post tx depression

Does anyone find depression a worse problem post tx? I'm still using prozac 40mg. in AM and Remeron 30 mg. in PM. Sleeping ok but such blackness all day!

[cajunlady]

Sorry, this is happening to you.  I would suggest to call your doctor and maybe he can switch things up with the meds.  If anyone has had this post; they will be on to give you there stories.  In the mean time check with your doctor.

Cajun

[friole]

Morgiana - I know Chevy had problems with this.  I hope she sees your post. I am just finishing and don't know yet what will happen
frijole

[Califia]

So sorry to hear this.  We can end up in such biochemical disarray after treatment, in spite of our best efforts to avoid it.  Two thoughts, based on personal experience:  Check thyroid levels!  Check B12 stores!  Deficiencies in both areas (and excess in the case of thyroid) can contribute pretty dramatically to depression and anxiety.  You have my full sympathy, girl--take care.

[DoubleDose]

I also had heavy, and very noticable post-tx depression problems, after both of my long tx'es.  I had very little real depression during either tx, but after tx the chemistry changed, and I seemed to slide into a long funk, along with severe anxiety attacks.  Now, almost three years after my successful tx ended, I am slowly coming out of the depression, and beginning to see more 'light' ,and feel more upbeat.

I firmly believe this phenomenon after tx is due to physiological changes (bio-chemical, nerve, and cell) from all the interferon.  Several doctors who have studied interferon effects have also told me that the interferon changes cells and nervous system function, and this may remain changed over many generations of cells...meaning for some people, months, or years.  One Hopkins doctor flat out said that I could expect at least a few years of problems from the interferon, if not longer.

I am hoping that I am on the way back, as far as mood and function...only time will tell.  I am feeling better lately, and much more motivated.  Less anxious.  

DoubleDose

[Morgaina]

Well, I'm feeling a little more hopeful and even part of the norm (our very strange norm). It's just so overwhelming sometimes and I've got to get back into my classroom end of Aug. At least they offered me a position with high school inclusion students so thats a whole lot lighter load than my wonderful little behavior kids. Hope that grief lightens up over the year!! Thanks you guys for your encouragement.

[Morgaina]

Did you come across any meds or tricks that either lightened things up or made them worse?

[PasoPerson]

I was actually so relieved to see your post.  I am suffering as you are, big time depression, funk, crying, very tired/lazy, and other similar things.  

I'm on Paxil, 40mg.  I also take SAM-e DS.  I was encouraged by DD's post ... even years and years after treatment, but it's leaving.  I knew for six months minimum it would still be in my system (it's only been four months post-tx).  Now I know so much more.

You're sure not alone, and you have my thanks for asking a question I should have asked.

God bless -
Carolyn

[susan400]

I too, never took anti-D's when I was on treatment.  But, off of treatment, every time I've done this, I go through a cycle of ups and downs.  Last time, it was big time hyperness, mania-like and then about 4 mon., later followed with depression. (I've never been diagnosed with bipolar.)  This time, I've only had the hyperness for a couple of weeks. Since then, depression.  Each and every time, I've had insomnia. This is the worst of all of the symptoms for me post-TX.  Without some sort of sleep aid, I hardly sleep at all.  If I am able to sleep, it's for like 1-2 hrs and that's it.  I've been able to borrow some of my Mom & Dad's Ambien-CR (since I already had a prescription for it, my insurance wouldn't cover it).  Dad said he didn't need it and gave me about 3/4's of his script. So, this has helped me at least get some sleep.  I also got some Lunesta (which doesn't work all that great on me).  I really will be so glad to have the treatment drugs out of me so that I can start weaning down off the sleep meds and get normal sleep.  I exercised all through treatment and still continue with that, but unfortunately, it hasn't helped a whole lot with this other problem.  My body chemistry after years of these drugs is so darn out of whack, I don't know if it's ever going to get back to "normal", whatever that is, I think I forgot what "normal" is???  At least now, I don't have to worry about my white cells and being in crowds, so I can be involved in my church and attending services again and this has helped me the most.

Susan

[chellski]

i am 5mo post tx and still suffering from depression...1st thing my doctor did was check for thyroid probs....he may change my dosage....i am starting rekei treatments again (they really helped me during tx) and also water aerobics - both combined helped me during tx and hopefully will again..i don't really want to up my dosage on the zoloft although i will continue to take it...

[DoubleDose]

Sure looks like we have stumbled on a pattern here.  I wonder how many people finish a long tx and DO NOT experience this funk, post-tx depression, black hole, lack of motivation, and whatever else you might call it?  From what I have been reading on the forum over the past few years, this strangely timed depression seems fairly common, and seems to hit sometime after a month or so beyong the ending of tx.  I really have to believe that it is an interferon induced issue.  Withdrawing the interferon probably throws the body and immune system into some sort of 'other mode', generating or maybe not generating substances that it did before and during therapy.  I really felt pretty good much of the time, mood wise, on therapy, even though I felt horrible physically!  The body chemistry must change, trying to compensate for the sudden lack of good old interferon for all those months.  I think that reversing this new state is probably a long road, and takes the body a good while to re-regulate.

