Pain and Depression

Roblin · #1 (**permalink**) 05-31-2008, 02:44 AM

I found an interesting article that links pain and depression and thought I would share it with those of you who haven't seen it before. Here is the website: http://www.health.harvard.edu/newswe...n_and_pain.htm Best wishes! Roblin

fuzzy · #2 (**permalink**) 05-31-2008, 07:44 PM

A well known fact, I think.

I was offered antidepressants a few times to treat my pain. ...

wendy · #3 (**permalink**) 06-02-2008, 09:24 PM

hi
thanks for that but the way i read it is if we cure your depression your pain will go away? i am not saying its not correct i think its a hand in hand thing you get the chronic pain then the depression will sneak in at some point its bound to but i am a natrually happy person and i know if the pain wasn't there i'd get the happy me back immeadiatly so its just treating the symptoms not curing the problem!
but as i said interesting reading as i too have been offered anti d over the past few years and maybe if i had of took them i would have been numb when they said i had to live with it/or when they said the pain was in my head, which was later proved not true and something can be done and there is something wrong so where would anti d haved cured it?
wendy

mmglobal · #4 (**permalink**) 06-02-2008, 10:01 PM

After years of chronic, severe pain, I became pretty depressed. I too have always been a naturally happy person, but all the good reasons for situational depression, plus the double whammy of the chemical changes that occur with chronic pain took their toll. I avoided AD's for a long time, but as the depression worsened, it became clear that I should try them.

They did not make me numb. They did not help with the pain. But they sure helped with my ability to cope with the pain. I was much more functional and able to enjoy more of life. They helped me a great deal.

Mark

mmglobal · #5 (**permalink**) 06-02-2008, 10:03 PM

For me, it was the opposite if what wendy said. The recovery from surgery made the depression and need for AD's go away. The AD's just helped me live a better life when I was dealing with years of chronic pain... but there is no AD that could have made my spine and the pain it was causing better.

Eddie G · #6 (**permalink**) 06-06-2008, 09:38 PM

My PM prescribed Zoloft for me. I don't think I'm depressed but I do get sad when I think about living the rest of my life in pain. I think sometimes the AD's are used to treat chronic LBP so hopefully it will help. Im waiting....

Still WAITING..........

How 'bout now?

Still waiting!!!!! OW!!!!

nopain · #7 (**permalink**) 06-07-2008, 05:54 AM

The problem with ANY Drug Therapy is you are altering brain chemistry and the long term effects are completely unknown.

So you have to weigh the benefits vs. the risks (as always). For me I'll take my chances with pain meds, but that's it.

There are no side effect free drugs period.

If drugs could "fix" things we'd all be better.

ans · #8 (**permalink**) 06-07-2008, 11:09 AM

I'm lucky: Cymbalta helps my probably inherited depression and also stops my nerve pain. Not that I disagree w/you re: long-term effect risks.

Maria · #9 (**permalink**) 06-07-2008, 08:24 PM

While I was offered antidepressants I took them very briefly to treat depression only after my failed spine surgery.

Relieving pain for me with oral medication or ESIs and off label Neurontin use made me a far happier person albeit a terribly more forgetful person.

I don't feel the need for antidepressants however I would love a memory stimulant coupled with my pain med regime and yes, I'd be tweaking my brain chemistry quite a bit however the relief from pain and ability to be out and about is definately worth it in my book. If not now, when?!

If ADs work for anyone in this form or fashion to either relieve pain or treat the depression created by pain or just a depression in general, then this is what works for the individual and that's a wonderful thing!

Roblin · #10 (**permalink**) 06-14-2008, 08:05 PM

I am in need of a revision surgery of 2 levels of ProDiscs but my problem has now become a 3 level problem because of L3/4 going bad and after a discectomy at that level that level is now collapsing. Both of my ProDiscs are severely subsiding and are placed wrong. I should never have been a candidate in the first place because of end stage facet arthrosis at L4/5. I am on Cymbalta twice a day for the depression and my depression seems to be worsening. Cymbalta also has an added effect of some pain relief supposedly. As far as the side effects, I think the Fentanyl is killing me day by day by ruining my digestive system. I saw another surgeon this last week and he said if I were his relative he would tell me to see Dr. Pimenta in Brazil or Dr. Regan but first he would tell me to try a spinal cord stimulator. I am really scared about the spinal cord stimulator for some reason which may be pushing the stronger depression. This surgeon told me I had an extremely complicated case. I told him that my first PM doc told me that a spinal cord stimulator wouldn't help me and the surgeon said he didn't care what he said that I should go in and get a trial with one. I guess you can try one for a 24 hour to 2 week period with only a portion of it implanted and the controls outside the body. If it works, then the whole thing would be implanted and it is pretty permanent. The surgeon told me it would buy me some time because a new technology was in the development works that will make it fairly easy and much less dangerous to explant the L4/5 ProDisc from the anterior. I also need L5/S1 taken out as well as something done with L3/4. I just see very little hope and the pain seems to be getting worse even with Fentanyl patches and other pain meds. I can't say the depression medicine is helping because my depression is getting worse, but it must be doing more than I think because I went off of it recently for awhile and I felt like killing myself.
I'm sorry if someone thinks I'm airing my dirty laundry...just telling it like it is. I will see my pain management doctor on Thursday and I guess I will talk to him about a spinal cord stimulator. Does anybody have one or know anyone who does? ProDiscs have ruined my life! Thanks!
Roblin

