Depression after treatment? Just curious

[Lady E]

I'm curious after reading that depression often occurs AFTER treatment has been completed. Has anybody gone through that?  It makes me wonder because I would think that I would be happy to be over the therapy.

[jmjm530]

I agree with many of the above comments regarding the physiological effect of interferon therapy and interferon withdrawal on depression.

Another thought is Post Traumatic Stress Disorder (PTSD) which is often defined as "a psychiatric disorder that
can develop after a life-threatening or very distressing situation that causes a person to feel intense fear, horror, or helplessness." I believe this is very close to what many of us experience both before and during treatment.

Lastly, tx can often leave a big hole to fill. While some are able to more or less continue as before, others may have to leave their work, discontinue many of their prior activities --  not to mention losing contact with business associates, friends and sometimes family members. That said, within this veil of depression exists a unique opportunity to rebuild (or *build* depending on your take) a new level of being drawing on what you may have learned from the experience.

-- Jim

[PasoPerson]

My treatment ended right before Tater's did ... March 22.  I did not clear.  From about mid-July until now I have been sliding down that slipperly slope of depression.  Post-tx I have had a couple of bouts of "sadness", lasting only a few days each time.  But this time it's going on a month.  And I already take 40mg of Paxil each day.

The past two days have been much better than the past several weeks, so maybe it's slowly going away.  In the meantime, besides major praying (okay, begging) to God, I have been racking my brain for "why".  

Much like Tater, I blame it partially on stress, in my case my two kids (aged 12 & 16).  

I also blame it partially on the meds still left in my system.

However, I believe the major part of my depression is the feeling of frustration that I'm just "sitting around and doing nothing" while the HCV just continues killing my liver little by little.  

I go back to my hepatologist for a 6-month post-tx check-up in September.  And I'm going to insist I be put back on treatment, after another biopsy.  Hope she goes for it; if not, I'm changing to a hepatologist who will agree.  Thanks to all of your help the other day, I now have a clear idea of what to insist on and the strength to see it happen.

Anyway, this isn't about me - it's to tell you Lady E that this happens.  Crummy, except for the fact it sure does tell you that you're still among the living, eh?  And that ain't bad!

[Tater-ToT]

I stopped Tx in April, & within this few weeks I got hit with a MAJOR Case of depression... I am going to the Dr for it next week... Having crying spells, mood swings you name it... was telling friends that I haven't experianced that to this degree since I started my FIRST Round of TX before they upped my AD's..

However, in my case I believe it was triggered by unmanagable stress that I have absolutely NO Control over... so had that not of happened, I MIGHT Not have had the melt down.

In a nutshell that outside source of stress was that my daughter abandoned her baby, & I had to make an emergency flight across country to basically baby-sit until what-ever unknown transitions take place...

So I don't think these are under any means normal circumstances!
Well see what the doc thinks about all this next week when I can ask more questions myself concerning this!
:)

[mike c]

I treated with the combo intf/rib  going on 7 yrs ago. Im a 1a ~Lucky ME`  Did not clear but did 48 weeks any way. Was able to get thru tratment with out too many Depressive sides/  1-2 yrs after treating i went into a major depression, which turned Manic and almost did me in. Real bad time of my life.  Finally came out of it and  never another depression . Also before treatment had never had depression, at least not at all severe.
  Im sure i had a delayed severe depression brought on by the Meds and made worse by the Doctors trying to treat the depression with multiple Anti`s.  ( i think the Paxel was the one that caused the slide or fall into Mania)
  Im still afraid to retreat even though i long to rid myself of the Virus.  Hopeing for something less toxic to our mental health then the interferon.
MIKE C

[sundancer2007]

YES, 8 months past treatment and relapse I have been depressed and it seems to come out of no where just like before treatment off and on over the years

I was not depressed on treatment just moody and fatigue looking back I should have taken something however I have never had much luck with antidepressants they always made me feel zoned out. I have been so disappointed the depression has come back post treatment. I don't know I just try to keep busy and try not to focus on still having the virus and stay in the now but I get into this whole projecting trip.

I am waiting on ernie also but it looks like he will visit the other coast.

Hope everyones blues fade away

[Magnum]

Good afternoon Lady E

Depression not so much 4 months post tx, but anger is yet another matter. I still blow up too easily in confrontations with anybody. I have to check myself in moments or ire and anger, which don't appear to dissipate easily.

