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Treatment and depression
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Treatment and depression

I suffer with depression and a concerned about treatment and the effects of....~  I have actually acted (tried suicide)
on my depression twice~ending in the ER. I a happy,now~This really scares me~ Thoughts please??  Augustvon
Tags: Augustvon
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163305_tn?1333672171
You have good reasons to be concerned.

Depression is a common side effect of treatment.
Many patients who are normally even tempered land up taking ADs.
And suicide is listed as one of the less likely, but possible side effects of interferon treatment.

My advice is to seek out a top notch hepatologist/liver clinic with a lot of experience treating many hep C patients.
Then consult with the  doctor honestly.

Here's a good video which talks about the obsessive behavior treatment can induce:
http://www.youtube.com/watch?v=U2FPH3A11eQ
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789911_tn?1368640383
see a good psycologist that understands hep treatment.  I have had a many mental side effect as physical.  which mental is physical also to me.  I have thought several times that I might not make it .  As mean, hateful, depressed, sad tearjerker, whiner, control freak. Dead in the water- baton twirling crazy idiot lady, the list goes on and on  If I told my doc everything she would probably pull me off.  My family and I have decoded to stick it out.  I would say because of the serious mental side effect that come along with this treatmant for a lot of us, I would weigh it out.  I did not understand what kind of efffects, so how would anyone be able to make a judgement call.  It might not even effect you that way.    If you decide to treat. either weight for shorter duration treatments. or before you start get in with the good phyc doc and get your plan.   I have thought so many times I would rather have HCV than loose all my friends and family since Im so hard to put up with!  But here I am.  Actually at this point I dont care if anyone talks to me again or not ever!    Only 8 more shots to go after tonight.  Whew!        
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446474_tn?1404424777
Are you currently taking an antidepressant?
Are you seeing a psychiatrist?
You should do both before ever starting hepatitis C treatment.

A serious potential side effect of Hep C treatment is depression. People who suffer depression while taking treatment, people who have thoughts of suicide or self-harm or people with a family history of depression should be encouraged to access support and counseling. Anyone with a history of depression should be monitored throughout their treatment to make sure that treatment is not causing a major depressive episode.

Antidepressant medications should also be prescribed before and during treatment. An antidepresssant that works for the patient should be given 4-6 weeks before starting hepatitis C treatment. So that the therapeutic effect of the antidepressand is working to prevent a major depressive episode.

As long as you have good help for your mood issues it is doable. I had major depression for decades and was able to do hepatitis C treatment with the help of an antidepressant and a psychiatrist monitoring me throughout my treatment. I had many other side effects but I never became depressed.

From the Pegasys (peg-interferon) label

"5.2 Neuropsychiatric
Life-threatening or fatal neuropsychiatric reactions may manifest in all patients receiving therapy with PEGASYS and include suicide, suicidal ideation, homicidal ideation, depression, relapse of drug addiction, and drug overdose. These reactions may occur in patients with and without previous psychiatric illness.

PEGASYS should be used with extreme caution in all patients who report a history of depression. Neuropsychiatric adverse events observed with alpha interferon treatment include aggressive behavior, psychoses, hallucinations, bipolar disorders, and mania. Physicians should monitor all patients for evidence of depression and other psychiatric symptoms. Patients should be advised to report any sign or symptom of depression or suicidal ideation to their prescribing physicians. In severe cases, therapy should be stopped immediately and psychiatric intervention instituted "

Good luck.
Hector
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1856494_tn?1340546214
Hi,  Personally, I think one is darned if they do and darned if they don't.  I never revealed that I have attempted the big "S" a few times (can't even say it anymore) and that I ideate with such thoughts every day.  I believe the disease itself creates depression.  When I tried my hand at atleast 4 different ADs and lost even more of my mind and direction, I turned to weed and like minded people with whom I shared an understanding and could be up front with our frailties or not - becoming a recluse temporarity was an option.  I stumble through life.  

I was tired.  All I wanted to do was sleep.  Hep C is a robber.  I wanted my life back - used cognitive therapy (talk therapy) and that was wonderful, a couple groups helped too.  I guess I do not trust ADs.  The idea of delaying treatment was not copesetic for me and I am so greatful to have 3 shots left.  

I hope you will find stores of energy and commitment to go around this supposed impediment and fight one more hard as hell battle that may free that blossom waiting to bloom with in you.  We are here for you.
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1815939_tn?1377995399
I concur with Hector. He has covered the major points and given you some good advice.

I know true clinical depression cannot be taken lightly. It won't just go away by wishing it away. And, it can be deadly. However, you said you are happy now and that is excellent. If you are not already seeing a good psychiatirs familar with Hep C treatment, then I would agree with Hector, to find one and seek his/her treatment. I am sure if you are not already on antidepressants, a good psychiatrist will get you started on them a few weeks before you start Hep C treatment.

It is doable with the right care and treatment.

I also have a history of clinical depression and have been on ADs twice. I am currently on Hep C treatment with triple med treatment and I am currently taking an AD. I have had no problem with depression, mood swings, anxiety, anything mental/emotional, since starting triple med treatment in Sept. In fact, my mood has been exceptionally stable (more than I can say for the physical side effects, lol) (but they are also doable).

