Anxiety - like tiny quick blasts of ice water - courses through me at times. Still, I am active (short walks daily, playing music, seeing people) and don’t feel “blue” except on rare and appropriate occasion. But my rheumatologist and GP are insistent that I take an antidepressant. 25 mg of Zoloft for “your depression and anxiety.” I realize now that I only tell them about my aches and anxiety blasts and not the good things in my life. But I wonder if I should try to ignore their annoying and offbase diagnosis and take the med for my anxiety, which is not all the time. I’m working on it with breathing, tai chi and diet , which seems to help, I am largely anti-medication, but also would take a medical shortcut to a goal if it won’t create another problem! Am on 12mg Prednisone, down from 15mg started in October. Thanks for any advice, thoughts.
Anxiety but not depression?: Anxiety - like tiny... - PMRGCAuk
Anxiety but not depression?
The Pred in itself can cause anxiety and/or more seriously depression in some, for me (fortunately ) it was never an issue, but it should decrease as you get onto lower doses.
If you don't feel its having that much of an impact on your daily life and can manage it, then, like you, I would be inclined to forego additional medication.
But it's obviously your decision.. and as you rightly recognise there is a big difference between anxiety and depression.
Thanks. That makes sense to me.
Good, let’s hope you don’t need extra help, but if you do, you know it’s there if you do.
Thanks 🙏
Hello, Pred gave me anxiety that was proportional to dose so it gradually reduced as I went down the dose scale. After that it got worse again when I had adrenal insufficiency and went as that resolved. I just told myself it wasn’t me, was par for the course and probably wouldn’t last forever. So I rode it out, being lucky enough to be able to do so. My question would be, do you feel you need medicinal support to get through even if you don’t want it? Are they suggesting this medication on the face of what you tell them as, as you say, you mention the negative stuff and not the positive? Another question is, why do you think you dwell on the negative stuff when you do see them? What are you trying to convey?
You say you have aches. What are these aches? Is your PMR stable at this time?
I have so little time with the doctors. I have tried to have my thoughts gathered on what is wrong with me, assuming that would give them the clues they would need to help me. It didn’t occur to me to take up their time with the good things in my life. My error. But they are convinced that I have to take this for depression, which they see as arising from my alleged depression. They do not associate anxiety at all as an affect of the prednisone. I do not know if my PMR is “stable.“ I have wobbly legs, tight and tired calves, mainly in the morning. I have a few mild shooting pains and neck/back and shoulder. Some scalp tingling. The anxiety slips in and out. I probably should talk about the good stuff now. 🤣 Just trying to answer your questions. Thanks.
I think it is a matter of weighing up whether you are happy to put up with the side effects to alleviate the depression. It is worth talking to your doctor about the side effects. Untreated depression can increase the chance of people using other drugs or alcohol. Serious depression can also destroy relationships and cause mental health problems.
I don’t have depression. (-: really!
If it isn't interfering with normal life I'd be inclined NOT to take a pill. The thing that gets me is when I am forced to deal with admin stuff where I feel out of my depth - lots of it dealing with Italian authorities at the moment after OH's death. But I really don't think a pill would help - being sad appropriately as you say is normal but has become medicalised I think.
Couple of things ... Zoloft cannot be taken when needed. It needs to build up in the system. It will do nothing if only taken periodically. And discontinuing it abruptly can cause major problems.
Second, depression can take on many different forms. For some, it's agitation and anxiety. For others, it's lethargy. And, for others, it's the classic bad mood.
I see that Zoloft is recommended for the 1st type, and even for straight-up anxiety disorder. There are also things you can take for anxiety attacks.
Finally, if the anxiety is pervasive and long-lasting (& not primarily from pred), there are also a number of psychotherapeutic ways to handle it.
I like your approach better than your doctor’s one size fits all. This passes in my experience. Obviously if it gets worse consider medication but I think your ideas are brilliant and will stand you in good stead in a Pred free future.
Thanks for the support!
Private messaging you.
