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Avatar universal

I was wondering what is everyone's depression level in regards to your treatment?

We don't know anyone else who is on the treatment and I was wondering if severe depression is common.
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Avatar universal
Week 45 of 48 trial treatment with PEG, Riba, and other new drugs.  No depression.  No sides.
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Avatar universal
I didn't become depressed during treatment, but I had other psychological problems such as uncomfortably repetitive dreams. And while I'm normally mild-mannered, I became somewhat irritable and was more easily angered by times during treatment.
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163305 tn?1333668571
LOL ! I still think most people are idiots ! But now I laugh about it.

Yes, Faith use whatever you need to keep you moving forward. I truly am happy simply looking up at the amazing sky again. That didn't work for me while on tx.
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2114467 tn?1358210256
Hi there,
I am not prone to depression but have noticed mood changes due to drugs. Small problems create some anxiety. Some days I get irritated easily or cry at sappy thoughts. My coping mechanisms have been tweaked. Exercise helps relieve the stress I'm feeling.
Lately, I think most people are idiots, and I know thats not nice. Must remind myself to calm down.
C
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Avatar universal
I agree with how the word depressed is often misused, and I think it then muddles people's understanding of what depression really is.

I love your analogy of the evil twin during tx. Whether those evil twins come from clinical depression, tx side effects, or what; I'm counting on and hoping for your experience that "she" will be gone when I am done! lol  That's the only theory that keeps me going. :)
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163305 tn?1333668571
True. People often say depressed when they simply mean down or a bit blue.

I lost my joy while doing tx. It returned about 3 months post.
I'd fall apart at the drop of a pin and obsessed about things in a way that was not who I normally am. It brought out this mean evil twin. I'm so glad she's gone now.
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1815939 tn?1377991799
I agree that there are different levels of Depression. But I also think the term depression is loosely tossed about way too much. Not all sadness, unhappiness, irritability, restlessness, or insomnia are from Depression. I think people often use the term depression to describe their mood when they are actually sad or unhappy (not clinically depressed) ("Oh, I'm a little depressed today.") In addition, PCPs are not educated or trained in diagnosing Depression. Too many PCPs don't really have a clue about diagnosing depression and instead are relying on those ridiculous questionnaires, adding up the numbers and scores, and prescribing antidepressants (or not prescribing antidepressants) based on those scores. In reality, they should be referring the patients to psychiatrists for diagnosis and treatment.

The link below goes to an article from the Stanford School of Medicine Depression Research Clinic. It discusses major clinical depression as well as some of the other depressive/mood disorders. It is pretty informative.

http://med.stanford.edu/depression/depression.html
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163305 tn?1333668571
When I told my hepatologist I was extremely irritated, he said that was a sign of depression.

You don't need to explain but perhaps there are different levels of depression.


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Avatar universal
pooh thank you for all your words,

i found that at the beginning of treatment there was this motivating force that drove me. even with the physical effects of treatment i was in it full force.  when the liver doc pulled me of the incevik at week 10 it was a great disappointment.  at first i argued with the doc. it was like trying to argue with a zen master.  after which i broke down and cried in the examining room.

and then the sadness arose.  i found myself crying for hours each day, thinking about all the others that i had injured in one way or another over my lifetime.  followed by feelings of self loathing. and thoughts of suicide arose.  

concentration became impossible. short term memory was difficult.  i would spend most of my day trying to keep up with the most basic of human functions and for a while i could not even get up the desire to go to the supermarket.

you wrote "I was sort of in this shell of a body that seemed to have no feelings or responses  to anything."  i understand. now there is this feeling of emptiness, there does not seem to be any motivating force left. i have no interest in the things i once found pleasurable. the most basic desires are gone. like companionship and food. these thoughts arise that maybe i should try to make amends for those i have hurt over the last year, yet i have no motivation.
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Avatar universal
I understand it's hard to explain, but you did a pretty good job; I saw some finer points of light in what you wrote. It clarifies things a bit.  Thanks :)
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1815939 tn?1377991799
"I guess what I'm asking is how can one be on tx (which has 90% of the symptoms on the lists), but say, "However, I did not feel depressed and I was not depressed. I know the difference."  You are in a unique position to describe the difference and I'd be interested to hear what makes the difference. As I said, depression and its dx has always been a mystery to me, especially for people on tx. Maybe you can enlighten me on that."
-----------------------------------------------------