Anyway, don't let your history of depression scare you away from Hep C. I know it is serious, but generally speaking, it can be treated and controlled with good psychiatric care and the correct antidepressants.

Please keep us informed. This is a great forum for support and questions.

I wish you the best.
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148588_tn?1407125204
From your first posting:

".....told I was in aperiod where I would benefit treatment RIGHT AWAY,verses waiting~UNTIL I brought up the fact I was concerned about my depression issues and how severe my depression was off meds~Than the Dr. did a complete 180 and told  me I should wait 3 months!!? Than do a biopsy and see where I a at....~"

There are some things you need to get straightened out before even discussing stategies for dealing with interferon induced depression.
First, you need that biopsy to determine the true condition of your liver and whether treatment is even necessary at this time.
Next, you need to find out why your doctor thought you would benefit from treating right away. There are several different reasons I could speculate on why your doctor would do "a complete 180" on this, but *you* need to be clear on what your doctor's reasoning is and was. This means doing a lot of reading, here, on this forum and anywhere else you can gather information. As others have posted, alpha interferons can (possibly) have serious side effects and if you and your doctor feel you have time to wait for an interferon free treatment to be developed, that's great. Otherwise you need to have a doctor with a lot of experience using these drugs who is willing to work closely with you.
Good luck and take care.
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Avatar_f_tn
Looking back at your other posts, "I have already had one Bio~", I think you said you've already had a liver biopsy.  What were the results?  Also what is your Hep C genotype?
This can be overwhelming, especially if you already have depression and anxiety.  There are a couple of things that I would recommend that you do so that you can make informed decisions and be less overwhelmed (which can increase anxiety and depression).  Get a big expanding file folder and label it with sections such as "lab results", "Hep C information", "insurance", "bills/receipts", "prescriptions", etc.  Buy a small spiral notebook that you can take with you to your doctor appts so that you can have your questions in front of you and you can take notes while you're there, and bring a family member or a trusted friend with you to take notes.  Find some good sites on the internet about Hep C and book mark them so that you can study about your particular stage of liver damage and your particular treatment options.  Stay on this forum so that you can get support and encouragement.  There are also Hep C support groups in your community that you can reach out to.  I see that you live in Tacoma.  There are at least 3 of us on this forum that live in Western Washington (my husband and I live in Seattle, another lives in Port Angeles, and another lives in Everett).  Depending upon your level of liver damage, you should be seeing a good gastroenterologist or hepatologist.  You can usually read about their qualifications and areas of specialty on line.  Which hospital in Tacoma are you going to?  You also have to feel comfortable with the doctor and the nurse practitioner that would be treating you and managing your case.  If you are uncomfortable or confused right now about why he at first said treat and then later said wait, call and make an appt to ask what he meant.  So, in other words, research, get informed, organize your information, establish your support systems, and make sure you trust your doctor.  Then, make sure that your doctor knows all there is to know about your depression/anxiety and feels prepared to manage your Hep C along with your depression/anxiety or is willing to work with your psychiatrist so that both can be managed.  It is a tricky balance, managing the Hep C treatment and the psychological side effects even for patients who didn't previously have depression/anxiety, so I'm sure it can be even more tricky for patients who have or have had depression/anxiety/major depressive disorder.  Best wishes, and keep us posted.
Advocate1955
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2011699_tn?1328936953
Thank you,so much~to all~

First,I don't feel this Doc is a very good one~I have seen many~although,for other reasons. I am on AD now. Have bn for yrs. My liver Bio was very good/over a yr ago.I a syptomatic~I think,now,headaches,sever leg pain/aches,sweating,day and nite,all just recently began~like WOMP! I a getting 2nd opinion. First was VMason~Great place~My primary C is there~Just don't like the Gastro.

Ideas~thoughts~
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Avatar_f_tn
Virginia Mason in Seattle? Someone else on the forum is being treated there.
Advocate1955
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1815939_tn?1377995399
Have you thought of seeing a hepatologist? That is an option.
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148588_tn?1407125204
If you have had a biopsy, get a copy of the report. In fact, make a file that you can keep copies of your bloodwork and any other paperwork that might come your way. Post your bx results here. At the very least they should contain stage and grade. If there is anything more complex listed, there is usually someone here who can give you feedback.
Get a doctor you are comfortable with. If your current doc is confused/confusing about something like when/whether to treat, it's probably not going to get any better when it comes to issues like rescue drugs, frequency of viral load testing, etc.
Good luck.
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2011699_tn?1328936953
Thank You,

What You,have suggested is excellent~I realize I a all over the map~I am just becoming frantic with myself and need to stop~slow down~listen~I know I a not dying~I am just one of those people that is SOOO ANNOYING THAT WILL NOT LISTEN.YOU TELL THEM  OVER AND OVER~AND ONE BEGINS TO THINK~geez,what is wrong with this girl? Is she not reading my message? Hello? LOL~

Again,Thanks~~ I truly appreciate~
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