Greytree, I too admire your attitude! When I was first diagnosed with PMR nearly five years ago, I told my doctor I didn't want to take prednisone. She explained the very real dangers of allowing the inflammation caused by PMR to damage my body and the possibility of developing GCA and I caved in! I would certainly not add in another drug to the very powerful steroids we have to be on. You sound as though you only get periods of unhapppiness (don't we all?) and you are managing your mental health well with things like Tai Chi (I do that too) and, most importantly, see ing people. You are obviously self aware and would be sensible if you feel your mental health slipping. Your decision as D.L. said but I rather think you are doing well as you are.......
Thanks for backing me up!
Last year I suffered with terrible anxiety, I think it was due to going back out into the real world after so long at home, and because I would often cry my GP wanted me to take antidepressants, she said it would help my anxiety but I refused, I had some cbt to help me and it did. Although I still have some anxiety it is manageable.
I’m glad to hear it worked out. That’s inspiring. Thanks.
Hi Greytree, I too suffer with anxiety, not depression , so I appreciate what you are saying. My GP once said to me are you feeling depressed and I replied , no I just want to feel well! You sound as if your reduction of pred is going ok and your doing the right things with your tai chi.Most importantly , you are seeing people and also talking to ‘us’. I’m sending you a big hug and lots of positive vibes . X🌺🌺
Have you thought about a therapist for your anxiety which in my opinion isn't depression. They can teach you ways of handling it without addictive pills. You may only need one private session to talk it through in a relaxed atmosphere. There should f be a therapist attached to your surgery.
Greytree lives in US so set up may be different to UK -but a speaking to a therapist may be a good option.
I asked for training in such practices in November but didn’t get a referral from docs. I sought out how-to info myself online and found good examples, techniques that I’m working on. One doc finally gave me a referral in February but one appointment could not be til May and another in June, The med world is in a sad state of affairs here! But I know to keep my expectations low with it and push ahead on my own - now with the help of a chorus of supporters and counselors here on this site. I love getting diverse opinions, too! It keeps the mind open.
The thing is clinical depression is not the same as feeling sad or unhappy. I suffered from it years ago and didn’t think I was depressed - I just felt sick all the time. I also suffer from anxiety and have been on Sertraline for some time, long before I started taking pred, and like you didn’t want to but eventually realised I needed them.
I’m glad if that can help you get by. My go-to for solace was always sports/physical exertion that is not possible with PMR. I still find being outside and walking (slowly) for 30-60 minutes daily is helpful, aside from breathing and other anxiety-calming methods found online. I would rather just still be playing badminton!
Being outdoors certainly helps me. We try to walk at least twice a week, just a mile or so. The garden needs attention now after the winter but I limit myself and my hubby does all the heavy stuff.
At high doses of prednisone 80 mg then tapered to about 40 mg I easily cried and usually when talking with my pcp. I wasn't depressed but very sad about situational things too (grandson cancer) and also my losses i.e. unable to do all activities I did prior to gca & other health issues. Dr's questioned me about depression but I think after tapering below 40 mg pred they realize prednisone & ?? actemra were major contributors.What you're doing sounds right and you know your body/mind and spirit better than anyone. You need others support and believe what you tell them. Give yourself more time, and be as gentle and kind as possible with your self talk.
GCA, PMR and effects of the meds produce a kind crazy world for us. I've been so lucky and grateful to have Dr's that give me all the time I need with them. Prednisone also cause rambling thoughts and excessive talking for me. I don't feel crazy but I think I've put a few other people on the brink
It's all getting better for me and you will too.
I so identify with what you said about the talking and maybe driving other people crazy with it! I was always a fairly quiet person and sometimes find myself jabbering like a crazy woman. I hope to get past that in the near future!! Thanks for your comments.
Yeah it will, first few months on high doses my late hubby used to say I could talk for England and many a time told me to shut up! Brave man to do that! 😳
It is known for Pred to cause anxiety in bursts. I agree with DL perhaps making smaller tapers might alleviate these symptoms. I suffer similarly and can ride it out. If you can then an additional tablet I wouldn’t take at this point.You’re doing all the right things to help yourself and only you know if it’s time to take things further. I always go with my gut and if the GP’s advise doesn’t feel right then leave it for now.
You’re body, your decision.
