Chronic pain and depression

[darktimes]

Can anyone help me work out if I need to see a doctor about this? I have rheumatoid arthritis and although it has been well managed in the past I am really struggling with pain at the moment. It is difficult to do anything beyond going to work, I am spending my evenings slumped on the couch exhausted and unable to face doing anything. I am short tempered and sleeping very badly and feel close to tears whenever I have to talk about my illness. The last twice I have been to the doctor I have ended up in floods of tears. I am very aware a lot if this sounds like depression but it is all entirely related to my illness. Is it worth trying to get anti-depressants for something which is purely situational? I can see that I am lucky in many ways, I was diagnosed 20 years ago and I have managed to keep well enough to do most things I've wanted to in the past. How do I try to accept this is what my life is like now? I feel I had loads of support in the past when I was first diagnosed and I don't know where to seek help now because I am seen as a 'coper'. And I am not coping, not at all.

Please see your GP - he/she is there to help. It may be a change of meds might help or antidepressants or some other form of action but your GP is the person to speak to. If you don't feel you can get your words out clearly then write it down - I do this, I write what I want to say and give it to my GP to read! Another advantage is I don't forget anything important. I find it hard to discuss my health issues without getting upset at time so writing it out also helps me feel a bit more in control.

You could also come and chat to us on the Spoonies thread?

Spoonies thread

I could have written your post last summer. I started on anti tnf, pain and inflammation dropped and depression disappeared.It's hard hurting all the time. I would push to see your rheumatologist and get meds adjusted and speaking with hindsight ask gp for temporary or low dose anti depressant. That's what I hope I will realize I need next time

I will come to the Spoonies thread, thank you. I see my rheumatologist a lot but I think they are running out of ideas. I've just started another new biologic / anti tnf and they won't change meds till I've been on it for a few months to see if it works. Do anti depressants work if you are just low because of something like this? Thank you all for your advice.

Please do see your GP. As well as medication can I recommend trying to get on a Pain Management Course? I accessed mine via my pain clinic. I found it helpful and have a group I now meet up with regularly.mthe course was quite Mindfulness based. I also get counselling and got Alexander Technique classes free ( eight one to one sessions) which I found very helpful indeed.

It might be that anti depressants are helpful but trying to use a psychological approach as well as all the best modern medicine can provide has helped me. Plus quite major lifestyle adjustments.

Definitely see GP, and agree altogether with Matilda.
Friend with about 40 years RA and multiple joint replacements is now managing without painkillers in old age, which I find just amazing - had to pass it on.

Given you are on atleast second line biologic therapy - I'm guessing you'd know your RA pretty well. Does this feel like a flare ? Is there any correlation between fatigue symptoms and your new biologic medication - side effect of some can be fatigue.

Or it may not relate to RA and drugs at all. Sadly RA patients are allowed to get other problems as well if you know what I mean.

So I reckon , if this feels like an RA flare or if the fatigue is significantly worse since switching biologic , speak to your Rheum specialist nurse. Otherwise head down to your GP

Hi please see your gp. I actually found the ad sertaline was an effective pain relief though not prescribed as such. I had awful spd/ hms which was missed by gp but sert took it all away.

At the same time as other pain meds perhaps being adjusted it might be worth asking to check if there's any other issues eg thyroid. I think RA is auto immune? They can co hand in hand. Hope you feel better soon

But also agree with Mathilda.

I have chronic pain, and I did take anti depressants for a while, and they did really help. It gave me space to do some counselling and develop some more coping strategies around the pain and the reason for it.

Its also worth trying some other pain management strategies, especially for nighttime - I find I can use methods to deal with it in the day (visualisation, distraction, or whatever), but nightime pain is much harder - and if I don't get enough sleep nothing is good

Thank you all so much for taking the time to reply and share your experiences. I felt a bit more upbeat today so I'm going to give it a week and then go to GP if I still feel the same. I will definitely ask to be referred to a pain management clinic when I next see my rheumatologist. I think hellomynameis might be right - this feels like more than a normal flare, it feels like initial diagnosis so maybe something else is going on. It really helped to hear from you all yesterday when I was at a very low point so thank you again, I really appreciate it.

I've learnt that sleep is part of the pain management cycle - better sleep can lead to better recovery, more physio etc. So anything that helps with that - inc antidepressants (sertraline seems to be good for sleep and amitriptyline) is going to help.

And certainly for me, bring a coper leads to anxiety and then depression.

Being!