At least that is my take.  Maybe post traumatic stress syndrome is more chemical in nature, and happens because the body, after a long shocking event (probably producing its own interferon) then over-reacts after the stressful stimulus is withdrawn, and produces damaging chemicals, hormones, or whatever.  Interferon users have their own 'interferon producing' stress event....injecting actual interferon itself...thus recreating a super high stress body reaction.  Maybe we suffer from PTSD after interferon therapy ends because of a similar mechanism...chemical, and biological.

I have a hard time buying ideas that say depression is caused by our mind, or our thought processes.  I think generally depression comes from chemical changes, that are caused by something specific, either external, or internally produced.

My expectation is that time, and our ability to slowly re-adapt physically, will eventually restore more normal function.

Think about how many people probably had depression decades ago, from unknown HCV, and then wonder how many were told they were causing the depression, it was in their minds...and self generated.  Now we know that HCV itself is a cause of much depression.  Chemical changes take place that bring about mental and mood disorders.  Look at the study published today on the HIV and Hepatitis website regarding depression and HCV in veterans.  High correlation.

Just some thoughts.

DoubleDose

[anise]

Excellent advice to Morgaina about depression.  I feel as though I am also slipping into a post treatment depression.  I have never had problems with depression in my life, anxiety, but not depression.  So this is new to me and feels like a huge black hole where I am not interested in anything.  I will heed your advice.  Thanks!

[GoofyDad]

I didn't fall into any real funk after tx, but there was a strange feeling of emptiness or lack of purpose. I think a lot of us get some satisfaction when we begin tx as we commence doing all we can to fight the disease. At the end of tx, I guess that emotional crutch disappears.

I'm with Chevy on that birdfeeder idea. I've said it before but it bears repeating... nothing like a couple hummers in the morning to chase away the blues!

[lat36]

I started feeling bad at about the classic 3 month stage of tx but thought I'd just tough it out. By month 9 I was very nearly psycho and took up the offer of AD's from the doctor after being honest on the HAD test they like you to fill in. I realised there was going to be problems if I didn't do something, was working full-time in an office environment, had kept it to myself and trouble was brewing. Within a couple of weeks I was amazed how much better I felt and regetted going for so long feeling like I had been. It made treatment so much more tolerable, the physical sides I could handle, the mental ones really knocked me around. Never been so down and hostile.

I finished tx, 48wks for a 1a, phased out the AD's, then a month later started to feel exactly the same as I had been earlier, hopeless, sad and angry. The sunny, happy and healthy post-tx world that I had my sights set on just wasn't there. The AD prescription was finished, went to a doctor (in general practice) because I didn't want to be a nuisance to my nurse from the hospital. I was intending to ask for a prescription for them, didn't think it would be a big deal. That was a mistake, after hearing my story he immediately asked if I was a "homosexual" (which I'm not). I obviously got the wrong doctor, made me realise exactly how much misunderstanding there is, even in the medical community.

I ended up getting the same ones from a friend who had been prescribed them and decided they didn't agree with him. Still taking a half dose a day, I'll ditch them again in a week or so. I understand now the effects that tx has, even though I was a bit gung-ho at the start. I increased my ribavirin during tx and kicked up such a fuss over dose reductions that they let me stay on 1200 when my weight dropped to 65kg (143lbs). No procrit here, public health system, fair enough it's expensive. Hgb was 8.9 by the end and ANC wasn't great either. I remember being out of breath lying in bed, ha ha, glad that's gone. I'm still undetectable 3 months post tx, hope it stays that way.

Good to see a post from goofydad, the ones from him and jmjm kept me laughing back then (I won't mention "stumped" again!). I guess my point is that depression on tx is a real effect, no matter whether you've had
problems before. And it can stick around afterwards as well. I was interested to see the other posts discussing long term problems like that earlier on.

Was looking at this a few days ago, it's kind of interesting..

http://nchsr.arts.unsw.edu.au/pdf%20reports/SRB03.pdf

Best of luck to those who are still treating, I get the impression there are only a few things long-term, most others sort themselves out with time (like this).