On high dose of Pred I suffered awful anxiety but at that stage didn't realise it was the steroid. My GP got me on a Cognitive Behaviour Therapy course which I found really useful as it taught me how to relax and how to handle those 'icy' feelings. As I reduced it became less persistent but by then I knew it was a drug effect and found distracting strategies to cope. Now I'm way down onto 5mg the anxious/depressed feelings are more apparent again. I know it's the adrenals and that I will get through it. I wouldn't have asked for or taken an anti-depressant as I have seen my DIL trying to come off them after post-natal depression. We are all different in what we can manage. I've tried to cut out every drug offered apart from Pred, just to give my body one thing, but I take all the diet precautions mentioned here.I hope you find your own way of getting through this, unpleasant as it is.
I am sorry to hear what your DIL had to go through, and you too. Thanks for the heads up that anxiety can ramp up possibly on the lower doses. I will make extra effort To instill - try to truly master - coping mechanisms to make it through and try not to let up.
Good morning, l have been having anxiety issues and depression that has been very bad since December. I thought l was completely loosing the plot. I have been taking 10 mg amytriptaline for neuropathic pain that my doctor's have upped to 20 mg. I think it is helping l am also reducing steroids at the moment which should help l think. I also do Tai chi which is great. I try to meditate daily as well and listen to YouTube. Ajahn Brahm and Thay Nhat Han from plum village are great one English one Vietnamese. Unfortunately Thay died in his nineties recently but everything is on the Plum Village YouTube sight. Also Jeffrey Chand has great chi gong videos. Hope this helps.🙏
I agree with Dorset Lady on this, the steroids will have an impact on your endocrine system and may well be heightening your feelings of anxiety which seems to be what is called "free floating". It means its sort of around most of the time but not allway's impacting significantly and your distraction techniques with meaningful activity are a positive coping mechanism. The medical fraternity are way too quick to pathologize "life" with its ups and downs and we can all have periods of feeling less than happy but that is the human condition and in my book only the deluded are always "happy". There is too much of this playing to weaknesses rather than strengths in our culture.
Great descriptive term : free floating. Perfect. I second everything you said. My father was a doctor, a humble one who knew medicine in no way had all the answers. Among some of his many favorite sayings: The physician is only nature’s assistant (Galen, 2nd cent. A.D.) And: A doctor’s duty ... to cure sometimes, To ease often, To comfort always. (Proverbial)
I think you have inherited and possess a broad perspective, a salve that can soothe the endless arbitrary vicissitudes life (meaning other people) cast at us. I recommend "Meditations" Marcus Aurelius.
Thank you. Marcus Aurelius quotes are among my father's favorites, too. but he was better read than me (and more grammatical). I will now have to get a copy of Meditations and actually read it. Thank you for spurring me on to do this.
Thank you Greytree for starting this discussion. I too am experiencing bursts of anxiety. I’m down to 3 mg of prednisone and based on what has been said it must relate to adrenals trying to come back to life. Like you, mine is manageable and good to know it will resolve at some point 😊
Greytree, before I tell you what I really think, I have to say you're doing amazingly well in managing self care and life with PMR.
I've been playing the game for 8 years now and was offered antidepressant medication in the first 6 months. Turned it down without batting an eye and never look back. Yes, I like others I've have had, and will continue to have, mood swings, both good and bad, but that's life.
I don't deny that others with PMR or GCA may truly suffer anxiety and/or depression and my heart goes out to them. However, from all you have said you're not in this category. I'd tell both your dics to get stuffed, politely of course, and continue to enjoy life as you clearly do.
You left out the d in dics. 😂. Thanks for all you said. I have this stupid feeling that I want to convince them about this, but keep telling myself to just drop it - and not give them this power over me to effect me with their words. This forum is great reinforcement for me - And I think I sound braver and stronger than I am! But it helps to talk it out, for sure. Thanks to all.
I hate the way that anxiety and depression are so often linked together. I do have times of anxiety but never have I felt I had depression. I have friends who describe their symptoms of the latter and it is something quite different. Twice I have been given medication for A & D -could not tolerate it. Meditation, a lot of breathing exercises and listening to baroque music are the things that really help me.
Thanks. I like that route, too - even more so after all these comments. The mental calming seems to be helping at this point.
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