It is not actually easy to describe major clinical depression to others. It is sort of like describing Hep C Tx side effects to others. It is difficult to understand if one has not been in the situation.

Many diseases (as well as Hep C Tx) can cause symptoms such as fatigue, loss of energy, loss of motivation,  sleep disturbances, weight changes, crying spells for no apparent reason, back pain or headaches, changes in appetite, reduced sex drive.

In addition to the above, Hep C Tx can cause impaired concentration, distractibility, trouble thinking/ concentrating/remembering, irritability or frustration,  irritability or angry outbursts, slowed thinking, feeling slowed down.

In addition to the above listed symptoms, major depression usually has many of the following symptoms: agitation or restlessness such as pacing, hand-wringing or an inability to sit still, loss of interest and/or pleasure in most activities, indecisiveness and inability to make decisions, feelings of worthlessness or guilt, slowed thinking, fixating on past failures and blaming oneself, feelings of sadness or unhappiness, recurring thoughts of death, dying or suicide.
    
While I had the more general side effects related to many diseases and disorders and those related to Hep C Tx, I did not have the following major depression symptoms: feeling very sad or unhappy, fixation on past happenings or failures, pacing or hand wringing or bouncing my knee. I did not have knots in my stomach, did not lose interest or pleasure in most activities, did not feel worthless, did not feel guilty, did not think about death, dying or suicide. I did not think I would be better off dead.

During Tx I had the general symptoms that can be due to many diseases and factors. But I did not have the more severe symptoms such as are listed in the above (last) paragraph.  Therefore, I knew I was not in a major depression.

In addition, due to the chemical imbalance in the brain, major depression generally brings with it distorted thinking. The thinking is more in black and white, extremes, there is no in between. Examples: failed my exam solution is to kill myself; relationship disintegrated ... suicide again; lost my house ... suicide; reprimanded at work ... suicide. No other options/solutions make themselves known. Generally, when one fails an exam it is disappointing and perhaps embarrassing, but most people would just study more and make arrangements to take it again. The severely depressed person (while in the depression)  never even thinks of that option. Same with losing a relationship or losing anything else. There are always options but a severely depressed person cannot/does not think of them. The first thing that comes to mind is suicide. Another problem with someone who is in a severe depression is the inability to make sense of and figure things out and then do them. When I was depressed in 1983 it took me months to draw up a sales contract for some land. I would sit down, look at the papers (for hours), but nothing came into my head of how to go about it. Once I got out of the depression, I drew up sales papers in a matter of a couple of hours. Last year when I got depressed, I could not figure out how to lubricate my treadmill. I read the instructions. They were simple and easy. But I could not figure out how to do it. After I got on antidepressants, I lubricated that treadmill in 5 minutes, no problem, no mystery, easy as pie.

In addition, absolutely nothing made me smile when I was depressed. Nothing brought me joy or happiness. Nothing was funny. I was sort of in this shell of a body that seemed to have no feelings or responses  to anything. And that is another thing, when one is depressed, one really has no feelings other than to feel completely hopeless and dejected and that there is no way out of it except suicide.

I actually have seen people who were in a major depression and who could not string enough words together to make a complete sentence. And, if they got a few words out, it took them forever ... maybe3-4 words in a full minute. There entire bodies (and minds) were in slow motion. Lucky for me I never got that depressed. A good friend of mine made an appointment with a psychiatrist (emergency basis), came over to my house, and physically took me to the psychiatrist. He started me on antidepressants immediately.