mmglobal · #11 (**permalink**) 06-14-2008, 09:49 PM

Dear Roblin,

I'm so sorry that you find yourself in such dire straits. I'm glad that you found the AD's were helping... it gets to be so very dark and bleak when the depression gets to be so bad.

With such a significant structural problem, it would seem that symptom maskers like SCS would only be after reasonable options to address the mechanical problems have been exhausted. I have several clients with SCS... some have them after ADR, some have them removed when they get ADR.

All the best...

Mark

dshobbies · #12 (**permalink**) 06-15-2008, 07:43 PM

Roblin,

No one cares about your 'airing your dirty laundry'. This is the hand you were dealt and you're dealing with it as best you can. We all have suffered, some still, some not. Your circumstances are unfortunate (to put it mildly) and we are all here for more than one reason. First and foremost, we support each other. We educate each other. We learn from other's successes and failures. We laugh with you and cry with you. We try to pull you up when you're too far down as now seems to understandibly be your case.

We are all sorry you did not find the relief you hoped for with your surgeries. The double edged sword of pain meds has many of us concerned but is often the necessary part of two evils. The pain associated with our backs is often unbearable and we do what we have to.

So to get through the day, my advise to you is do what you have to. Try what your instincts tell you to try. If there is a trial period for a scs, do it. You might want to get a second opinion from a pm or ask your two doctors for a three way phone consultation.

You want to be pain free and to get your life back. One way or another, this may very well be in your future. Hope is still on your side so if nothing else, hang onto that.

I do wish you all that you wish for yourself, Dale

Roblin · #13 (**permalink**) 06-19-2008, 06:06 AM

Thanks Dale!
Roblin

Kanutta · #14 (**permalink**) 06-21-2008, 01:02 AM

I'm so sorry to hear that you still are struggling so hard, I wish that you soon find someone ore something that can help.

We have had some members with unsuccessful outcomes after ADR on the Norwegian spine forum ( it's a national patient organisation for spine sufferers, funded partly by the govermement).

It's hard to find information in norwegian, (and also in english) about revision surgery, but I found this tread on a german forum:

http://www.diebandscheibe.de/ibf/ind...howtopic=28242

The subject of this tread is revison surgery, where people ask for help where to go, where to find a surgeon etc. They also have a hard time finding a surgeon willing to do the revision, and are left alone by their original surgeon..

Theese people have had their surgery in an ordinary clinic, not the private clinics we often hear about.

I'm not that good in german, but maybe some one on the forum can translate some of it, the essence...I was thinking of B 13, or maybe Anastasia or her husband.

I just posted the tread on the Norwegian forum, and when I saw your post I thought that it couldn't harm to post it here either...I hope Mark doesn't mind.
But I don't think he will, he's not that type.
I read Marks posts with great pleasure, and I'm impressed of the medical knowledge he has about many things, and he also seems to be very honest.

Keep strong, and I am following you and thinking of you Roblin!

Kanutta

Roblin · #15 (**permalink**) 06-23-2008, 05:32 AM

Thanks Kanutta for the link to the German board. I am not good in German but I used a free translation to read it and translate it. It basically told of some people who sounded like they were in a situation much like mine except they only had the one level problem at L4/5 which is the really difficult ProDisc to remove. Facet issues seems to be a common problem. One person said that they had L4/5 removed in early 2007, but did not say who removed it. I hope that there is someone on this board who is fluent in German and could contact that person and see who it was that removed it for them. I am still trying to figure out what to do. My pain management doctor told me Thursday that he thought trying a spinal cord stimulator first was my best option. I am just not sure what to do. I have a 3 level problem and I don't think realistically that there is a doctor anywhere that wants to touch me and even if they could, I probably couldn't afford their price. It is so sad that when a person is in pain and depressed that the doctors want to send them for psychological testing before they will touch them. The doctor that was going to do the surgery in February made me go see a certain psychologist for testing and he said that I was fine to have the surgery. Then, the surgeon decided I had to get something done with the SI joints first and cancelled the surgery. Then, the pain management doctor told me I should be careful with that doctor because he didn't have my best interest in mind. I went to another doctor who said try a spinal cord stimulator first so I went to my pain management doctor and he said I will have to go back to that same psychologist for the same stupid test to have a spinal cord stimulator put in. What is up with that? I am not crazy, I just hurt! I am so frustrated!
Roblin

Roblin · #16 (**permalink**) 06-23-2008, 05:44 AM

Mark,

"With such a significant structural problem, it would seem that symptom maskers like SCS would only be after reasonable options to address the mechanical problems have been exhausted. I have several clients with SCS... some have them after ADR, some have them removed when they get ADR."

