PMR and Depression, anxiety, and all the rest

[Purplecrow]

Hi Forum folks,

Just wondering about research which addresses the psychological/emotional aspects of PMR.

Seems lots of quality work exists regarding the physical aspects of this disorder, but dont recall the other issues receiving much focus.

[DorsetLady PMRGCAuk volunteer]

Hi I doubt it!

But you could lump it in with other chronic disorders - there have been studies on those which prove depression in some is a well know side effect. Just google chronic illness and depression.

[SheffieldJane]

I have not come across anything and would also be very interested. I certainly know from my own experience that the psychological features of PMR can be just as significant as the physical ones. Having a disease that limits you so much would be enough to trigger depression on its own and Prednisalone will complicate the picture bringing with it anxiety, mood swings and depression ,potentially , amongst the known side effects.

It is nice to see you here again it has been a while. I hope that you are doing ok and not having a tough time yourself,

[Purplecrow in reply to SheffieldJane]

Thanks Jane, I've been around, reading and watching.

I'm doing well at this time, enjoying our gorgeous summer, and as always, overdoing it in the garden😎

[Purplecrow]

Thanks DL,

I was just hoping our research wizards had noted these topics being addressed in any of the newer research. It does seem that pred+PMR/GCA are prime breeding grounds for some psychological glitches, including fairly pervasive depression.

Always curious...J

[morrison in reply to Purplecrow]

I personally think steroids affect your hormones and there forever of course depression sets in. If you think about it our body has been invaded enough with our own immune system attacking our body. Isn't that enough for our brain. It must be so confused. Wish you well. Sometimes it can be just logical when we think about any drugs we put into our body. Something has to give. But when you have PMR abd GCA you have no choice just in case it affects your eyesight in a very big way. 😊

[HeronNS in reply to morrison]

Very good point, and I guess that's what this post is really about. We do get psychological effects from the drugs and there should be some information given to patients to help us recognize what may happen and what we can do to help ourselves. Like being told we may put on weight and this is how we can mitigate it, that sort of thing. Maybe the depression caused by moderate to high dose pred can be easily managed by some kinds of food, or a simple supplement. We do know pred can deplete some of our electrolytes. If those were managed, maybe our depressive state would be less severe? But of course we won't know without research!

[morrison in reply to HeronNS]

Any drugs have effects on your body coming first into your brain. That is logical. Before I was undiagnosed for over 3 years I thought I was dying. Then suddenly after being sent by ambulance to a eye hospital in London and being given 40mgs of Pred. .I was great within 2 days. So what helps then. Off course must bring your brain and body down coming down. I sometimes try so much to ignore it. Possibly wrong 😊

[HeronNS in reply to morrison]

No doubt, we are complex beings.

I'm going out for my evening walk now, so signing off. It's just after 7 pm here and the sun is shining, must enjoy while I can. 🌞

Take care!

[morrison in reply to HeronNS]

Summer soltace here. Longest day of the year. Enjoy your doggy walk😊

[Angiejnz in reply to morrison]

Just enjoying a beautiful sun filled shortest day of the year, funny old world

[Purplecrow in reply to Angiejnz]

Where I live, its the longest day of the year!!🤪

think too hard, and it sounds pretty crazy!

Kind regards wherever you live. jerri

[Angiejnz in reply to Purplecrow]

Emigrated to New Zealand 28 years ago from London, from grey to green and it's magic

[podo]

You might be interested in a new book entitled "The Inflamed Mind" by Edward Bullmore. This suggests that mental states like depression are caused directly by the inflammatory Cytokines acting on the brain.

[CT-5012 in reply to podo]

Thank you for the information will have a look at that it sounds interesting.

[HeronNS in reply to podo]

This book is so new I can't even ask our library to buy it - to be released in December 2018 here!

[Hidden in reply to podo]

I've just finished reading it. Scary to think of macrophages chomping on brain cells, though.

[jinasc]

As Dorset Lady says, just look at any of the 800 orphan illnesses not one of them escapes

psychological/emotional effects.

Some children are on prednisolone for life, without it they would not be living and that comes with all the side effects that anyone taking pred gets, not all of them by any means, but somewhere someone gets a few.

No-one I know, so far and my knowledge is limited, has ever said to me 'I have had none'.

How many of have us have not experienced psychological/emotional feelings stressed when a loved one is ill, suffering from an incurable illness etc. And that is not us suffering it is them.

