does long term opiate therapy cause depression??

[Skyfoxglitter]

I have been on long term opiate therapy for 3 back surgeries, the last one a 3 level fusion that has so far not been successful...The opiates I take do help make my pain manageable but lately I have been extremely depressed sometimes to the point I have fely suicidal...I would not take my life as I have a daughter that I would never put that burden on... I have tried Cymbalta and Pristique because of the anti-depressent and pain relief qualities and both times ended up with seratonin syndrome which made me gravely ill...Is there any other type of antidepressent that anyone else has experience with that helps the situation?? Is my only hope to wean off the opiates and see what happens with my pain and depression?? I know alot of you here have experience with these exact issues and would love some serious advice....I am at my wits end with this, I no longer enjoy any aspect of life I am always aggitated and have thoughts of hurting other people as well as myself which in NOT like me at all!!!! Im so scared of these feelings and would do just about anything to remedy the situation....Please anyone help me understand what is going on with me and is there any hope in making a difference in this crappy life???

[Jaybay]

I'm not a doctor, but had a similar experience early in the pain journey.  Whether it's from the opiate therapy or your pain or a combination of both, you seem to have landed in the black pit of depression.  I also hear a hefty dose of anger in your words.  I couldn't give you real statistics, but I believe every last person on this forum has experienced the same thing to one degree or another.  We move in and out of various phases of grief as we realize that our lives are not what we expected them to be and likely never will be.  Accepting that loss and moving ahead with what we CAN do can be an incredibly difficult journey.  Depression, anger and even bargaining are parts of that process.  

Too many pain clinics neglect the mental and emotional aspects of patients in this transition.  Pain management is so much more that taking pills all day long and waiting for things to get better.  We are responsible for our lives; the doctors can only try to help make us more comfortable while we figure it all out.

First you need to understand that these feelings are completely normal.  The problem is that you've gotten stuck with them and can't move forward into a new life WITH your pain.  It's a tough journey and some of the hardest work I've ever done.  Without my pain shrink, I would be exactly where you are today.  My pain doc didn't insist on therapy, but encouraged at least giving it a try .  Talk about skeptical!  The pain doc informed the shrink that she had a new client, and she called me the next day.  Had that call not happened, I never would have gone under my own steam.  

Therapy is so much more than kvetching about your pain for an hour - at least, it is if you have a good therapist who specializes in pain management.  The crux of it is learning not to focus on your pain and to avoid "becoming" your disease.  There's a lot more as well but I don't want to scare you off!  No doubt you already get the point anyway.  I don't think you can get your mental state and life back on track without someone to help guide you through the process.  You don't have to sit alone in the black pit waiting to explode.  Your life isn't over by a long shot and you CAN have a wonderful life in spite of pain and illness.

I implore and beg you to please talk to your pain doc about all this.  Ask for a referral to a pain psychologist so you can get busy living again.  And please stay in touch.  We're all here to back you up and encourage you as you find your way back.  :-)

[runitskat]

The same thing happened to me. I take Norco and started feeling horribly depressed (way worse than my normal depression) back in March or so. I went to a psychiatrist because I didn't want to talk, I knew it was the opiates. He put me on Welbutrin, and things have been a lot better. I still have my days but it's no where near as bad as before. It does not make me happy, it just makes me not want to cry all the time. Which for me is a major help at this point in my life as I was literally walking around crying all the time.