I have just read a very long, very interesting article, more by accident than design, on RLS. I got it by Google then the following heading appeared. jnnp.bmj.com.
I felt I needed a dictionary as well. It does appear that much of the problem is related to anxiety, depression and loss of wellbeing.
So many people complain on this site about their GP, I have a very good one who listens to me, which is important, but I don't go in telling him he knows nothing, or threatening to sue him if he gets it wrong.
Do read the very long article, you may need to read it two or three times as parts are quite complex, at least they are to my 'inexperienced' mind.
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leadingwren
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Can you copy and paste the link to the article you’re referring to? There are so many articles on RLS on the bmj site that we won’t know which one to read.
I believe the issue is that anxiety and depression is associated with RLS Hence people with RLS are more likely to suffer anxiety/depression than people who don't.
Not surprising really.
There is a suggestion that people diagnosed with RLS should also have a psychiatric assessment. That might be a bit worrying! Some doctors already think RLS is all in the mind or that anxiety causes RLS, not the other way round.
A follow up "longtitudinal" study to see if the results could be "replicated" is also suggested. Repeating a study and getting the same results, i.e. replicating means that the results are more reliable.
A "longtitudinal" study it would be carried out over possibly years. Since this study was published in 2004, another study may have been completed and published since.
Interesting that the article, as you say, links RLS to anxiety or depression. Many people are prescribed anti-depressants for relief. It could be these drugs bring on RLS. I was prescribed Lexapro many years ago, which I used for a short period of time, after which started to experience RLS. I now take an iron supplement, a magnesium supplement, a multiple vitamin each morning. Every evening around 9:30 PM, I take 0.75 mg of ropinirole and a 5/325 narco tablet which is 5 mg opioid and 325 mg Tylenol.
I have to go to a pain treatment doctor every two months to keep the narco Rx. The ropinirole causes my muscles to ache and the narco has let me reduce the ropinirole to 0.75 mg from 1 mg. I hope to reduce the ropinirole to .50 mg. This regimen has allowed me to function for a decade but I cannot sleep during the day, the legs will not let me. What I have noticed is sweets or sugar seems to increase episodes of RLS while salt or salty foods seem to reduce or halt episodes. The other remedy I have for the evening episodes is to watch a movie or documentary without commercials or to play bridge or other card game which tends to hold my focus. However, some evenings I still have to walk around or stand and flex my legs for 20 - 30 minutes until I can sit or lie down to sleep. My experiences with RLS, the treatments, the lack of research, etc. has been frustrating, painful, and at times depressing. I hope this post can help someone better understand how RLS affects and disrupts a person's sleep, rest, diet, work, relationships and daily activities.
Hi, the focus of the study I referred to makes no mention of antidepressants nor does it mention any causes or aggravating factors for RLS. It's about the effects of RLS, not causes.
However, it is well known that SSRI antidepressants, (like lexapro) can exacerbate RLS. Unfortunately, this doesn't appear to be well known by doctors who prescribe antidepressants.
The antidepressants are however a trigger rather than a cause. Severe idiopathic RLS will only occur if there is an inherited pre-disposition. SSRI antidepressants do not cause RLS in people who don't have the pre-disposition.
This does make a major dilemma/problem however, since people who suffer RLS are more likely to suffer mental health issues which are normally treated by medicines which make the RLS worse.
It sounds as if your RLS is not under control. In fact as you suffer symptoms during the day it sounds as if you are suffering augmentation caused by ropinirole.
In which case, the solution, as you may already know, is to wean off the ropinirole altogether. i.e. eventually, stop taking it. This may resolve the daytime symptoms.
I suggest you read posts in this forum about weaning off ropinirole.
Its the sleep deprivation from having RLS, that can cause anxiety, depression and loss of wellbeing. If you are not sleeping at night after night, then depression can set in, anxiety from knowing that it will be another night of lack of sleep. That will affect your wellbeing, you dont have the energy from lack of sleep, your body needs sleep and lack of it can lead to to other health issues. If you are getting enough sleep because the meds you are taking are working, letting you get a decent nights sleep, then your are not depressed . You might be suffering from depression because of another reason, alot of people are naturally anxious about things and life.
The study was suggesting that people with RLS are more likely to suffer anxiety and/or depression than people who don't. It possibly is largely due to the insomnia.
However, I bet if you compared any group of people with a nasty condition (e.g. cancer) and compared their anxiey/depression to people who don't have it you'd find the same thing.
It's also a statistical thing, i.e. "likely".
There's going to be people who don't have RLS (or cancer) who do have anxiety/depression for other reasons.
It's also a matter of "resilience" : some people are more resilient than others. That is despite the RLS or dsepite the cancer etc, they are less likely to suffer anxiety/depression.
I thought I'd inject a bit of health psychology! I hope Arjiji appreciates it.
in reply to
I certainly have very down moments, from bad nights and the lack of sleep, low mood. But not go to the stage of complete depression that i need to see a doctor for anti=depressants.. I usually bounce back after a day or two.
When I was suffering badly with augmentation, I don't remember suffering with anxiety or depression. I certainly had low moods but that was due to lack of sleep and being stressed out because of my job at the time.
When I made the decision to wean myself off the very high dose of ropinirole I was taking, (sometimes up to 10 mgs a day), and because of the absolute hellish withdrawal symptoms, coupled with the lack of sleep, I probably did suffer with some form of anxiety and depression. Now that I'm through the withdrawal, I feel relatively good. I'm still in the process of trying to get the right balance of medication to control my symptoms but am certainly feeling a lot better within myself as my symptoms are improving. I don't feel anxious nor depressed.