I also wanted to comment on this. I couldn't agree more, but do you know of anyone who has had 2 ProDiscs removed? I haven't heard of anyone. I not only need those 2 removed, I need a 3rd level fixed. Has anyone heard of anyone that has had such a surgery? If so, I would very much like to be put in touch with them. If not, does anyone know of anyone anywhere that has had 2 ProDiscs removed at the L4/5 and L5/S1 level? I am not sure at this point I am willing to be another doctor's guinea pig! Thanks for your help!
Roblin

mmglobal · #17 (**permalink**) 06-23-2008, 06:44 AM

I have a client who has had 2 Charite's removed. (L3-4-5). Contact me off the forum and I'll give you details and contact info if you would like.

IMHO, each revision is a one of a kind surgery... each revision is a unique case. Unfortunately, we'll ultimately see the day when revision experience will be so great that revisions won't seem like the great unknown.

Mark

KL Aguilar · #18 (**permalink**) 06-29-2008, 12:32 AM

I think I should look into antidepressants. The pain I have most of the time now is more or less tolerable, but the other things (dealing with WC who takes months and months to authorize anything; lack of money--also partly due to WC who pays me, then stops until ordered by the court to begin paying me; dealing with the huge bureaucracy of my job AND WC--each blames the other; being disabled; making medical and surgical decisions; my MIL recently diagnosed with terminal cancer; having a baby grandson who I cannot take care of even for a few hours as I can't pick him up; gaining weight) all of these are causing me to begin each day feeling overwhelmed.

I take Flexeril when I get muscle spasms (frequently), Vicodin on occasion, but not much else spine-related. What antidepressants work with these medications?

dshobbies · #19 (**permalink**) 06-29-2008, 05:59 PM

Do you have a pain managment doctor who oversees your meds? Living in constant pain isn't easy and there's help out there but you have to pursue it. Tell him/her about your depression and it might take a few tries/combos before finding what's right for you but it is so worth it. You'd be amazed at the difference it can make.

Wishing you better days, Dale

Roblin · #20 (**permalink**) 07-02-2008, 05:31 PM

Dear K L Aguilar,
Please check in to an anti-depressant as they can be helpful. The pain meds alone can cause depression not to mention pain and an altered lifestyle being major contributors of depression. I am on Cymbalta which also has the added benefit of some pain relief although I can't tell that it is doing anything for my pain. Sometimes I don't believe it is helping my depression until I miss taking it or try to take my self off of it and then I am so depressed I want someone to shoot me and put me out of my misery. LOL but not at the time. Be careful on what you choose to take because many of them can cause weight gain which can also be a cause for increased depression at least it is for me. Cymbalta doesn't cause weight gain but many of them do. I am still waiting to hear from Dr. Regan to see if a revision for me is going to be possible with a 3 level problem. I sure hope so or I don't know what I will do.
Best wishes on getting some help with the depression!
Roblin

KL Aguilar · #21 (**permalink**) 07-02-2008, 09:37 PM

Roblin, Dr. Regan is wonderful--I hope he can help you.

I saw the pain management doctor today and I broke down and cried as I described all I am dealing with. Yesterday I was informed on the phone that my position has been terminated, meaning that I haven't been fired, but no longer have the job that I had; when I return after surgery, they will place me wherever there is an opening, whether or not it is what or where I want or am best qualified for; undoubtedly this will result in a pay cut as I had a special position.

The pain management doctor gave me a prescription for Lunesta, a sleep medication. Maybe just sleeping all night will help.

I go to court next week, to try and get surgery authorization and my pay nightmare resolved.

Maria · #22 (**permalink**) 07-07-2008, 04:45 AM

I'm not experiencing high level lumbar pain right now however my neck is really driving me crazy. Migraines too. I'm definately very anxious lately, not so much depressed, but worried about several things. Oh well, perhaps it's depression as well but I've been so nervous I don't feel depressed, just anxious.

KL, sorry to hear your position has been terminated. I've been thru this quite some time ago (several times) because of my low back probs and each time it caused me some high anxiety as well as depression..

I wanted to add that I had taken Lunesta for almost 2 weeks but it didn't agree w/me even tho I fell asleep 10 -30 mins. after taking it and slept well. I had GI probs with it.

I'm thinking for relaxation from nerves I'd want to have a few doses of a benzodiazapine around.

Good luck with your court date and hope the Lunesta will be ok for you.