[cuteus]

I had felt some form of mild depression for yrs before tx. Before knowing of HCV.  I'm sure that the daily aches and sciatic pain for yrs contributed to that fact. It is known that chronic pain causes depression. For yrs, theories in the psychiatric community seem to acknowledged that they  can't pinpoint if the chemical changes in the brain come first that lead to depression or the depression first and then the chemical change that keeps the depression going.  I guess the cause is purely individual.  
In the case of hcv, if you are still positve for the virus post tx, that can't help with the mental health recovery to know this. When you  experience a long tx,  daily discomfort, change of focus and direction from the life as you knew it, then right after tx, not knowing if all this pain achieved the goal of SVR, and the rebound from the build up of medications, plus, in some of us the pre tx aches never did go away (the reason for the pre tx depression), it almost seem as if we should go for post tx counseling to help us redirect our life, to ease the fears of relapse  and hopelessness from the financial burden of tx, to learn to live with the issues we wanted gone once we treated.
  It is all very complex and it looks as if therapy should be made a part of the post tx era, if not by the drs, then by us.  I would have been extremely depressed if after a long tx, I would have relapsed, and that depression would probably have made my aches worse.
In my case, I was depressed to see my pre tx pains did not go away after tx and that I needed to learn to live with the possibility of experiencing them for the rest of my life, geesh! just writing it makes me depressed!
For others, the financial, marital, familial situation post tx that was brought about by tx is still there for months to come, another source of long term depression.
The reason can't just be assigned to one issue.  The IFN can be a major contributor, but it can't be the main reason, since not all people suffer from depression while on it.  
The more I read, the more I think we should have consulted a therapist post tx, it could have made the road back easier, and could have assisted in accepting  the things that did not go away and the ones that surfaced during the tx  time.

[sfbaygirl]

Great topic and discussion!

I have had depression mild and otherwise for years before tx. Luckily, I don't have it now on my 4th month of tx. I agree that pain can cause depression and/or depression causes pain in the body. My GI had my shrink call him before tx, he had a patient commit suicide while on tx and doesn't want to take any chances, so he wants all on AD's.

It seems that the post tx depression could be caused by the whole change of life that happens when tx stops. One could feel a little "lost" and without purpose after spending so long doing a very difficult tx and having a definate purpose. Those of us who can't or don't work may have to think about new jobs, being there more for our families, feeling responsible to get back to doing all those things we may not have been able to do during tx. This would cause depression, I think.

It's good to understand this as I already feel guilty for not being able to carry my load financially, relationship wise, work wise etc. If I can't do it after tx, that will be a tough one for me.

I agree Cuteus, therapy after tx is a good idea! I love having therapy now, when I feel so useless it sure helps, on tx. Talking about these issues with a shrink or on this forum help tremendously.

[Morgaina]

Thanks for your thoughts and ideas. One of the things that dawned on me through reading this thread is that I have been engaging in years-ago non-activities (if that makes any sense) that I used to do when I was really down. I can change those things. I'm still contemplating the hummers, er..hummingbirds.

[sfbaygirl]

Birds are great! I have about 6 birdfeeders, all around the house, with different food for different birds and fill them up sometimes once a day. They are such a joy to watch and listen too. I got a bird book and look them up if I see a new one. It's fun to figure out their songs, sounds and names.

[tonybuck]

This thread and others is warning me not to have any expectations of what the future holds in reguards to how my treatment will turn out.I had a good day today but now 24 hours since my 14th. shot of 48. I am beginning to feel the medicine at work, starting with muscle aches, insomnia, and a mild headache. I wonder If now my depresssion will grow worse as the drug works in my body this next week and I will be happy once agian at weeks end. It felt so good today to feel my true spirit. I have a wonderfull family who truly has my back while I am on this treatment. Thankyou to the people in this forum that are sharing their wisdom and experience so that others like myself can see more clearly the things they need to learn to cope with this virus and treatment.

[hippygem]

I finished tx 2 years ago, ive been in such a depressed, down and out state of mind, i have felt absolutely hopeless.  I couldnt see a future, but like so many have mentioned before we all have different things happening around us that this also has an effect on our mind.
I stopped taking the ADs because they make you feel depressed anyway, so i figured i may as well be in some form of 'reality' and try handle the depression myself.

I started walking first, not far, but just enough to get out of the house, then further each time, that clears the mind and helps the endorphines and seretonin levels in the brain.  

Half an hour every day for the rest of your life----just tell yourself that and do it.

Keeping active helps with the depression, leaves little time to sit and think too much about how we are feeling, and questioning our life and disease.

I have a counsellor now, he specialises in people with Hepatitis C and HIV, he has been on the tx as well, non-responder, he is helping me get through the depression and anxiety.  Meditation is a great thing, never was much into it myself, but hey, it works.
Talking to someone other than family and friends helps a lot, an outside opinion and encouragement, so if you have a Hepatitis C office somewhere near where you live, make use of it, there is so much help they can offer that you will need eventually.  

So, seek out these places, get the information on what is available and when you are ready to take the next step, when everything else is failing you know where to go.

I have rambled on a bit here huh, anyway hope it helps some of you.

Cheers
Linda