I don't know if that helps explain the difference between sadness/disappointment as opposed to major depression. But there is a huge difference and I know the difference between when I am in a major depression and when the feelings/symptoms are due to Hep C Tx side effects.  
  
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Avatar universal
   Hi cupcake: For me, I think the anxiety I experienced correlated directly to my hemolytic anemia. The lower my HGB was, the lower I elt, physically and psychologically.
   I havent experienced any "clinical depression" since being on Triple Tx, though. But then again, I havent ever sufered from clinical depression, at other times in my life.
  My own theory is: what-ever psych symptoms we are prone to, may seriously exacerbate, while on Tx.
  
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Avatar universal
Thanks!!
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Avatar universal
As you wrote, so many of the symptoms on those lists overlap with tx, and that is why I don't understand how they can determine the if it's tx or depression. I suppose a pre-evaluation and history is the key.

In trying to "measure" myself I've decided "thoughts of suicide" would be the real danger sign, or not being able to pull myself together in the same day..

When clinically depressed outside of tx, are thoughts of suicide one of the main differences? Or staying in bed for days, unless because of physical symptoms like sever nausea, headache, etc.? But most of us have some degree of those symptoms all the time on tx. Yes, a matter of degrees is the operative phrase.

I guess what I'm asking is how can one be on tx (which has 90% of the symptoms on the lists), but say, "However, I did not feel depressed and I was not depressed. I know the difference."  You are in a unique position to describe the difference and I'd be interested to hear what makes the difference. As I said, depression and its dx has always been a mystery to me, especially for people on tx. Maybe you can enlighten me on that.

And of course, we probably all know people who say, "I'm depressed" at the drop of a pin when in fact they are just "unhappy" or whatever. I guess part of the problem is how I hear the word "depression" thrown around to describe "feeling" down/unhappy/bored that truly do not constitute depression. The person usually just needs to change some unhealthy habits and get their lives together.

My experience was being treated for symptoms of depression/anxiety by a psychiatrist for three years (my GP finally referred me) and no number of different Rx's made a dent including finally resorting to nardil which was seldom used in this country at the time. The situation was getting serious when no progress was being made. I finally got a divorce and was "born again" as a whole new person. The psych didn't recognize me the next time he saw me and said, "Well, I guess we now know the source of your depression."  But, as in that case, no ad affected the depression.

That little story leads me to believe that an ad is not worth trying during tx and I'm not going that route. I believe I will "recover" once I get these poisonous meds out of my system. Three more injections and Labor Day is my last riba dose.

Again, to everyone,  if in doubt it is better to err on the side of caution and seek help.
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Avatar universal
www.webmd.com/depression/features/fish-oil-to-treat-depression

But not for use while on treatment unless your Hepa okays it.
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Avatar universal
Interesting comment on omega 3 fish oil for depression. I don't know if you mean pre and post tx as I was told absolutely no omega 3 fish oil (among some other supplements) during tx.
Like Will, I'd be interested to know more about this for depression if you have some links.
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1815939 tn?1377991799
There is a huge difference between feeling down and being  in a major clinical depression.

Almost everyone gets somewhat depressed or feels down at various times in their lives. Some situations can make us feel down or somewhat depressed (not getting a promotion, ending a relationship, not being able to do something one wants to do, failing a test, etc.).  These feelings are uncomfortable but not overwhelming or incapacitating. In addition, they usually lessen and go away on their own.

But feeling down or somewhat depressed is not the same as major clinical depression.  There is a huge difference. Major depression significantly interferes with one's thinking and one's life and can be incapacitating or even fatal.


