: it's your body! There are a wealth of other BP drugs out there. Ask to switch!

[NeverAgain127]

Wow!  Thank you for such a well though-out response.

I'm having a treadmill stress-test in the next few weeks so I'll get answers about my cardiovascular health, but I expect the results to be positive.  I had one, with contrast, plus an echo, about 8 years ago and my results were excellent.

In my state, it is next to impossible to find a doctor who has an open practice.   My daughter, who moved back to the Northeast after graduating college in the southern US, could not find ONE doctor who was willing to take on a new patient.    It's crazy, and I'm not sure what is going on.   I think this is just a "blip" in our current health care in this state...the reason I say this is that I don't think I could FIND another physician who would give me a second opinion.

My GP is a great guy; he's thoughtful, very smart, and he listens to me.  I have a degree in pharmacology and we discuss my meds at length.   BUT..you bring up a good point; he is NOT a cardiac specialist.   I dearly hope I do not need one.

I re-read my post and I think I may have misstated what happened.  I didn't have any sort of cardio event, and my BP wasn't high after exercising...it was high after I was sitting at my desk making phone calls, and I just started feeling dizzy, and my HR was up.

The pre-eclampsia that i experienced while pregnant left me with elevated blood pressure for six weeks post-partum.  I remember distinctly my OB telling me "this might be an early sign that you will develop high blood pressure later in life."

According to my doctor, high blood pressure can be primary (genetics) or secondary (caused by overweight, lifestyle, etc.)    I gained maybe 20 lbs after menopause that I cannot lose and wow have I tried.    According to the doc, the extra adipose tissue is supplying me with estrogen my body needs.   He thinks keeping the weight on (I'm not "medically overweight") is ok.  

I, of course, hate. it.   I would love nothing more than to be the same weight as I was in college.  I've gone to nutritionists, dieticians, tried the Paleo diet, South Beach, you name it.   I've counted calories, done interval training, and nothing, but nothing, makes the scale move.

If I eat EXTREMELY low carb (under 20/day) I can lose 5-8 pounds, but I think it is mostly water.

Anyhow, I'm digressing.  

I chose the name NeverAgain originally on the Substance Abuse forum.    I have degenerative disc disease in my upper spine (very painful; diff doctors have told me surgery MIGHT help...not willing to go this route yet) plus costochondritis (I studied classical piano for over 12 years, plus I use a computer all day long).   My doctor had me on oxycodone and Gabapentin for what was often excruciating pain.  

After years on the opiates, they 1. stopped working and 2. had side effects that were very unpleasant.  I decided I wanted OFF them.   Told my doctor I was going to taper down and them stop taking them.  I remember him saying "you might be a chronic pain patient who has to take these...its okay, you know."  I never abused them, but opiates are just nasty, and imo, over-prescribed.

Also, they might have been masking my hypertension.  Next week I will be six months off the oxycodone (the withdrawal was not fun, but I did it.) While I was taking pain meds, my blood pressure was always nice and low.

It started to creep up, and then, a month ago, when I saw that my diastolic was over 100, I thought it was time to call my doctor.

You are correct in that I do think I "know" my own body.  I don't take my health for granted.  I'm not obsessive about my health, but I try to generally make good choices.

Bottom line:    I definitely feel depressed since I started the metoprolol.  It's actually a pretty commonly reported side effect, and from what I can see on the internet, seems age related (the older you are, the more depression.)

I do take my BP a couple of times a day.  It's usually 120/80, on the medicine.  

Thank you again for taking an interest in my question...

[persephonedemeter]

I really should not sign off so quickly. I forgot to say that it may not necessarily be depression, but it can affect mood. I honestly cannot say if it is an initial effect or if it longlasting. People I know who have been on it for awhile have not really spoken to me about it, and it doesn't really come up much in conversation. They don't seem depress or emotionally labile  to me and nothing really stands out of the ordinary.

[persephonedemeter]

I also forgot to answer to major question, Yes. Metoprolol can effect your mental state, but whether it is giving you depression really has to be explored further because of all those things I said above that may play into it. It's kind of hard to pinpoint it to just the metoprolol, but I wouldn't think it was unlikely for your dose. Hopefully, you are checking your blood pressure more than once a day to see how long the metoprolol is effective for you, I would imagine it is at least 3 to 4 times a day and logging it down in a journal along with when and what your activity is that is relevant to those things. You can also log your moods in it. It is helpful to do that and helpful to show the doctor and lend more to the discussion. Everyone likes concrete, objective  and evidence based treatment. It's fundamental to health care.