I can certainly understand why RLS symptoms causes anxiety and depression. It's an extremely testing condition to live with.
Chicken and egg. Which comes first. In my case I never suffered depression till I got rls as an adult. I still don’t have depression, but I get very down if I don’t sleep, but it’s not clinical depression, it is caused by rls
I have never had anxiety or depression although I have suffered from people envy . I would watch people walking up the street and think oh God how I wish I did not have this wretched disease and I have been 100 % suicidal but not depressed. I simply could not bare the torture.
Thank goodness for Dr Brooks putting my in buprenorphine for giving me my life back .
I wish these doctors knew what it was like to stand NOT SIT NOT LIE DOWN every minute of every day micro blink sleep whilst standing and see how they feel .
I sure some people do get depressed, anxious I was simply furious sure I would feel down but is was more jealousy that I was not like other people having as I viewed it a normal life . However we never really know what other crosses people are bearing I know I hate my cross we all bare !
He is based in New York. Shumbah travelled from Australia to NY to see him and he treated her with Buprenorphine to get her safely off dopamine agonists.
A knowledgeable doctor- one of the few.
There seems to be some confusion about what is simply "low mood" and what is "clinical depression".
It's not particularly easy for any person experiencing these to make an objective judgment.
Part of the confusion may be that some people say they're "depressed" whenever they are in a low mood no matter how short lived this mood is.
People suffering depression may not recognise it because they're not aware of all the forms depression can take.
Some people deny that they're suffering depression, I note some of the subjects in the linked study did this.
Depression can be "measured" using various validated scales, which was what was done in the study. These scales ask questions about symptoms which are indicative of depression. One of them is suicidal ideas.
Here's a link to one of the scales used in the study : WARNING it is NOT supposed to be self-administered.
One of the ways of distinguishing between a simple "low mood" and "clinical depression" is that the former is short lived and the latter is persistent.
I got onto Buprenorphine via Dr Brooks in NYC I had never heard of it until I met him.
I only prescribes Buprenorphine for RLS it is much safer than other opioids because it hangs onto less receptors in the brain . I have no side effects it works perfectly and gives me 24 hour coverage.
My prescribed dose is 2 mg however I have never needed to take more than 1mg.
Dr Glen Brooks is an a practicing anaesthetist 2 days a week and manages his Ketamin clinic 5 days a week. Long story how I made contact from Australia I am thrilled I did he has saved my life.
Dr Brooks really cares and answers his emails personally .
Buprenorphine is an opioid a partial agonist , it works perfectly . If you read my Bio you will see how severe my condition is all the medications I have tried without success.
Also I posted emails to me from Professor Richard P Allen from the John Hopkins institute I was at the hospital may 2019 for 5 days Professor John Winkleman and Dr Glen Brooks.
Buprenorphine has a long half life although shorter than methadone, it is also regulated the same as methadone and very difficult to get in Australia I have had to go through a drug clinic to get access and all the BS..... that goes with attending those clinics . I did a video on Youtube on my first visit.
Buprenorphine stops all my RLS symptoms I feel totally normal, and now because I sleep my blood pressure has returned to normal and my Blood pressure medication has been ceased by my GP after 16 years of use.
I met with Professor Winkleman in Boston a couple of weeks after my appointment with Dr Glen Brooks .
Professor Winkleman told me that Dr Brooks had done the right thing by me in prescribing Buprenorphine.
Winkleman and Brooks both said Doctor should me really happy to prescribe buprenorphine because of its safety record and track record of non addiction due to the fact that is hangs onto less receptors. I appear to be the only person in Australia that I can find who has been able to assess Buprenorphine sublingual, a couple of people have managed to get the patches .
Buprenorphine comes in Sublingual, film, suppository and patches.
It is definitely an opioid not sure if you are confusing it with another medication.
Sorry if this throws a spanner in the works, but for me there’s a definite link between stress and RLS, ie stress bringing on RLS, not the other way round.
I’m 58 and have suffered from RLS my entire life. Before I could even walk! As a child I suffered day and night, although didn’t know then that it was RLS. If I was put under any stress my legs would immediately go crazy. It’s made life very difficult at times, as when I was at secondary school and needed to run for the bus my legs would almost turn to jelly, or feel like lead weights, as the RLS hit them while I was trying to move. Thankfully I’ve not had that happen for a very long time now. I have also found that the week before my period is/was due, when I would be pre-menstrual, my RLS would go through the roof at night. Still does even though I no longer have periods and am on a low dose of Pregabalin. I know from reading other posts on here that there are other sufferers who experience the same thing. It makes sense if you think how RLS is affected by the brain chemistry and stress affects brain chemistry also.
Obviously this isn’t going to be a trigger factor for everyone, but it is for a sizeable number off sufferers. Food and drink don’t seem to affect me, but stress, whether you’re consciously aware of it or not, definitely does.
Stress isnt a trigger for my RLS thankfully, Stress is a trigger for my IBS big time. Food and drink is not a trigger apart from alcohol, and i can drink coffee any time day or night and it can help my RLS. But i think there is a difference in anxiety and stress.
Yes, stress isn’t the same as anxiety, though one does lead to the other. I suffer from both these days, though have only suffered from anxiety for the last decade. The thing with stress is you’re not always aware that you’re even suffering from it, unlike anxiety, until you feel the effects.
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