From WebMD:

Most people feel sad or low at some point in their lives. But clinical depression is marked by a depressed mood most of the day, particularly in the morning, and a loss of interest in normal activities and relationships -- symptoms that are present every day for at least 2 weeks. In addition, according to the DSM-IV -- a manual used to diagnose mental health conditions -- you may have other symptoms with major depression. Those symptoms might include:

    Fatigue or loss of energy almost every day.
    Feelings of worthlessness or guilt almost every day.
    Impaired concentration, indecisiveness.
    Insomnia or hypersomnia (excessive sleeping) almost every day.
    Markedly diminished interest or pleasure in almost all activities nearly every day (called anhedonia, this symptom can be indicated by reports from significant others).
    Restlessness or feeling slowed down.
    Recurring thoughts of death or suicide.
    Significant weight loss or gain (a change of more than 5% of body weight in a month).

http://www.webmd.com/depression/guide/major-depression


Definition
By Mayo Clinic staff

Depression is a medical illness that causes a persistent feeling of sadness and loss of interest. Depression can cause physical symptoms, too.

Also called major depression, major depressive disorder and clinical depression, it affects how you feel, think and behave. Depression can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and depression may make you feel as if life isn't worth living.

More than just a bout of the blues, depression isn't a weakness, nor is it something that you can simply "snap out" of. Depression is a chronic illness that usually requires long-term treatment,

Major Depression symptoms include:

    Feelings of sadness or unhappiness
    Irritability or frustration, even over small matters
    Loss of interest or pleasure in normal activities
    Reduced sex drive
    Insomnia or excessive sleeping
    Changes in appetite — depression often causes decreased appetite and weight loss, but in some people it causes increased cravings for food and weight gain
    Agitation or restlessness — for example, pacing, hand-wringing or an inability to sit still
    Irritability or angry outbursts
    Slowed thinking, speaking or body movements
    Indecisiveness, distractibility and decreased concentration
    Fatigue, tiredness and loss of energy — even small tasks may seem to require a lot of effort
    Feelings of worthlessness or guilt, fixating on past failures or blaming yourself when things aren't going right
    Trouble thinking, concentrating, making decisions and remembering things
    Frequent thoughts of death, dying or suicide
    Crying spells for no apparent reason
    Unexplained physical problems, such as back pain or headaches

http://www.mayoclinic.com/health/depression/ds00175/dsection=symptoms


I agree that many of the side effects of hep C treatment are similar to the symptoms of major depression (no energy, no motivation, severe fatigue, inability to concentrate, appetite changes, sleep problems, to name a few). But these symptoms are not necessarily due to depression, per se. And to make a diagnosis of major depression, one needs some other symptoms and feeling in addition to those such as fatigue, lack of energy and motivation, inability to concentrate.

As a person who has experienced major clinical depression twice and now the side effects of Hep C Tx, I know there is a major difference. With Hep C Tx I had all of the Hep C Tx side effects such as severe fatigue, no energy, lack of motivation, inability to concentrate, memory problems, lack of interest in doing things, appetite and sleep changes). However, I did not feel depressed and I was not depressed. I know the difference.

I think it is imperative for people who are contemplating Hep C Tx or who are on Hep C Tx to notify their treating MDs of any depression history or of any new depression symptoms while on Tx. The person should be evaluated by a psychiatrist. Regular MDs are not educated in or experienced in diagnosing true major depression and they are not educated or experienced in treating major depression.  

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Avatar universal
Could you please post the data and  study research that states "omega 3 fish oil " can relieve depression ..

Thanks

Will
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Avatar universal
What really seems to help for the depressions is meditation...and Omega 3, the fish-oil.
Wish you all the best
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Avatar universal
I watched the video and all I can say is that depression is a very complicated thing and everyone is different. Is it "situational depression" or "clinical depression"?  I feel that my anemia and the general sx of INF and riba just won't let me do what I want to do or have to do; I just don't have the energy or strength to do them, and I feel like crap all of the time. Terrible insomnia, aches/pains, hair falling out, etc. So, that gets me really down. Are those dark moments clinical or situational depression, and is there a pill that can change that? I think anyone would be bummed out. In those darkest times I just recognize that I'm letting my mind go in a bad direction and I change my thoughts. I start thinking about how great things will be when I'm done with this tx (whether I clear HCV or not). I do feel positive about the future. I guess I like to think I can control "mind over matter". On top of tx I have several horrendous life issues...it's almost like the perfect storm. I live alone and I don't have a support system other than my tx team. I have a history of suicide and depression in my family, so I really don't know if my depression is serious or not; as said in the video, that history is a big red flag. As I said, everyone is so different; I don't know how these psychiatrists figure out what the bottom line is and/or how to treat it.