People and situations that anger me the most are:

- Morons who work at Best Buy and think they know everything
- Car salesmen with fake smiles and their hands too close to my pocket
- President Bush, but not his wife, who is a Southern sweetie
- Home remodelers that always seem to get sick and not show up just before they finish the final details and clean-up
- People who refuse to learn English
- Press 1 for English
- April 15
- waiting in long lines at the post office while three of the five windows are unattended
- Rich fat cats at Exxon who are golfing in Hawaii while we dig deep into our pockets at the pumps
- Waiting in line at the DMV, and looking around at what seems like I'm in a foreign country.... alright, alright, like Mexico
- Waiting six weeks for a doctor's appointment
- The fact that my gate at the airport is always the furthest one
- and finally ..... the fact that Taylor Hicks won the American Idol

And what angers you Lady E?

My suggestion is a mild anti-depressant. You wouldn't want to add yet more chemicals to your body than you absolutely must. Good luck...

Magnum

[dirtytown]

I was treated with pegasys/copeg for 12 weeks.  I did take anti-depressent while being treated.  I was treated 3 yrs ago and I am experiencing some depression.  I was told at the mayo clinic that interferon changes the balance of seritonin in your brain.  I don't know if this is permanent.  A good question.  DT

[anise]

I finished treatment about 5 weeks ago, and I find I am feeling depressed.  Normally, I am not prone to depression.  So this was a surprise to me.  I am going to talk with my NP this wednesday and see what we can do about it.  It is this awful empty void feeling.  

Chevygal, you mentioned depression for up to a year after your treatment.  You also were perceptive in noticing that I was going through it and may not have known about it.  Yep, I am having post treatment depression.

[susan400]

I'm more depressed after treatment and also have had continued sleep problems.  I did not have a big problem with depression on treatment and never took Anti-D's.  I can't speak for anyone else, but I'm sure part of my problem is disappointment with not clearing. Of course, there is the physical changes, too.  I had a surge of energy right when I stopped, but now I still have to pace myself.  If I push too hard, I get overtired, feel like I'm going to drop and then, have even a harder time of sleeping at night.  Yesterday, I tried to do too much around here cleaning and stuff to catch up on past due cleaning. I was exhausted afterwards and then, only slept a short period last night.  Oh, by the way, that's even with sleep meds.  The last time it took about 5 mon. post treatment for my sleep to start normalizing.  I still have anxiety issues, but I may have had those prior to treatment.  Right now, I'm over-reacting to the storm threat of Ernesto.  Watching the weather forecasts is probably not a good idea because the forecasters get so excited and then, a couple of days later say that the storm has fallen apart.  Which is a good thing, don't get me wrong on that.  But, I get so anxious, go running around getting the car gassed up, getting water, ice, batteries, etc., etc. Even though I already had some supplies stocked up. Does that sound just a little bit anxious? Well, at least I'm well prepared for storm season!!  And bird flu and any other natural disaster!!!  I've got about 5 flashlights!!  I'm hoping that my power never goes out and that they sit there un-used!  I've also got plenty of non-perishable food.  Every year after storm season, I donate it to a charity and start over for the next year.  Susan

[Morgaina]

I'm about 9 wks. post tx and still on my AD's. I found the depression and anxiety much worse than on treatment about a month after I was done. It's getting a little better, I think changing meds helped. I will return to no AD's again but today was my first day back at work and it went well. I know I'd be an anxious, nuerotic mess or worse than I was a couple weeks ago or on treatment if I went off them too soon. All in time (my doc keeps telling me).

[Califia]

Just listen to a few Lenny Bruce bits if you want some instant recall.   Salud!

[susan400]

Hey there. It seems like you stopped Hep C treatment around the same time I did.  This time.  I've treated many times before and gone through this.  You'd think I'd know better!

Susan

[DoubleDose]

I am not surprised at what the Mayo Clinic told you about interferon changing the Serotonin in our brains.  I do believe that for many of us the changes are not very quickly reversed.  This is probably the root of much of the post-tx depression.  The odd thing though, is that many of us had little or no depression while on tx, and then several weeks after finishing were hit by a barrage of physical and mood related effects.  I have to believe that when the interferon is withdrawn there is some sort of bodily reaction, sort of a withdrawal reaction that sets off a chain of hormonal, immune and/or cellular changes that are often intense, long lasting, and disturbing.  