None of us can escape some of it but just remember 'You are Not Alone' there are whole lot of us out there and sometimes people giving you a tip or trick that worked for them helps alleviate those problems.

[Purplecrow in reply to jinasc]

🙏🏽

[piglette]

Steroids are supposed to have psychological side effects including suicidal problems as well as depression and personality changes, also increased aggression.

[HeronNS in reply to piglette]

At the high doses, surely? Very relevant to GCA patients.

[piglette in reply to HeronNS]

I think at the 20mg or even 15mg levels too.

[Purplecrow]

I believe I knew that, but viewed as a package...holy whatever!!!

! Wouldn't you expect that someone would address these issues as co-morbidity in the studies of PMR/GCA, Prednisone, and the other conditions for which the drug is prescribed long term?.

My question has arisen in light of the several recent mentions of folks dealing with some severe depression...

just curious, Jerri

[PMRpro Ambassador in reply to Purplecrow]

"Wouldn't you expect that someone would address these issues"

you would hope yes - but where does the funding come from? It all comes down to money in the end - and this is a factor that won't make a big company bucks...

[Purplecrow in reply to PMRpro]

So correct...especially given the demographics of PMR, etc sufferers, as in older, etc.

[PMRpro Ambassador in reply to Purplecrow]

Yes - I'm sure the perception that only older people develop PMR/GCA has influenced it a lot. There are still doctors who believe you have to be over 70 to have PMR (the AVERAGE age at diagnosis is 72, that isn't the same thing at all). There is also a clear majority of women - and until recently women were retired at 60 so them being unable to work wasn't a problem. With retirement age at 67 (and rising no doubt) this will become a different matter.

[Hidden]

I'd be interested in any research that might be out there...

[HeronNS in reply to Hidden]

A google search of depression and autoimmune disease brings you to a list of lots of research. Searching depression and polymyalgia rheumatica also brings up a number of articles. For example: ncbi.nlm.nih.gov/pubmed/285...

[Purplecrow in reply to HeronNS]

Interesting bit of info...majority of sufferers, female, mean age 78,, comorbidity diabetes... doesnt seem like the group that commands huge pots of research funding.😡

Thanks for the link.

[Littlejan22 in reply to HeronNS]

Thank you for this post, it has honestly answered so many of the questions regarding the onset of PMR and depression, really grateful thanks janet

[PMRpro Ambassador]

There probably is - except it will be for chronic illness in general. Autoimmune disorders are really all of a muchness. Plus the outlook for PMR is regarded as good once it is managed with pred so probably not so much of a psychological concern.

[HeronNS]

Coincidentally there was a program on our tv last night (I only saw it in passing, didn't watch as not currently relevant to my life) about the psychological problems many new mothers experience, I suppose they were specifically talking about postnatal depression, and how it's dismissed as not important.

I remember when I was in the midst of my own midlife depression (which was pretty bad) and saying something to my doctor and he reached over for his prescription pad saying one didn't have to live with this any more because.... And I cut him off because the mere fact that he did that cleared my mind and I knew what I needed was someone to talk to, empathetic companionship, not a chemical solution.

It's becoming more widely recognised that medical management of depression is an abject failure in many cases, because only a very few of us really do need chemical treatment. Most of us are lonely or disappointed human beings who need more companionship, more fresh air and sunshine, better food, more exercise, better quality sleep.

PMR and pred haven't made me depressed. It's other factors in my life, which have really not changed since I was fifteen, mostly a lack of kindred spirits.

[Purplecrow in reply to HeronNS]

Your assessment is spot on...the prescription is so easy for the doc, not so good for the patient...in many ways . Thanks for that insight.

[HeronNS]

ncbi.nlm.nih.gov/pubmed/285...

Unfortunately full text costs money, but if you have access to an academic library you may be able to read it in their facilities. I was able to read some articles on line in our local medical school library a few years ago.

[Purplecrow in reply to HeronNS]

Will check for it.

[Dream21]

I looked up something very similar last night that may help. The patients interviewed were part of this very forum...The title was “What is the impact of Giant Cell Arteritis on patients’ lives?” If you google the title, look for this website ncbi.nlm.nih.gov>articles.

Even you have PMR, I think this article could be helpful. Best of luck to you.

[Purplecrow in reply to Dream21]

Read it, interesting, thanks,