I've also missed this whole "rage and agitation" thing; to the contrary, I take a real "Pfff, whatever, I could not care less" attitude and move on.  It actually takes a lot more to get me going than when not on tx, and maybe that's due to depression, lol. But then again I'm alone 100% of the time so I can't rage at anyone, lol.

I think I have an inclination to go into denial, so while that can be a bad thing, while on tx it works well. I can have a terrible situation and be about ready to lose it, but I walk away and forget about it, lol. Not so good for following through on things I need to take care of, but at least I feel okay mentally when I say "screw it" and walk away. I get back to them the next day or week.

The whole thing is crazy....months and months of what one person said is like a bad never ending LSD trip and the movie "Ground Hog's Day" rolled into one.

I've always said it is as much, or more, of a mental battle than a physical one. One has to keep fighting it day in and day out for such a long time. (I get down/depressed when I just get a cold; I can't believe I've made it 21 weeks!)

On the other hand, as is said in the video, if you have suicidal thoughts or can't pull yourself together, you need to seek help. I don't know where the line is, but there is a line that can be crossed and one must seek help. If in doubt do not be afraid to err on the side of caution.

It seems to me that so many have gotten through so much and it leads me to believe that our human spirits are stronger than we realize; this tx puts them to the test and we learn what we are really made of. I wish we had hard stats on how many people really do go off the deep end or commit suicide on tx. I just think we are miserable/down/depressed because we are miserable and for so long! But we are tougher than we think.

But again, not always; so know yourself and be careful to do what you need to do if you find you can't pull yourself out of a dark period. GET HELP!
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Avatar universal
Hi eric, good to hear from you...Hope all is well...

Will
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Avatar universal
will - thank you so much for posting the link a while back. it helped me to understand what i was going through.  for me the anxiety was really much more difficult than the depression. looking back i think i may have dodged a bullet when the PA ignored my symptoms.  had he prescribed an anti-depressant, my anxiety may have gotten much worse.   i also am experiencing attention deficit that has resulted in some close calls when i am driving.  now i do not drive long distances and try to be extra vigilant when i do drive.
thank you
eric
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Avatar universal
. It  is not recommended a patient take an Antidepressant prior to starting HCV therapy unless you have been diagnosed with clinical depression or have had issues with such in the past.
Otherwise,it is recommended  for you and your doctor to be aware that depressive episodes  should be watched for.
Actually. many AD"s can have an anxiety reaction in many as side effect.

The psychologist in the short video  below has treated many patients on HCV therapy regarding depression and anxiety and you may find it interesting if not watched already

Good luck..
Will

http://blog.texasliver.com/2011/11/psychiatric-complication-of-hepatitis-c-therapy/
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Avatar universal
i am week 46 and was on triple therapy with incivek and experience cirrhosis.  at about week 10 the depression and fear hit me big time.  one aspect that, at least for me, that contributed to depression is isolation. i live alone and did not have contact with another human for days on end. i had too much anxiety to even leave the house. i managed to torch all my relationships including the wonderful people on this board.  during the darkest time, the first thought i had in the morning was "how am i going to kill myself today?" another contributing factor may have been the the prednisone that was prescribed for the rash.  prior to treatment i was not experiencing depression or anxiety.  i spoke the the treating PA and also my primary about it.   i found their attitudes to be very cavalier, and they were unwilling to prescribe a drug. if i had it to do all over again, i would have got a psychiatrist on board prior to treatment. please don't make my mistake of not seeking competent help either from your treating doc or a mental health professional.
blessings
eric
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