There is little to no research on this phenomenon after tx, and the attitude of most HCV doctors is 'see no evil...hear no evil', or, 'the drug companies told us this does not happen, so it should not happen....its probably all psychological.'

Of course, this is not rational at all, since most of us were expecting the opposite reaction after getting the SVR, and we often felt pretty good during tx, when we should have felt the worst of all...if it were psychological.

Maybe, with some research, they might just determine what adjunct medications, hormones, SSRI's, or other substances might restore some normal balance to our rather frazzled brains and nervous systems after long durations of interferon treatment.

Too much trouble I guess.

DoubleDose

[Kalio1]

The drug companies, the doctors practically every site talking about Hep C treatment mention depression as a potential side. All warn of the depression caused by interferon tx, that is one reason why some of those on tx who are prone to depression already are put on ADs before they begin. This is nothing new. Those treating Melanoma with Interferon have much higher doses than we do and are dosed intravenously several times a week so it makes sense they would have even more issues with serotonin imbalance.

[Morgaina]

Before I went on treatment, I had been dealing with levels of depression my whole life. I had been taking DHEA for about a year and was feeling better than ever in my life. I stopped during treatment as well as milk thistle and phosphytidal choline (sp?) but have started all again with the AD's and am having less problems with anxiety and depression fairly quickly. DHEA is a precursor to estrogen and testosterone so maybe it's helping to kick things back in gear. Dont know enough and I've been reading about it for 10 yrs. There are always surprises!!

[Morgaina]

Hey, it does sound like we ended about the same time. What a drag down fight you've been having with this virus, you sure are one tough lady! Time for a break, maybe win a lottery or all expense paid trip or hell, lets get crazy and demand SVR!! We just got to get an appt. with the BIG boss! He's usually got his hands full with the not-so-gentle-men of the forum but lets give it a shot.  There must be forms....hmmm.....

[strator]

Just a thought to throw out here, and I may be reaching a bit. I never really dealt with depression before tx, other than a few short intermittent periods that probably had to do with my alcholism and addictions which probably also affect the seratonin levels, and again detoxing  out of them to get sober and clean brought some serious depression. Depression as a possible sx was stressed to me before tx and  I worried depression would lead me to bad places, went tot a therapist for 6months at the suggetsion of my dr to see if I should start on ADs prior to tx. He said no and I never did take them.
On tx I never really felt I was suffering depression, other than waking in the mornings with that overwhelming fear, and sometimes just from being so dang fatigued. Also I had more anxiety than I usually experienced. Usually that morning fear lifted a few hours after I got up, maybe because I kept so busy.
When I stopped my meds at 45 weeks, the thing that I really noticed..like a snap that you can hear

[Morgaina]

When I went on that short round of prednisone which was suppose to calm my immune system, I lost all anxiety and depression and had energy. Ah, was a good 5 days...There are so many sides to steroid treatments but maybe that round helped me get a little more levelled out. How do we ever sort out what it is that helps??

[DoubleDose]

I will add this:  I believe that it can take a long time for the effects of the interferon on our system and chemistry to go back to 'normal'.  If you had shock therapy, or were hit by lightening, or did radiation therapy for a year, etc. do you think that you would feel anything close to normal once these events were finished?  I think interferon is similar, in that it actually changes the way our bodies function, and stopping the drug does not equate with stopping the effect.  I experienced marked depression after ending therapy, as well as anxiety attacks, autoimmune problems, and so on...over the past three years.  Things are improving, but SLOWLY.

This also seems to be a similar experience to some of our other forum members, and I would not doubt that there are a good percentage of people in the general tx population who have the same pattern after ending tx.

When you consider how powerful interferon is, and what it does to our immune systems, I think we are actually fortunate that there are not worse problems after tx!

Just my take on this issue.

DoubleDose

[Lady E]

Thank  you! :)

[NYgirl]

It is not a psychological / mental cause that we get depression while on treatment (although tx is rough) but a PHYSICAL one from the IFN.  That is why many of us went on anti depressants BEFORE treatment started (1/3 of patients develop depression bad enough to have to QUIT tx without help of ADs so I did it as a preventative).

So I'm assuming afterwards it is the same thing - we have loads of physiological changes going on in our bodies and the IFN causes and can cause major problems chemically (ie: my thyroid being killed by an autoimmune disease caused by the IFN).

So it wouldn't be too surprising to find out it can also happen afterwards although everything I've read said during...I never really LOOKED for what happens once we go off the meds and through WITHDRAWL from the IFN / Riba.