[persephonedemeter]

Sorry, It wasn't a Freudian slip but a typing error. I meant prone to not probed to depression and other mental states. The "b"key is by the "n" on my touchscreen,

[persephonedemeter]

I haven't personally to cardiovascular problems, but to other health/trauma circumstances I had. Just like you, I did  everything right. Took really good care of myself and glowing with good health. I remember the first time I got admitted to a psych ward, and the resident exclaimed, "You're going to love her, she's incredibly healthy." I'm no longer golden like that, but I've had a few "knocks" since then, and came to accept my current condition, although I kept what I had going for me, took things in stride, became a lot more forgiving, and I would say, I'm healthy again. It knocked me down hard when I got admitted to a psych ward. I always thought I was very resilient and strong mentally. As a result, I expected to get back to "perfect awesome condition" in a snap. That was decades ago. A lot of people who take really good care of themselves get knocked down by a health problem and condition  that "shouldn't have happened."

People with thick armor also have their Achilles' heel. I personally don't see crying as a vulnerability. People cry for a lot of reasons, including frustration, anger, passion, joy,and fear to name a few.

If anything, look at it this way. You watched out for yourself and conditioned and did everything good for prevention and health. At the very least, your body isn't a bed of contributing factors to add on to your hypertension. At this point, since high levels of exercise does increase cardiac workload and stress raising blood pressure and heart rate during a workout, I would talk to a good cardiologist about exercising safely and keep them in the loop about how much you are exercising.

There is an emotional and psychological effect here also, that you seem to instinctly recognize. It sounds like you really pay attention to what is going on with you. I don't know if your dr. is a cardiovascular specialist, but there is a recognized phase after being diagnosed and going through a cardiovascular event, that a significant amount of people require emotional support afterwards because most people do get probed to depression or some sort of mental effect. It's a big change and it's scary.

Sorry to say, there are people like your doctor who seems to lack emotional intelligence about these things, and who knows why, but, hopefully, they'll learn for themselves and for the people who cross their path. First and foremost, you need to take mental good care of yourself along with what you are doing physically, because it goes hand in hand with each other. Exercise does make you feel good, but it doesn't sound like it is lasting because how you feel and think about what is going on with you. It is still there. From what I hear in your post, it sounds like there is anger, disappointment, maybe frustration and a lot of "why" questions. At the very least, ask to get a therapy consult. Whether it comes from the medication, which can happen, getting the hypertension diagnosis, anxiety, or what, it is something that you need to explore, in my opinion. It's always a process, and it's not about getting answers but doing something to handle it while trying to get answers. As we say repeatedly, it is different for everyone. Also, it is not unreasonable to think your other conditions like GERD, hypothyroidism, your other meds, can play a role. There can be an interaction going on there and the body systems do not work in isolation to each other.

If it was me and I'm not convinced that my problem is being addressed fully, I give the doctor a call and ask to discuss it further because I need help or advice, I would go over what my concerns are and what I am going through now and how it is affecting me. I would put it out there what I think I would need. If you have a therapist and psychiatrist, get them involved in the discussion. I've done that too, so no one assumes anything,everyone gives their opinion from their field, and everyone including yourself knows what is going on. If you feel the doctor is not listening or working against you, get a second opinion or consultation, and/or change doctors. I've even asked the doctor to sound it out with another doctor in the field or at least, think about it and explore it more. Most of the time, I don't have to say that, and a lot of times, they get back to me after they put more time and effort into it, like what you are doing now asking questions and exploring on your own, and consulting with people. That is taking health care responsibly all around, and more to the point, taking care of yourself with your best interest in mind. It also tends to give everyone a good working relationship with each other. I think it is a good idea to get back to a discussion if you are having someone manage something long term for you to build a good relationship with each other.

What do you do for yourself besides exercise and healthy eating for healthy well being? I noticed your online name is "never again." How do you deal with adversity? Even the attitudes we have and the way we see things plays into health because it usually involves how we expect things to be. It's more a question for you to answer for yourself then it is for here.